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Glossary

Initial assessment visit

The agency's first visit, by a registered nurse or the appropriate rehabilitation clinician, to determine the patient's immediate care needs and Medicare eligibility. It must happen within 48 hours of the referral, within 48 hours of the patient's return home, or on the physician-ordered start-of-care date.

Also initial assessment, 48-hour visit

The initial assessment visit is the first of two assessments the home health Conditions of Participation require, and the one with the shortest clock. Under 42 CFR 484.55(a) a registered nurse must conduct it to determine the patient’s immediate care and support needs and, for Medicare patients, eligibility including homebound status. When the referral is for rehabilitation therapy only, the therapist may make the visit instead.

The clock is 48 hours. It runs from the referral, or from the patient’s return home from a facility, whichever applies, unless the physician or allowed practitioner has ordered a specific start-of-care date, in which case the visit happens on that date. Forty-eight hours is also roughly the whole window in which the agency can still get records before the visit, which is why the referral packet matters so much and why a missing face-to-face note or history and physical is chased by phone rather than requested by mail.

The initial assessment is distinct from the comprehensive assessment, which follows within five days of the start of care and carries the OASIS items. In practice many agencies complete both at the first visit; the regulation allows them to be separate.

Where it is defined

Vivlio for home healthThe face-to-face note, orders, discharge summary and medications, assembled before the first visit.

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