Phone: (651) 665-9795

Fax: (651) 665-9796

Monday - Friday: 8:30 am - 5:00 pm

Admissions Process

  1. A referral may be received from the physician, social worker, other health team member, third-party payer, client, family member, friend, or another home health care company.  When a new referral is received by Divine, the Intake Form collects the following information:
    • Client’s name

    • Current address

    • Date of birth/age

    • Sex

    • Referral source

    • Date of discharge from a facility, as applicable

    • Name, address, and telephone number of the nearest relative or responsible person to contact in the event of an emergency

    • Name, address, and telephone number of attending physician

    • Diagnosis: principle and secondary

    • Whether the client is under the care of a physician, licensed by the state of the client’s residence if a Plan of Care is required

    • Known allergies

    • Names of other individuals/organizations who might be involved in care

  2. Admission Procedures (Opening a Case by an RN)
    Prior to providing services, the admission professional will meet with client/caregiver/client’s representative to 1) verify client-provided information, 2) identify care needs, 3) present and discuss legal forms and agency policies, 4) address questions, and 5) obtain informed consent while completing the Admission Packet Checklist*:

    *Admission Packet Checklist includes, but is not limited to, the following forms
    • Intake Referral Form
    • Agency Policies
    • Service Agreement
    • Admission Agreement
    • Advance Beneficiary Notice/Advance Directives
    • Authorization for Emergency Procedure Plan
    • Client Information
    • Abuse Prevention Plan
    • OASIS Consent
    • Start of Care Oasis Assessment
    • Fraud Prevention Plan
    • Privacy Act
    • Homecare Bill of Rights
    • Motor Vehicle Authorization
    • Resuscitation Guidelines
    • Transfer and Discharge Policies

    Prior to providing services, the admitting professional will:
    1. Verify all the information on the Intake Form with the client/caregiver/client’s representative.
    2. Provide the client with a copy of the privacy rights and the notice of privacy practices and obtain consent to use and disclose protected health information (PHI) for treatment, payment, and health-care operations.
    3. Provide the client/caregiver/client’s representative with a copy and an explanation of the Home Care Bill of Rights and Responsibilities, and the procedures for filing a complaint. This includes the Statement of Privacy Rights related to the collection and transmission of personal health-care information.
    4. Complete the Assessment Form, including Outcome and Assessment Information Set (OASIS) data elements, Plan of Care/485, Care Plan if indicated, Medication regime review, and additional documents, as required. The data gathered shall form the basis for the Plan of Care and Care Plan.
    5. Assess and document the client’s vulnerability status and risk of hospitalization. Identify specific safety measures relating to the vulnerability area. Safety measures will be documented in the record and on the care plan as applicable.
    6. Review the plan for services, treatment, and care with the client/caregiver and obtain input when possible. Inform the client/caregiver/client’s representative of any reasonable risk and/or alternative associated with any procedure provided in the home.
    7. Advise the client/caregiver/client’s representative of the charges and billing procedures and, to the extent possible, the anticipated insurance coverage, the client/caregiver/client’s representative financial liability, and other methods of payment.
    8. Explain the concept of assignment of benefits and the liability for payments received from the insurance company for the agency’s services. Clients will be informed of any possible financial obligations related to the care.
    9. Obtain the client’s signature on the Service Agreement, Home Care Bill of Rights, and other forms required by the agency.
    10. Provide the client/caregiver/client’s representative Advance Beneficiary Notice identifying when orders for services will not be covered under the Medicare benefit.
    11. Inform adult clients of their right to formulate advance directives, and explain the agency policy regarding advance directives.
    12. Develop an Emergency Plan with the client/caregiver/client’s representative.