Pandemic Relief via legislation, CMS waivers, and enforcement discretion

• Telehealth
• Waived requirement to use volunteers
• Face to Face encounters to establish HH services
• Non-physician practitioners (NNP) certification authority accelerated

Telehealth and Telephonic Visits

• CMS permits HHAs to provide all necessary telehealth during the emergency period
• Must be physician-ordered and on the plan of care
• Does not replace in-person visits (telehealth or telephonic visits are not billable visits)
• Allows for HHA to supplement in person visits for patients who might refuse more frequent visits or senior living or other congregate living facilities that might be restricting access to HHA personnel.
• The Home Health Face to Face visit may also be provided by telehealth but must be performed utilizing 2-way audio and visual programs.

In an effort to protect patients, some SNF, LTC, hospice, and other facilities are limiting the number of visits that Abode Healthcare staff may make to patients in their care. Some patients are even requesting fewer in-person visits to reduce their exposure to the outside world. Abode Healthcare understands and joins in these protection measures by offering telehealth visits. In some cases where access has been limited or is desired, Abode staff are utilizing telehealth on a weekly or bi-weekly basis in order to maintain contact with high-risk patients. In all cases, telehealth visits are meant to be supplementary to in-person patient visits. Telehealth visits should not replace in-person visits altogether. Telehealth Tools Our commitment, as always, is to serve our patients as best we can. Our clinical team has been trained in effective ways to utilize telehealth systems to streamline patient care through our own remote access system using the following tools:

• Phone: Abode Healthcare staff may conduct remote visits with patients through phone calls.
• Video: Abode Healthcare staff may conduct remote visits with patients through Doxy.me. (All F2F between NPs or MDs, DOs must be done through a 2-way type of technology. This is for both HH and Hospice)
• me can be utilized via tablets or phone and has been selected by Abode due to the ease of use for both the clinician and the patient/family/caregiver as well as its ability to capture/validate that the tele visit occurred, and its security features.

Though telehealth is never our first choice, it is the right choice during this time. Abode Healthcare continues to partner with providers to preserve the health and wellbeing of all of our patients. CMS clarification on homebound status for COVID-19 patients and those at high risk of contracting: Non-Physician Home Health Certification Authority

• Allows patient to be under the care of an NPP to the extent permitted under state law
• NPP= Nurse Practitioner (NP, ARNP), Physician Assistant (PA) and Clinical Nurse Specialist (CNS)
• Authorities
• Order Home Health Services
• Establish and review POC (Plan of Care)
• Certify and recertify eligibility
• CMS utilizing discretionary authority not to enforce rules
• Must also check state HHA licensure for any barriers to implement
• CARES Act makes this relief permanent, but CMS needs to implement

For more information, contact Jon Wilder.