The objective of the home health supervisory visit is to determine...

1. if the aide is following the careplan,
2. if the careplan is meeting the patient's needs,
3. if the patient/caregiver is satisfied with the careplan and the performance of the aide.

Ask open ended questions to get the patient/caregiver's true opinion. 

You want to avoid getting 'yes' or 'no' answers from the patient/caregiver and obtain an objective observation of what the aide is doing.

It's common for the patient/caregiver to want to prevent the aide from 'getting in trouble' if s/he is not performing tasks.  The patient/caregiver may feel the s/he will lose services if s/he complains.  Its important to ask questions correctly to get the true nature of services being provided.

To get the true picture...

Ask 'open-ended' questions:

• What time does the aide arrive?  (instead of 'Does the aide arrive at 8am like s/he is supposed to?')
• What time does the aide leave?  (instead of 'Does the aide stay the full 2 hours?')

To get the true picture of what the aide really does:

• What are the tasks that the aide performs? (instead of 'Does the aide help you with your bathing?  Does the aide do the laundry?')
• What would you like to change about the careplan? (instead of 'Are you happy with the careplan?')
• Do you want to keep the same aide or try someone new? (instead of 'Are you happy with your aide?')

The CoP rules for HHA supervisory visits...

• The every-two-week requirement for supervisory visits for patients receiving skilled care translates into at least once every 14 days.
• The home health aide, per federal regulations, does not have to be present for any supervisory visit for the patient who receives skilled care.  An agency must check state licensure requirements to determine whether there are any specific requirements.   
• A therapist can supervise the aide if the patient receives therapy as the only skilled service.
• There are no federal restrictions on the scope of supervision by a therapist.  If the aide is providing only personal care services, the therapist can still make the supervisory visits.
• The Conditions of Participation require a supervisory visit for patients receiving only personal care services at least once every 60 days.  Only a registered nurse can make these visits and the home health aide or personal care worker must be present and providing care.
• Neither a licensed practical nurse nor a therapy assistant can make supervisory visits.
• Only visits to the home, not telephone calls, fulfill the supervision requirements

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