Page 87 - Business Development Orientation Binder

Applies to: VNSNY Certified Home Health Agency
Service: VNSNY Certified Home Health Agency
Procedure Section: Provider Service Administration
Number: CP.164
Page 3 of 5

b. Document its communication with the physician who is responsible for the
patient’s home health plan of care,
c. Document measures token to investigate the patient’s refusal and the
interventions attempted in order to obtain patient participation with the plan of
care.
2. The HHA may consider discharge if the patient’s decision to decline services
compromises the agency’s ability to safely and effectively deliver care to the
extent that the agency can no longer meet the patient’s needs.

D. When discharge for cause is considered.
Clinician must discuss the situation with the Clinical Field Manager. Patients under
care can be discharged for cause per agency Policy: Discharge, termination criteria.
The agency will do the following before discharging a patient for cause:

1. Advise the patient, representative (if any), the physician(s) issuing orders for the
home care, and the patient’s primary care practitioner or other health care
professional who will be responsible for providing care after discharge that a
discharge for cause is being considered.

2. Make efforts to resolve the problem(s) presented by the patient's behavior, the
behavior of other persons in the patient’s home, or situation;

a. If all options have been explored with the patient and/or family and there is
continued refusal to cooperate with VNSNY in planning for on-going care,
only services which are medically necessary will continue to be provided until
an appropriate termination plan has been developed. Medically necessary
services are those which cannot be withdrawn without jeopardizing the
patient’s safety or resulting in the rapid deterioration of the patient’s medical
status.
b. Throughout the discharge planning process, there will be on-going
consultation with and input from the VNSNY legal and compliance
departments and the patient’s physician.
c. Written notification of the reasons and plan for discharge will be sent to the
patient/family, the physician and other involved agencies as appropriate and
documented in the medical record.

Responsibility: Quality Management Services-Homecare
Procedure date:
Revised: 6/2015, 12/2016, 12/2017, 12/2018
Approval: Senior Vice President Patient Care Service