Home Health Forms

Required documentation of a face-to-face encounter with the patient within 90 days before or 30 days after the start of home health. Must document homebound status and need for skilled services.

Authorization and care plan for home health aide services. Documents specific tasks the aide may perform, schedule, and supervisory requirements. RN supervisory visits required at least every 14 days.

Documents the home health treatment plan including diagnoses, medications, services ordered, frequency, and goals. Must be signed by physician. Reviewed and rewritten every 60 days.

Outcome and Assessment Information Set. Standardized data elements integrated into comprehensive assessment for Medicare home health patients. Includes socio-demographics, functional status, health conditions, and service utilization. Used for quality reporting and payment (PDGM).