Name of the Procedure:

Direct Skilled Nursing Services of a Registered Nurse (RN) in the Home Health or Hospice Setting

• Common Name: Home Health Nursing, Hospice Nursing
• Technical/Medical Term: HCPCS Code G0299

Summary

This procedure involves a registered nurse (RN) providing direct, skilled nursing care to patients in their own homes or in hospice settings. Each session of care is measured in 15-minute increments.

Purpose

The procedure is designed to manage and support patients with medical needs who are homebound or receiving end-of-life care in a hospice. The goals are to ensure patients receive appropriate medical care, support patient comfort, manage symptoms, administer medications, and provide education to patients and family members.

Indications

• Chronic illnesses requiring ongoing medical management
• Post-operative recovery that necessitates professional nursing care
• Terminal illnesses where hospice care is required
• Conditions like heart failure, respiratory diseases, diabetes, and neurological disorders where skilled monitoring and intervention are crucial

Preparation

• No specific patient preparation required for each session.
• Prior to the initiation of home health or hospice services, an initial comprehensive assessment is typically conducted by a healthcare provider.
• Patient-specific care plans are developed based on medical history, current health status, and specific needs.

Procedure Description

1. Assessment: The RN conducts an initial and/or ongoing assessment of the patient’s condition.
2. Care Delivery: The RN provides care which may include wound dressing changes, administration of intravenous or oral medications, monitoring of vital signs, symptom management, and other skilled nursing tasks.
3. Education: The RN educates the patient and their family about managing the condition, medications, and any necessary lifestyle changes.
4. Documentation: Detailed records of care provided and the patient’s progress are maintained.

Tools, Equipment, or Technology:

• Medical supplies such as dressings, syringes, and IV equipment
• Medication
• Monitoring devices (e.g., blood pressure cuffs, glucose meters)

Anesthesia or Sedation:

• Not applicable for this procedure.

Duration

Each visit or session is billed per 15 minutes of care provided. The total duration varies based on the patient’s needs and care plan.

Setting

The procedure is performed in the patient’s home or hospice setting.

Personnel

• Registered Nurse (RN)

Risks and Complications

• Minimal risks directly associated with the procedure.
• Potential for adverse reactions to medications.
• Risk of infection at wound sites or IV lines if not managed appropriately.

Benefits

• Personalized and compassionate care in a comfortable, familiar environment.
• Management of symptoms and improvement in the quality of life.
• Education and support for patients and families.
• Reduced need for hospital admissions and emergency room visits.

Recovery

• Continuation of home health or hospice care as needed, based on the patient’s condition.
• Regular follow-up visits scheduled as per the care plan.
• Adherence to prescribed medications and care instructions.

Alternatives

• Hospital or outpatient clinic visits for nursing and medical care
• Assisted living facilities or nursing homes for more comprehensive long-term care
• Self-care or family-provided care with periodic professional support
• Each alternative varies in terms of cost, comfort, convenience, and the level of medical expertise available.

Patient Experience

• Patients typically experience a higher level of comfort receiving care at home.
• Any procedures performed (like blood draws or IV administration) might cause some discomfort, which the RN will manage effectively.
• Emotional support is a significant component, aiding in a positive patient experience and mental well-being.