21 Sep OPS8/Missed Visit Session
Missed Visit Session Guide
- This session is used, when a participant is on the OPS8 report, to document interactions related to the missed visit
- The note is completed per reason code of the missed visit. If the participant has more than 1 reason code reported for missed visits, a separate note is required for each reason code.
- Reason Codes CV, FA, IS, SI, and TX will ONLY be applicable during the COVID-19 pandemic and will not be used when the public health crisis has ended.
| Reason Code | Explanation of Reason Code | Questions for Follow up with the participant |
AR | The participant/family refused the visit or were not available for the scheduled visit and/or the participant declines a replacement worker when offered by the agency if the primary caregiver is not available (call off, vacation, etc.) | Has this been a reoccurring problem? Is there a reason the participant is unable to keep the scheduled visits? Are follow up actions necessary and/or being taken? Is there a day of the week that the participant no longer needs paid support? Is there a particular aide from the agency that the participant will only agree to work with or refuse to work with? Does the participant need reassessed for their service hours |
HU | Unplanned hospitalization. Incident report is required | Were there missed Home Health Aide or PAS that impacted the unplanned hospitalization? Was the SC made aware the participant was in the hospital? Was the PCSP adjusted due to the hospitalization? Was a trigger event visit completed? Has there been an observed trend of unplanned hospitalizations? |
UN | Agency was unable to staff the case for a reason other than COVID-19 | Why weren’t the services received? What did the agency do to address the missed service to ensure the participant wasn’t at risk? Has the issue been resolved? Was the backup plan initiated? If yes, explain the backup plan. If not, explain why it was not initiated. Is there a need to change providers? |
CV | Agency was unable to staff the case due to COVID-19 related to their staff and not the participant | Did the provider contact the CHC-MCO of a change in business practice or that the provider is having capacity issues? Did the SC contact the participant? Did the missed service cause any health and/or safety concerns? What follow up actions were taken? |
FA | Participant is in the hospital or nursing facility due to COVID-19. Incident report is required | What is the anticipated discharge date? When will services resume? Will the participant need additional support upon discharge? |
IS | Participant refused due to COVID-19, receiving service through informal support | Are there any additional supports that the informal caregiver needs to prevent burnout? Do the services need to be placed on hold during this time? |
SI | Participant refused, self-isolating due to COVID-19, not receiving service | Does the participant have a backup plan and/or informal support to assist during this time? Do the services need to be placed on hold during this time? |
TX | Worker switch to cover another case due to staffing limitations as a result of COVID-19 | Were the original participant’s services fulfilled? If so, how? If not, explain why services were not rendered. Provider will need to give details of why the services were not rendered. |
Process:
- SC receives notification that participant is on the OPS8 report for missed visit(s).
- SC makes outreach to the participant and asks the above mentioned questions for follow up (based on the reason code in the OPS8 report) and discusses if the backup plan from the PCSP was utilized.
- SC completes a Missed Visit Session in Function Portal and documents responses for each Reason Code on the OPS8 report.
- If there is more than one visit in the month per reason code, enter the date of the first missed visit of the month.
- SC selects the reason code for why the visit was missed
- SC identifies the type of missed service and adds the amount of units approved for the MONTH for the missed service as well as the amount of units that were missed
- SC selects a reason code for the missed visit, per discussion with the participant
- If the reason code does not match what was on the OPS8 report, select “No Reason”
- SC adds the summary of the conversation
- This must include all of the answers to the above questions for the reason code.
- If there are multiple dates for the same code, provide information for each date.
- Document any follow up plans (ie. helping the ptp find a new PAS agency, updating PCSP to match the new backup plan the participant discussed)
- SC selects if there are any Health or Safety concerns
- If there are concerns, then the SC must follow up with their supervisor to discuss next steps (ie. call to APS/OAPS, incident report, other service(s) that can be offered to ptp, or additional resources)
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