Home Health & Hospice Week

What do you do when a patient won't sign a home health advance beneficiary notice? This can be a big problem for psych patients, a home health agency said in a recent NHIC teleconference about HHABNs.

"If the beneficiary refuses to sign the HHABN, the HHA must write that the beneficiary refused to sign on the HHABN itself, and provide a copy of the annotated HHABN to the beneficiary," CMS says in its ABN form instructions. Then "the HHA must keep the original version of the annotated HHABN."

If the agency wants to provide care anyway, it "should have a second person witness the provision of the HHABN and the beneficiary's refusal to sign/select an option by making an annotation on the HHABN indicating that he/she witnessed this event," CMS adds in the instructions, according to NHIC. "The witness must then sign and date next to his/her annotation." You can contact someone by phone to provide the witnessing and they can sign the form later, the agency says.

Remember: "An HHA is not obligated to provide noncovered care when a beneficiary refuses to accept liability," CMS says.