LHCR / Home Health Newsletters

May 2008

EMERGENT CARE

Emergent Care is a Utilization Outcome, encompassing M0830.  Tracking "utilization outcomes" as proxies for decline in patient health status is a key component of outcome monitoring.  Effective monitoring of patient condition and appropriate intervention before a condition becomes emergent can reduce the incidence of emergent care encounters.  

Home health patients may need to have urgent, unplanned medical care because of a sudden decline in their health or because of an injury.  They may need to make an urgent trip to the doctor or emergency room, or a doctor may have to make an urgent house call.  This type of care may be avoided if the home health staff adequately checks the patient's health condition at each visit to detect problems early.  Staff must assess the patient's ability to eat, drink, and take medication, as well as their safety in their home.  They should coordinate the patient's care by regularly communicating with patients, informal caregivers, doctors, and other care providers. 

Some clarifications that may be helpful include: 

• Emergent/unscheduled (within 24 hours) care is the definition CMS is using.  It does not justify why the patient sought treatment, only that emergent care occurred.
• A “prn” visit by your agency is not considered emergent care.
• Any access of emergent care, regardless of how brief the encounter, should be reported.
• If patient is evaluated by EMTs and not transported, the ambulance services are not included.  Only the providers listed under Item M0830 are reported.
• Types of activities that would be considered emergent care include portable x-ray at home, home visit from doctor or staff, physician visit within 24 hours of scheduling.
• If a patient went to the ER, “held” for observation (not admitted) and released, the patient did receive emergent care.
• Remember to include the entire period since the last time OASIS data were collected, including current events.
• Clinician may need to verify the type of encounter – ER, observation, outpatient, inpatient.
• M0830 and M0840 relate to OBQM for:  injury caused by fall or accident at home, wound infections/deteriorating wound status, improper medication administration/side effects and hypo/hyperglycemia.

Proper and consistent assessment is important in managing your patient’s health status.  We can provide you with the tools to improve performance and increase efficiency while still providing patient centered care.  For additional intervention tools, click here to view RESOURCES and download LHCR developed brochures and posters that may be useful for in-servicing staff on the importance of consistent assessment.