Home Health Articles and Information


Oct 13, 2020 6:00:00 AM / by Kristi Bajer, BSN, RN, COS-C

TeleVisit Success Story

Have you been hearing about agencies incorporating TeleVisits or Telemedicine but find it hard to even imagine such a different way of treating patients? Did you write it off because CMS isn’t reimbursing home health agencies for virtual visits?

LivinRite Home Care, based in Northern Virginia, a long time OperaCare user, shares how they were challenged to incorporate virtual visits to meet the needs of one patient, and how they met this challenge, expanded the program, and will never look back.

"At first, seeing patients in a virtual environment, felt odd," says Colin Elliot D.Sc. PT, Senior VP of Business Development, with LivinRite Home Health Care.  “We had a referral for a 93-year-old patient with a prolonged hospital stay due to UTI, CVA and fall, who adamantly refused any home visit due to his immunosuppressive status and COVID -19.”

Not wanting to lose the referral coupled with the patient’s use of commercial insurance, which DID cover OASIS and subsequent visits done via TeleVisit, Elliot and the team at LivinRite decided it was time to jump into the virtual world.

“We contacted the patient and offered video visits and because he was highly motivated to restore his functionality, he was receptive” Continued Elliot. “We started with the OASIS visit, we performed all follow-up visits via Tele-Heath/ video visits, and the results were surprisingly good!"

A typically virtual visit consisted of having the patient take a complete set of vital signs, going over exercises and watching him complete them on the video screen, and offering suggestions, reminders and remediation's for activities not appropriately done- just like a usual in person visit.

Elliot reported impressive results, "The client progressed from using a rollator with moderate assistance to stand and transfer. He started with less than 5 minutes exercise endurance and moderate assistance with ADLs and progressed to independent ambulation with single point cane. He completed 14 steps to exit his home, tolerated 40-45minutes of almost continuous functional/strengthening exercises and regained his PLOF with ADLs.”

When asked how they begin Elliot admitted to seeing challenges at every level. Realizing the biggest challenge was the fear of the unknown he encouraged his team to come up with ways to provide virtual therapy versus reasons NOT TO. This was a huge mental shift that included focusing on meeting the needs of the patient and expediting his recovery.

Elliot started by designing a set of assessment tools for his team to identify and monitor the patient’s progress and effectively apply the therapy skill set in this new environment. Elliot admits, “It was easier than I thought, and in retrospect, I spent way too much time overthinking it. It helps that physical therapy isn't just about touch. It often involves a lot of analysis of a person's movements, followed by developing, educating, and monitoring them doing their exercises.”

Because of the success LivinRite experienced with this patient, they have expanded the use of TeleVisits to their Medicare patients, providing in-person visits for OASIS assessment and to meet LUPA thresholds where appropriate, and opting for virtual visits anywhere they can.

Patient outcomes continue to be as good as their previous in person model with significant financial saving for the agency.

Tags: PDGM, Therapy, Home Health, Quality assurance, Telehealth, OASIS, 5-Day RAP Penalty, RAP

Kristi Bajer, BSN, RN, COS-C

Written by Kristi Bajer, BSN, RN, COS-C

Kristi Bajer BSN, RN, COS-C, brings over 10 years of real world experience as a clinician, director, and administrator in home health. She is a firm believer in diagnosis driven evidence-based care in home health. Currently, she assists agencies with external chart audits and Medicare appeals, as well as providing training and coaching on OperaCare implementation and building QAPI programs using data to drive success and protect agencies from government audits.