Home Health Documentation

Home Health Forms – Which is Required?

The Advance Beneficiary Notice/Home Health Change of Care Notice/Notice of Medicare Noncoverage

Scenario ABN HHHCN NOMNC
Patient met goals under the POC and is being discharged from home health care     X
Physician writes an order to decrease services listed in the POC   X  
Physician writes an order to decrease services listed in the POC; patient wants to
continue to receive higher amount of services		 X    
Physician writes an order to discontinue services listed in the POC   X* X
HHA reduces services due to internal agency reasons
(e.g., staffing shortage)		   X  
HHA discontinues services due to internal agency reasons
(e.g., no staff available for a specific discipline)		   X  
HHA terminating care because of safety issue posing a threat to staff   X  
HHA terminating care because patient has not had face-to-face encounter with physician   X  
Patient wants to receive services from HHA but is not homebound X    
Patient only requires custodial care X    
Patient’s care not considered medically reasonable and necessary X    
Skilled nursing services provided to patient, but services are frequent and not considered intermittent under Medicare guidelines X    

 

* If a termination involves the end of all Medicare-covered care and no further care is being delivered based on physician’s orders, the only notice required is the NOMNC; however, the HHA may choose to issue the HHCCN as well.

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Revised 8/6/2024