Homecare Service Acceptance Statement

VNA of Hanover & Spring Grove – Home Health & Hospice Services

The VNA of Hanover & Spring Grove accepts applicants for home health services based on a standardized review process to ensure we have the capacity, resources, and competencies to meet each patient’s needs. All admission decisions are made in accordance with federal regulations, including 42 CFR § 484.105(i), and the Pennsylvania Department of Health requirements for homecare agencies.

Admission Criteria

Patients are accepted when there is a reasonable expectation that:

• The patient’s medical, nursing, therapeutic, and psychosocial needs can be safely and adequately met in their home environment.
• The requested services fall within the agency’s licensed and resourced scope of care.
• The patient’s residence lies within the agency’s approved geographic service area.
• A qualified provider (MD, DO, PA, CRNP, or CNS) agrees to oversee the plan of care and provide timely medical orders.
• All payer and authorization requirements are met prior to the initiation of care.
• The patient meets medical necessity criteria including homebound status and skilled need, and a face-to-face encounter has occurred or is scheduled, if required.

Care and Service Limitations

The VNA does not provide the following services:

• Care for individuals under the age of 18
• Psychiatric or behavioral health homecare
• Ventilator-dependent patient care
• Twice-daily visits when no caregiver is available to assist
• Administration or management of:
  • Blood or blood products
  • IV chemotherapy agents
  • First-dose IV antibiotics (unless anaphylaxis orders and medications are available in the home)
  • New/recent tracheostomy care (<1 year)
  • Lymphedema management

The VNA may limit or decline services based on current staffing, caregiver availability, or clinical resources for the following:

• Speech therapy services (limited availability)
• Established tracheostomy and ventilator support (>1 year)
• Total parenteral nutrition (TPN)
• High-frequency injectable medication administration (unless teachable caregiver is available)
• IVIG or other specialty medications requiring advanced competencies
• Complex care such as negative pressure wound therapy, PleurX catheter management
• Interpreter needs that cannot be met through telephonic or certified resources
• High utilization patients whose care would exceed the agency’s Medicare outlier threshold
• Skilled or aide services in remote/outlying areas, even if within licensed boundaries

Home Environment Expectations

To ensure safety:

• The patient’s residence must be free from hazards and safe for both the patient and staff.
• Pets must be appropriately confined during all home visits to allow staff to safely provide care without interference.
• A caregiver must be available if the patient is not safe to be left unattended.

Non-Discrimination Policy

In accordance with federal law (45 CFR Parts 80, 84, and 91) and the Pennsylvania Human Relations Act, the VNA of Hanover & Spring Grove does not discriminate based on race, color, national origin, religion, sex, age, disability, sexual orientation, gender identity, citizenship, or source of payment. We do not deny admission based on communicable disease status, including HIV, MRSA, or Hepatitis B.

Referral Process

Referrals are reviewed upon receipt through phone, fax, secure email, or electronic portals (Epic, MatrixCare, etc.). Each referral is evaluated based on:

• Clinical complexity
• Staffing levels and competencies
• Current agency caseload and case mix
• Available caregiver support in the home

If the patient’s needs align with agency capacity, care is initiated and coordinated promptly. If not, the referring provider will be notified, and alternative recommendations may be provided.

Public Access

For more information or to inquire about eligibility for home health or hospice services, please contact our Intake Department. We welcome the opportunity to support patients and families with compassionate, high-quality care in the home.