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Glossary

Resumption of care

The point at which a home health agency resumes a patient's care after an inpatient stay of 24 hours or more. The comprehensive assessment, with the OASIS, must be updated within 48 hours of the patient's return home or on the ordered resumption date.

Also ROC, resumption of care assessment, ROC OASIS

How Vivlio handles this for home health

A resumption of care is a start of care for a patient the agency already has. The patient was on service, went into the hospital, and came home again inside the same sixty-day period. The agency does not discharge and readmit; it resumes, and the regulation treats the return as a moment that needs a fresh look at the patient.

The rule is 42 CFR 484.55(d)(2). The comprehensive assessment, including the OASIS, must be updated within 48 hours of the patient’s return home from a hospital admission of 24 hours or more for any reason other than diagnostic tests, or on the resumption date the physician or allowed practitioner orders. CMS’s Timely Initiation of Care measure counts resumptions alongside starts: care resumed within two days of the inpatient discharge or it did not.

What changed in the hospital is the whole point of the visit, and it is the part the agency usually does not have. The nurse is updating a drug regimen review after a stay that almost always changed the medications, and revising a plan of care after an event serious enough to admit the patient. The discharge summary says what happened, what was started and stopped, and who the patient sees next. Unlike a new referral, a resumption often arrives with no referral packet at all: the agency learns of the discharge from the family, and the 48 hours start anyway.

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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