Page 75 - Business Development Orientation Binder

Applies to: VNSNY Certified Home Health Agency
Service: VNSNY Certified Home Health Agency
Procedure Section: Provider Service Administration
Number: CP.181
Page 5 of 8

Admission Process
1. During admission visit the patient or patient’s legal representative will be asked to
sign Consent and Acknowledgement Form before care is provided. (See Consent
and Acknowledgement Policy
2. Clinicians will also provide verbal notice of the patient’s rights and responsibilities in
the individual’s primary or preferred language and in a manner the individual
understands, free of charge, with the use of an interpreter if necessary, no later
than the completion of the second visit from a skilled professional. Language
assistance should be provided through the use of competent bilingual staff, staff
interpreters, contracts, formal arrangements with local organizations providing
interpretation, translation services, or technology and telephonic interpretation
services.
3. If the patient has selected a representative, that representative shall also receive
written notices of patient rights. Please note: a patient may choose to decline
provision of patient rights to a patient-selected representative.
4. Patient/authorized patient representative will be informed of their approved plan of
care and their rights and potential responsibilities regarding source of payment for
services rendered. The information will be conveyed via the following document:
Facts about Your Home Care (FAHC) and explained to the patient/authorized
patient representative verbally.

a. The patient/family will be notified that they must pay the deductibles, co-pays
and co-insurance as required by his/her health insurance (The clinician
performing the Start of Care visit is responsible to check the patient’s fiscal
information in order to provide this information to the patient and to complete
the FAHC form accurately)
b. Financial status will be requested of the patient/family when charity care or
reduced fees are being considered for uncovered services

E. Patients Not Taken Under Care

Not Admit of Pending Referral

1. If the first level screening by intake staff or review done by CFM reveals that the
patient does not meet VNSNY Home Care admission criteria, the Intake staff/
CFM will update referral as Non–Admit with appropriate reason selected.

Responsibility: Quality Management Services-Homecare
Procedure date:
Revised: 06/2015, 12/2016, 12/2017, 12/2018
Approval: Senior Vice President, Patient Care Service