Page 67 - Business Development Orientation Binder

Applies to: VNSNY Certified Home Health Agency
Service: VNSNY Certified Home Health Agency
Policy Section: Provider Services Administration
Number: CP.130
Page 3 of 6
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5. The Agency reserves the right to reject those patients who do not meet
the admission criteria as set forth below in Criteria for Admission section
of this policy.

6. VNSNY Home Care evaluates its staffing capacity on an on-going basis.
If it is determined that there is a staffing shortage in a specific
region/program, the Regional/Program Vice President or designee will
notify the SVP of Operations (or designee), who will consult with the
Senior Management Team to decide on acceptance of further referrals.

Criteria for Admission:

1. The patient resides in one of the following counties in the State of New York:
Kings, New York, Bronx, Queens, Richmond, Nassau, Westchester or
Suffolk.
2. The patient requires professional services, e.g., nursing and/or rehab
therapy in accordance with applicable payer guidelines.
3. The patient is under the care of a physician who is willing to develop,
approve and regularly review the plan of care.
4. A patient with Medicaid or Medicare is under the care of a physician who is
Provider Enrollment Chain and Ownership System (PECOS) or Ordering,
Prescribing, Referring and Attending (OPRA) Physicians and Health Care
Providers enrolled, and is not debarred from practice by Medicare, Medicare
or other government funded program.
5. The patient/family provides VNSNY Home Care with information about
his/her health insurance.
6. Patients must have a payor source that has indicated it will pay, be willing to
pay privately or be eligible for charitable care. See Policy: VNSNY Charitable
Care.
7. Patients insured by Medicare must meet Medicare Criteria.
8. The agency has a properly trained and adequately experienced staff
available to provide the types and/or level of care required by the patient.
9. The patient/family has a reasonable emergency or alternate plan in place to
assure that essential needs of the patient can be met in an emergency, or in
the absence of agency personnel.
10. The patient/family agrees to be considerate of those providing care without
prejudice or discrimination.
11. The home/environment is safe for the agency personnel during the time that
they are providing services.

Approved: SVP, Patient Care Services; Professional Advisory Committee
Revised/Reviewed: 5/2016, 3/2017, 12/2017, 12/2018