Home Health & Hospice Week

Tip: Consult your state regs for exact documentation requirements.

Question: "I thought only a LMSW could do home health visits or had to sign off on LBSW visits. There is a home health in town that is having the RN administrator sign off on the LBSW visit notes. Can this be done?"

Answer: "You can employ a BSW, but they still have to work under the supervision of a master's prepared social worker," explains consultant Lynda Laff with Laff Associates in Hilton Head Island, S.C.

Look to Medicare's State Operations Manual for clarification, Laff suggests: "Medical social services that are provided by a qualified medical social worker or a social work assistant under the supervision of a qualified medical social worker may be covered as home health services," the SOM reads.

The home health Conditions of Participation clarify that a qualified medical social worker has a master's degree in social work and a year of social work experience in a health care setting, Laff points out.

However, you might have to look to your state regulations for documentation requirements. Medicare regs don't specifically require MSWs to sign off on documentation, explains Chicago-based regulatory consultant Rebecca Friedman Zuber. Under Medicare regulations, "the Medical Social Worker must be master's prepared and must be available to consult with a Social Work Assistant, but there is no requirement to co-sign notes," Zuber says.

More info: "A Social Work Assistant can be an individual with a bachelor's degree in social work or in some other related discipline like psychology," Zuber adds. They also must have a year of social work experience in a health care setting, the COPs say.

"There are a lot of people who just do not know the rules," Laff concludes.

Note: Would you like the experts to field your most pressing questions? Please send them to editor Rebecca Johnson at rebeccaj@eliresearch.com.