Home Health Audit Template

Home Health Audit Template

The Home Health Audit Form serves as a comprehensive tool for evaluating the quality and compliance of home health services. This form is essential for ensuring that all medical records and care protocols are properly documented and followed. By utilizing this form, healthcare providers can maintain high standards of care and meet regulatory requirements.

To ensure your home health services are up to standard, fill out the form by clicking the button below.

Table of Contents

The Home Health Audit form serves as a comprehensive tool designed to ensure that home health care providers meet essential standards and guidelines for patient care. This form includes a series of questions and checklists that cover various aspects of patient admission, care planning, and documentation. Key areas assessed include the timely initiation of care, the completion of necessary physician orders, and the accuracy of medical records. The form also addresses medication management, patient rights, and the presence of required agreements and acknowledgments. Additionally, it evaluates the consistency of care provided with the established plan, the documentation of skilled nursing visits, and the overall coordination of care among different health disciplines. By reviewing these components, the audit aims to promote quality care and compliance with regulatory requirements, ensuring that patients receive appropriate and effective services in their homes.

Home Health Audit Sample

Home Health Medical Records Audit Form

(Updated for CY2013)

Auditor’s Name/Title: ________________________________________________________

 

Date: ___________________________

 

Yes

No

N/A MR #

Comments

Admission

1.Patient Referral Sheet Complete Timely Initiation of Care

Face to Face Encounter Within 90 Days To SOC

Face to Face Encounter Within 30 Days To SOC

History of Physical Present

2.Pre‐Admit Physician Order –

Signed, Dated or VO signed by RN + Physician

3.Primary DX M1020 Secondary M1022 M1022

M1022

M1022

M1022

M1022

Any Codes 401.1 Any Codes 401.9

All DX Supported & Sequenced Properly

4.Medication (N)ew and (C)hanged Interactions – Included Food/OTC

5.Admission consistent with Agency Admission Policies

6.Patient/Client Service Agreement – Signed, Dated & Complete

7.Insurance Screening Form – Signed & Complete

8.Medical Necessity Noted

9.Acknowledgement, Receipt & Explanation of the Items Below:

a.Home Care Patient Rights & Responsibilities

b.Privacy Act Statement‐Health Care Care Records

c.Complaint Procedure

d.Authorization for Use or Disclosure of Health Information (if applicable)

e.Statement of Patient Privacy Rights (OASIS)

f.Consent for Collection & Use of Information (OASIS)

Yes

No

N/A

MR #

Comments

 

 

 

 

 

g.Emergency Preparedness Plan/Safety Instructions

h.Advance Directives & HHABN

10. Complete Post Evaluation –

D/C Summary Report by RN/PT/OT/ST on:

a. Start of Care

b. Resumption of Care

c. Recertification

Plan of Care 485

11.Plan of Care Signed & Dated by Physician Within 30 Working Days or State Specific days‐ ________

12.Diagnoses Consistent with Care Ordered

13.Orders Current

14. Focus of Care Substantiated

15.Daily Skilled Nurse Visit Frequencies with Indication of End Point

16. Measurable Goals for Each Discipline

17. Tinetti or TUG Completed at SOC

18. Recertification Plan of Care Signed &

Dated Within 30 Days or State Required

Time

19.BiD Insulin Visits Documented with Vision, Musculoskeletal Need, Not Willing/Capable Caregiver. MSW Every Episode

20. Skilled Nurse Consult

Medication Profile Sheet

21.Medication Profile Consistent with the 4 485

22. Medication Profile Updated at

Recertification, ROC, SCIC, Initialed &

Dated

23.Medication Profile Complete with Pharmacy Information

Physician Orders/Change Verbal Orders

24. Change/Verbal Orders Include Disciplines, Goals, Frequencies, Reason for Change, Additional Supplies as Appropriate

25.Change Orders Signed & Dated by Physician Within 30 Working Days

OASIS Assessment Form

26. Complete, Signed & Dated by:

___________________________

27.M2200 Answer Meets the Threshold for a Medicare High Case Mix Group

28. M1020 & M1022 Diagnoses & ICD‐9 are Consistent with the Plan of Care

Yes

No

N/A

MR #

Comments

 

 

 

 

 

29.All OASIS Assessments Were Exported Within 30 Days

30. OASIS Recertifications Were Done

Within 5 Days of the End of the Episode

31.All OASIS Were Reviewed for Consistency in Coordination with the Discipline Who Completed the Form

Skilled Nursing Clinical Notes

32. Visit Frequencies & Duration are Consistent with Physician Orders

33.Orders Written for Visit Frequencies/ Treatment Change

34. Homebound Status Supported on Each Visit Note

35.Measurable Goals for Each Discipline with Specific Time Frames

36. Frequency of Visits Appropriate for Patient’s Needs & Interventions Provided

37. Appropriate Missed Visit (MV) Notes

38. Skilled Care Evident on Each Note

39. Evidence of Coordination of Care

40. Every Note Signed & Dated

41. Follows the Plan of Care (485)

42. Weekly Wound Reports are Completed

43. Missed Visit Reports are Completed

44. Pain Assessment Done Every Visit with Intervention (If Applicable)

45.Abnormal Vital Signs Reported to Physician & Case Managers

46. Evidence of Interventions with Abnormal Parameters/Findings

47.Skilled Nurse Discharge Summary/ Instructions Completed

48. LVN Supervisory Visit Every 30 Days by Registered Nurse

Certified Home Health Aide

49.Visit Frequencies & Duration Consistent with Physician Orders

50. Personal Care Instructions Documented,

Signed & Dated

51.Personal Care Instructions Modified as Appropriate

52. Notes Consistent with Personal Care Instructions Noted on the CHHA Assignment Sheet Completed by the RN/PT/ST/OT

53.Notes Reflect Supervisor Notification of Patient Complications or Changes

54. Visit Frequencies Appropriate for Patient Needs

Yes

No

N/A

MR #

Comments

 

 

 

 

 

55. Each Note Reflects Personal Care Given

56. Supervisory Visits at Least Every 14 Days by RN or PT

57. Every Note Signed & Dated

PT

58. Assessment Includes Evaluation,

Care Plan & Visit Note

59.Evaluation Done Within 48 Hours of Referral Physician Order or Date Ordered

60. Visit Frequencies/Duration Consistent with Physician Orders

61.Evidence of Need for Therapy/Social Service

62. Appropriate Missed Visit (MV) Notes

63. Notes Consistent with Physician Orders

64. Evidence of Skilled Service(s) Provided

in Each Note

65.Treatment/Services Provided Consistent with Physician Orders & Care Plan

66. Notes Reflect Supervisor & Physician Notification of Patient Complications or Changes

67.Specific Evaluation & “TREAT” Orders Prior to Care

68. Verbal Orders for “TREAT” Orders Prior to Care

69.Homebound Status Validated in Each Visit Note

70. Notes Reflect Progress Toward Goals

71. Evidence of Discharge Planning

72. Evidence of Therapy Home Exercise

Program

73.Discharge/Transfer Summary Complete with Goals Met/Unmet

74. Assessment & Evaluation performed by Qualified Therapist Every 30 Days

75.Supervision of PTA/OTA at Least Every 2 Weeks

76. Qualified Therapy Visit 13th Visit (11, 12, 13)

77.Qualified Therapy Visit 19th Visit (17, 18, 19)

78. Every Visit Note Signed & Dated

SLP

79.Assessment Includes Evaluation, Care Plan & Visit Note

80. Evaluation Done Within 48 Hours of Referral Physician Order or Date Ordered

81.Visit Frequencies/Duration Consistent with Physician Orders

Yes

No

N/A

MR #

Comments

 

 

 

 

 

82. Evidence of Need for Therapy/Social Service

83. Appropriate Missed Visit (MV) Note

84. Notes Consistent with Physician Orders

85.Evidence of Skilled Service(s) Provided in Each Note

86. Treatment/Services Provided Consistent with Physician Orders & Care Plan

87.Notes Reflect Supervisor & Physician Notification of Patient Complications or Changes

88. Homebound Status Validated in Each Visit

Note

89. Notes Reflect Progress Toward Goals

90. Evidence of Discharge Planning

91.Evidence of Therapy Home Exercise Program

92. Discharge/Transfer Summary Complete with Goals Met/Unmet

93.Supervision of PTA/OTA at Least Every 2 Weeks

94. Every Visit Note Signed & Dated

Miscellaneous

95.Progress Summary Completed(30‐45Days) Each Episode Signed & Dated

96. Field Notes are Submitted & Complete

97. Chart in Chronological Order

98. Chart in Order per Agency Policy

99.Patient Name & Medical Records Number on Every Page

100. Physician Orders are Completed/ Updated for Clinical Tests Such as:

a. Coumadin: Protime/INR

b. Hemoglobin A1C

c. CBC, Metabolic Panel, CMP

d. Others: _______________________

101.Communication with Physician Regarding Test Results

Process Measures:

Timely Initiation of Care

Influenza Received

PPV Ever Received

Heart Failure

DM Foot Care & Education

Pain Assessment

Pain Intervention

Depression Assessment

Medication Education

Falls Risk Assessment

Pressure Ulcer Prevention

Pressure Ulcer Risk Assessment

Additional Comments/Recommendations

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

THE FOLLOWING IS APPLICABLE FOR QUARTERLY MEDICAL REVIEW REPORT

REVIEWED AND SIGNED BY THE FOLLOWING DISCIPLINARY REPRESENTATIVE

______________________________________

______________________________________

Registered Nurse

Occupational Therapist (If Applicable)

______________________________________

______________________________________

Physical Therapist (If Applicable)

Speech Language Pathologist (If Applicable)

______________________________________

______________________________________

Medical Director

MSW (If Applicable)

MR # ______________________

Document Attributes

Fact Name Details
Purpose The Home Health Audit form is designed to ensure compliance with regulations and quality standards in home health care services.
Auditor's Information Each audit requires the auditor's name and title, along with the date of the audit for proper documentation.
Patient Referral Sheet The form checks if the patient referral sheet is complete and if care was initiated in a timely manner.
Medical Necessity Verification of medical necessity is crucial and must be noted in the audit to ensure appropriate care is provided.
Insurance Screening Insurance screening forms must be signed and complete, confirming that the patient’s insurance coverage is verified.
Plan of Care The physician must sign and date the plan of care within 30 working days, or as specified by state laws.
OASIS Assessments All OASIS assessments must be completed, signed, and exported within specified time frames to maintain compliance.
Documentation Requirements Every note must be signed and dated, reflecting the care provided and ensuring accountability in patient care.
State-Specific Regulations Different states may have unique requirements for home health audits, which must be adhered to for compliance.

Home Health Audit: Usage Instruction

The Home Health Audit form is a critical document used to ensure compliance with healthcare standards and practices. Completing this form accurately is essential for maintaining quality care and meeting regulatory requirements. The following steps outline the process for filling out the form effectively.

  1. Begin by entering the auditor's name and title at the top of the form.
  2. Record the date of the audit next to the auditor's name.
  3. Review each section of the form carefully, starting with the Admission section.
  4. For each item listed, mark Yes, No, or N/A as appropriate.
  5. Provide the medical record number (MR #) for each item being assessed.
  6. In the Comments section, add any relevant notes or observations that support your assessments.
  7. Proceed to the next section, OASIS Assessment Form, and repeat the process of marking and commenting.
  8. Continue through the remaining sections, including Skilled Nursing Clinical Notes and Miscellaneous, ensuring all items are reviewed and documented.
  9. Double-check that all required fields are filled out completely and accurately.
  10. Finally, ensure that the form is signed and dated where indicated, confirming its completion.

Frequently Asked Questions

  1. What is the purpose of the Home Health Audit form?

    The Home Health Audit form is designed to evaluate the quality and compliance of home health care services. It ensures that all necessary documentation is complete and that care provided meets regulatory standards. The form assesses various aspects of patient care, including admission processes, care plans, and ongoing assessments.

  2. Who is responsible for completing the Home Health Audit form?

    The audit form is typically completed by a designated auditor, who may be a registered nurse, a quality assurance officer, or another qualified individual within the home health agency. This person reviews patient records and documentation to ensure compliance with established standards.

  3. What key areas are evaluated in the audit?

    The audit covers several critical areas, including:

    • Patient referral and admission processes
    • Documentation of face-to-face encounters
    • Completeness of physician orders
    • Medication management
    • Care plans and measurable goals
    • OASIS assessments
    • Skilled nursing and therapy notes
  4. What does 'N/A' mean in the context of the audit form?

    'N/A' stands for 'Not Applicable.' This designation is used when a particular question or item does not apply to the patient or situation being audited. For example, if a patient does not have a specific diagnosis, the auditor may mark that section as N/A.

  5. How often should the Home Health Audit be conducted?

    The frequency of audits can vary based on agency policy and regulatory requirements. Generally, audits are conducted at regular intervals, such as quarterly or annually. Additionally, audits may be performed more frequently if issues are identified or if there are changes in regulations.

  6. What happens if discrepancies are found during the audit?

    If discrepancies are identified, the agency must take corrective actions. This may involve revising documentation, retraining staff, or implementing new procedures to ensure compliance. The findings are usually documented, and follow-up audits may be scheduled to verify improvements.

  7. Can the audit form be customized for specific agency needs?

    Yes, while the Home Health Audit form provides a standardized framework, agencies can customize it to better fit their specific requirements or regulatory environment. This may involve adding additional items or modifying existing ones to address unique aspects of their operations.

  8. What is the significance of the OASIS assessments in the audit?

    The OASIS (Outcome and Assessment Information Set) assessments are critical for measuring patient outcomes and ensuring quality care. They help in documenting patient needs and the effectiveness of services provided. Compliance with OASIS requirements is essential for reimbursement and regulatory adherence.

  9. How can agencies ensure compliance with the audit requirements?

    Agencies can ensure compliance by regularly training staff on documentation standards, maintaining accurate records, and conducting internal audits. Establishing a culture of quality and accountability within the agency is vital for meeting audit requirements and improving patient care.

Common mistakes

Filling out the Home Health Audit form can be a complex process, and mistakes can lead to significant issues. Here are five common errors that individuals make when completing this important document.

One frequent mistake is failing to ensure that all sections are complete. Each item on the form is essential for a thorough audit. If a section is left blank or marked incorrectly, it can raise red flags during the review process. For example, if the Patient Referral Sheet is not filled out completely, it can lead to questions about the patient's eligibility for services.

Another common error is not providing accurate or timely documentation of physician orders. The form requires that physician orders are signed and dated, yet many individuals overlook this requirement. Missing signatures or dates can delay the initiation of care and create compliance issues. It is vital to double-check that all orders are current and properly documented.

In addition, many people do not consistently document patient goals and progress. The Plan of Care should include measurable goals for each discipline, but these can often be vague or missing altogether. Without clear goals, it becomes challenging to assess whether the patient is making progress or if the care plan needs adjustment.

Another mistake involves the lack of coordination between disciplines. The audit form emphasizes the importance of consistency in care. If the OASIS assessments are not reviewed for coordination with the discipline that completed the form, discrepancies may arise. This can lead to misunderstandings about the patient's needs and the effectiveness of the care provided.

Lastly, individuals often neglect to ensure that all documentation is signed and dated. Each note must reflect the care provided and should be signed by the appropriate personnel. Missing signatures can create confusion and may suggest a lack of accountability. This oversight can have serious implications for patient care and compliance.

Documents used along the form

The Home Health Audit form serves as a critical tool for ensuring compliance and quality of care in home health services. Alongside this form, several other documents are commonly utilized to provide a comprehensive overview of patient care, treatment plans, and regulatory compliance. Each of these documents plays a vital role in maintaining the integrity of home health services and ensuring that patient needs are met effectively.

  • OASIS Assessment Form: The Outcome and Assessment Information Set (OASIS) is a standardized tool used to assess patient health status and outcomes. It includes various data points that help determine the appropriate care level and services needed for each patient. Completion of this form is essential for Medicare reimbursement and quality reporting.
  • Patient Service Agreement: This document outlines the terms of service between the home health agency and the patient. It includes details about the services provided, patient rights, and responsibilities. A signed agreement ensures that both parties understand their obligations and the scope of care offered.
  • Skilled Nursing Clinical Notes: These notes are essential for documenting each nursing visit. They provide a detailed account of the patient's condition, interventions performed, and the effectiveness of those interventions. Proper documentation helps in tracking patient progress and ensuring continuity of care.
  • Plan of Care: The Plan of Care is a comprehensive document that outlines the specific treatment goals, interventions, and responsibilities of the care team. It is signed by a physician and must be updated regularly to reflect any changes in the patient's condition or treatment needs.
  • Emergency Preparedness Plan: This document details the procedures and protocols in place to ensure patient safety during emergencies. It includes information on evacuation plans, communication strategies, and resources available to both staff and patients in crisis situations.

These documents, when used in conjunction with the Home Health Audit form, create a robust framework for delivering high-quality home health care. They ensure that patient needs are met while adhering to regulatory standards and best practices in the industry.

Similar forms

The Home Health Audit form shares similarities with several other important documents used in the healthcare field. Each of these documents serves a unique purpose while ensuring compliance and quality care. Here’s a look at five documents that resemble the Home Health Audit form:

  • Patient Assessment Form: This document collects comprehensive information about a patient’s health status, including medical history and current conditions. Like the Home Health Audit form, it aims to ensure that care plans are tailored to meet the specific needs of the patient.
  • Care Plan Document: This outlines the strategies for providing care to a patient. It details the goals, interventions, and expected outcomes. Similar to the Home Health Audit form, it emphasizes the importance of coordination among healthcare providers to ensure effective treatment.
  • Medication Administration Record (MAR): This document tracks the administration of medications to patients. It is akin to the Home Health Audit form in that it requires accurate documentation and monitoring to avoid errors and ensure patient safety.
  • Quality Assurance/Performance Improvement (QAPI) Plan: This plan focuses on improving the quality of care provided by a healthcare organization. Much like the Home Health Audit form, it includes metrics and evaluations that help identify areas for improvement and ensure compliance with regulations.
  • Incident Report Form: This document is used to record any unexpected events or incidents that occur during patient care. It shares similarities with the Home Health Audit form by requiring thorough documentation and review to enhance patient safety and care quality.

Dos and Don'ts

When filling out the Home Health Audit form, attention to detail is crucial. Here are some important dos and don'ts to keep in mind:

  • Do ensure all patient information is accurate and complete.
  • Do sign and date all necessary documents promptly.
  • Do double-check that all required fields are filled in before submission.
  • Do maintain a clear and organized record of all documentation.
  • Don't leave any sections blank unless they are marked as optional.
  • Don't use abbreviations that may cause confusion or misinterpretation.
  • Don't forget to review the form for consistency with the patient's care plan.
  • Don't submit the form without verifying that all signatures are present.

Misconceptions

Misconceptions about the Home Health Audit form can lead to confusion and inefficiencies. Here are seven common misunderstandings:

  • 1. The form is only for compliance checks. Many believe the audit form serves solely to ensure compliance. In reality, it also identifies areas for improvement in patient care.
  • 2. All items must be completed for every patient. Some think every section applies to all patients. However, certain items may be marked as "N/A" if they do not pertain to a specific case.
  • 3. The auditor must be a healthcare professional. It is a misconception that only healthcare professionals can conduct audits. Trained administrative staff can also perform audits effectively.
  • 4. The form is static and unchangeable. Some believe the Home Health Audit form is fixed. In fact, it is updated regularly to reflect current regulations and best practices.
  • 5. A single error invalidates the entire audit. Many fear that one mistake will render the audit worthless. While accuracy is essential, auditors often focus on overall trends rather than individual errors.
  • 6. The audit is only for billing purposes. Some think the audit's primary goal is to ensure correct billing. While this is important, the audit also aims to enhance patient outcomes and care quality.
  • 7. Feedback from the audit is only for management. There is a belief that audit results are only shared with upper management. In truth, feedback is often communicated to all relevant staff to foster continuous improvement.

Key takeaways

Filling out and using the Home Health Audit form is essential for ensuring compliance and quality of care. Here are some key takeaways to keep in mind:

  • Timeliness is Crucial: Ensure that the initiation of care and face-to-face encounters occur within the specified timeframes. This is vital for compliance with regulations.
  • Documentation Matters: All required documents, such as the patient referral sheet and physician orders, must be signed, dated, and complete.
  • Insurance Verification: The insurance screening form needs to be completed and signed to confirm that coverage is in place before services begin.
  • Patient Rights: Acknowledge and explain the patient's rights and responsibilities, ensuring they understand their privacy rights and the complaint procedure.
  • Plan of Care: The plan of care should be signed and dated by the physician within the required timeframe, aligning with the patient's needs.
  • OASIS Assessments: Complete and submit OASIS assessments within the designated timeframes to maintain compliance with Medicare requirements.
  • Skilled Nursing Notes: Each nursing note must reflect the care provided and be signed and dated to ensure accountability.
  • Coordination of Care: Evidence of communication and coordination among healthcare providers is essential for effective patient care.
  • Missed Visits: Document any missed visits appropriately and ensure follow-up actions are taken to address patient needs.
  • Quality Control: Regularly review the audit form to identify areas for improvement and ensure compliance with agency policies.

By keeping these takeaways in mind, you can enhance the quality of care provided to patients and ensure that your agency meets regulatory requirements effectively.