Home Heath

Hello,

Can anyone provide clarification or resources to provide clarification on what is required in patient charting / admission consent for home health related to Patient Advocate / DPOA / Patient representative?  We were cited by CHAP related to this issue 6+ years ago

Do we only include names of people that are activated as making medical decisions for the patient, and if no incapacitation has been determined can we / SHOULD we leave these areas blank?

There seems to be confusion on if we put the names here that CAN act as medical decision maker versus those people that ARE and MUST act as medical decision makers. 

On our current admission consent it asks the questions: 

I have a DPOA for Health Care / Patient Advocate.    NO or YES.  If so, please write name and phone number named Patient Advocate.     

Should this name be left blank unless the patient is deemed incompetent to make their own medical decisions and someone else is acting in this manner as advocate. 

Any resources or guidance is appreciated

Thank you,

Amy

------------------------------
Amy Genthe
Director of Quality and Compliance
Porter Hills Home Health West
Grand Rapids MI
agenthe@mybrio.org
------------------------------

In the home health conditions of participation section 484.50 (patient rights) and 484.60(a)(2) (plan of care) contain information about protected health information and advanced directives.  Information related to any advanced directives is required to be in the plan of care.  I cannot speak to the specific CHAP standard(s) that are pertinent.  Any state requirements around advanced directives and the definition of "representative" also need to be considered. This would include when a representative is considered to be 'activated'.  

If the patient has a named representative that meets the state requirements, but there is not yet the need for the representative to make decisions, the agency should still document the name of the representative so the agency knows who to contact should the need arise. The agency should have a copy of any applicable advanced directives as well so that the staff knows how to respond/communicate should the situation arise where the advanced directives are activated. 

I hope this answers your questions.  Please let me know if it does not or you need additional information.

------------------------------
Katie Wehri
Director of Home Health & Hospice Regulatory Affairs
NAHC
Washington, DC
202-240-9254 #3360
------------------------------