Welcome to our dedicated provider resource page for Mad River Community Hospital Home Health Services.
We’ve created this page to streamline the referral process and provide you with the essential information needed to connect your patients with our comprehensive home health care. Our team is committed to creating a seamless transition of care and building collaborative relationships with referring providers across Humboldt County.
Connecting your patients with Mad River Community Hospital Home Health Services is straightforward. Our streamlined referral process is designed to minimize administrative burden while ensuring your patients receive timely care.
Confirm Eligibility: The patient must meet Medicare’s definition of homebound. A face-to-face encounter is required within 90 days before or 30 days after the start of home health care. This encounter can be performed by:
Coordinate Medical Equipment: Ensure all necessary medical equipment is ordered before the patient is discharged home. This prevents the need for an additional face-to-face visit, which can be difficult and burdensome for homebound patients.
Re-connect With Primary Care Provider: Confirm that the patient has follow-up care scheduled with their primary care provider or another designated medical provider after discharge. This ensures continuity of care and compliance with Medicare requirements.
Submit Referral Documentation: To avoid delays in case, please include
Download our referral packet for the MRCH Home Health Care form, instructions and a checklist.
Understand Eligibility Requirements: The patient must be homebound as defined by Medicare. A face-to-face encounter is required within 90 days before or 30 days after starting care. Documentation of this encounter MUST state the reason Home Health Care is to see the patient. This encounter can be performed by:
Provide Complete Referral Information: To avoid delays in care, please include:
Download our referral packet for the MRCH form, instructions and a checklist.
Follow Up on Plan of Care: After initiating the referral, you will oversee the patient’s care. You will receive plans of care and orders that will need to be approved, signed and returned to Home Health Care.
We understand you may have questions about our home health care services, referral processes, and coverage requirements. Below are answers to common questions from referring providers. If you need additional information, please call us at 707-826-8420, 8a-5p Monday-Friday.
The most efficient referral method is completing our referral packet and faxing it to 707-826-8428. For urgent referrals, please call 707-826-8420 after sending the fax to alert our intake coordinator.
For most patients, we try to initiate services within 48 hours of receiving a complete referral (download our packet for details).
At minimum, we need:
Yes, nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants (PAs) can order home health services under Medicare guidelines, but they must meet several specific requirements:
Medicare Enrollment Requirements:
Scope of Practice Requirements:
Important Note: Simply being a licensed NP, CNS, or PA is not sufficient. The provider must specifically be enrolled in Medicare’s PECOS system with the appropriate credentials to order and certify home health services. This enrollment process ensures Medicare can verify the provider’s qualifications and authorize payment for the services they order.
For questions about a specific provider’s Medicare enrollment status or PECOS registration, please verify directly through the Medicare Provider Enrollment portal.
Medicare considers patients “homebound” when:
AND
Leaving home infrequently and for short durations, such as for medical appointments, religious services, and other unique events, is allowed.
Yes, you can request specific services. Our initial assessment will be reviewed with you. Next, a plan of care will be created, and you will sign off on it.
Patients who benefit include those transitioning from hospital or SNF care, those with new diagnoses requiring education and monitoring, patients with complex medication regimens, those requiring wound care, and patients needing rehabilitation therapies who are homebound.
The length of Home Health Care services depends on your patient’s individual medical needs and Medicare eligibility criteria. Services continue as long as the patient meets two key requirements: they have a skilled care need and remain homebound.
The patient must require skilled nursing care, physical therapy, occupational therapy, or speech therapy that must be performed by licensed professionals. They must also meet Medicare’s homebound criteria, meaning leaving home requires considerable effort due to their medical condition.
You and the Home Health Care team will regularly evaluate the patient’s progress, medical condition, and homebound status. Services continue as long as the patient meets both Medicare criteria and is showing improvement or has the potential to improve. Duration typically ranges from a few weeks to several months, depending on the patient’s specific condition and response to treatment.
Home Health Care is not long-term custodial care. Services end when skilled care needs are met, maximum improvement is reached, or the patient is no longer homebound. If the patient’s condition changes and new skilled care needs develop while they remain homebound, they may qualify for continuing services with an additional provider order that addresses the new care need.
The Home Health Care team will keep you informed about your patient’s progress and any changes to the care plan throughout treatment.
Yes, our team verifies insurance coverage and eligibility for all referred patients before the first visit. We’ll notify the patient promptly if we identify any coverage issues.
We accept Medicare, Medi-Cal, Partnership, and most major private insurance plans. If you’re unsure about a specific plan, please contact our office at 707-826-8420.
We’ll communicate with the patient before reaching coverage limits so we can collaboratively plan for ongoing care needs. For patients with additional needs, we can assist with referrals to community resources or discuss private pay options when appropriate.
You’ll receive an initial assessment summary after our first visit. Subsequently, you’ll receive updates for significant changes in condition, responses to treatments, at recertification periods, and pending discharge. If you have questions, don’t hesitate to call us – and we’ll call you with ours. Communication in both directions is vital!
Our nurses perform medication reconciliation at the initial visit and throughout care. Any discrepancies or concerns are communicated to you.
Please contact the patient’s case manager directly (provided in the plan of care) or call our clinical supervisor at 707-825-4953 for immediate needs.
No, this is not a service we provide at this time.