Face-to-Face Encounters

Documentation

Based on clinical assessments during a face-to-face encounter with a patient, physicians, PAs, NPs, CNSs and nurse midwives may modify a patient's home health plan of care if medically necessary. Appropriate documentation must be completed by the recommending practitioner and signed by the patient's physician.

To include with a patient's homecare plan, please print and fax our Face-to-Face Encounter Documentation to Visiting Nurse Association (VNA) at 816-627-6235.

Helpful Information Before You Submit

To receive home health services from VNA, all patients must meet these qualification guidelines:

• Patient must be under the care of a physician who signs the home health plan of care, including the documentation of the face-to-face encounter.
• Skilled nursing or rehabilitation therapy services must be medically necessary.
• Patient needs care on an intermittent basis only (not daily).
• Patient must be homebound unless not required by the payer (Medicare requires homebound status for all home health patients). Individuals are considered homebound if leaving the home requires tremendous effort and assistance from another person or device.

Examples of clinical skilled services that can be used in documentation (if applicable):

Chronic Heart Failure

• • Weight gain of more than five pounds in one week, edema, shortness of breath
  • Numbness, tingling; dizziness post-event
  • Reconditioning required due to increased weakness/de-habilitation
  • Medication action, administration, side effects, safe guards
  • Cardiac precautions with activity
  • Pacing activities/energy conservation techniques/progressive walking program

Orthopedics

• • Safe ambulation in home
  • Dependent and unsafe in home with activities of daily living
  • Post-surgical infection/complications/bleeding
  • Lovenox or Coumadin administration/monitoring/complication
  • Stair/gait training, functional training
  • Compromised balance/coordination
  • Active exercise program

Wound

• • Compromised circulation
  • Prevention of complications, infection, bleeding
  • Patient/caregiver education required to complete complex dressing

Teaching

• • Treatment options and consequences
  • Home management of multiple disease processes
  • Prevention of complications, infections, bleeding, falls
  • Wound prevention due to compromised condition
  • Strength/endurance, maximization post exacerbation disease process
  • Medication action, administration, side effects, safe guards
  • Multiple medication management, contraindication, interactions

Please fax your completed Face-to-Face Encounter Documentation Form to VNA at 816-627-6235.