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Applies to: VNSNY Certified Home Health Agency
                   Service:  VNSNY Certified Home Health Agency
                   Policy Section: Provider Services Administration
                   Number: CP.130
                   Page 5 of 6
                   _______________________________________________________________

                   5.  Referral source and the patient and/or patient representative will be notified if
                       the acceptance of the referral is delayed or has been denied when the patient
                       is inappropriate for services


                   NOTE: If determination is made that patient is not admitted based on VNSNY
                   and regulatory admission criteria, but the patient appears to be eligible for
                   services from Adult Protective Services (APS), then VNSNY in collaboration
                   MUST notify the referring physician, and a referral to APS may be made based
                   on the patient’s circumstances. Any patient who is assessed as inappropriate for
                   agency services shall be assisted by the agency, in collaborating with the
                   discharge planner and other case management entity with obtaining the services
                   of an alternate provider.

                   Admission Process
                   During admission visit the patient and/or the patient’s legal representative or
                   patient selected representative (if any), are provided with the required notices
                   and are asked to sign Consent and Acknowledgement form in advance of
                   furnishing care to the patient. Patients are informed of their rights and their
                   liability for payment, if any. Comprehensive assessment is performed and a plan
                   of care is developed in partnership with the patient, caregiver(s), and/or patient
                   representative if any. See procedure CP.181 Admission to Home Care




                   REFERENCES:
                   Community Health Accreditation Program (2018).  Standards of Excellence.
                   New York: the author.

                   Centers for Medicare & Medicaid Services, Department of Health and Human
                   Services Conditions of Participation, 42 CFR 484.2, 484.50 484.60 – Home
                   Health Services.
                   https://www.gpo.gov/fdsys/pkg/CFR-1999-title42-vol3/xml/CFR-1999-title42-vol3-
                   part484.xml
                   New York State Department of Health (2003). Title 10 – Rules and Regulations
                   New York State Department of Health: Article 7 – Certified Home Health
                   Agencies.  Albany NY:

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