TELEPHONY GUIDE FOR TELEPHONY VISIT STAFF

TELEPHONY OVERVIEW

Telephony Number: 1-866-858-4466

1. Telephony is an integrated Horizon program which allows visiting staff to document visits via an automated telephone line. Telephony allows specified visiting staff to: • Access visit information such as name, type of visit, tasks assigned and directions to the home. • Receive messages from the office. • Notify the office of arrival and departure time through the Interactive Scheduler program. • Document tasks performed during the visit including vital sign documentation and apply an electronic signature to the document. • Enter reasons as to why an assigned task was not completed.

2. In Telephony a service visit is a called a service ‘order’.

3. If you can’t make aTelephony call due to technical problems and you have not been notified that the Telephony system is down, notify your supervisor immediately.

4. If the telephony system is down, staff will revert back to the paper documentation. • A visit will either be documented electronically via telephony or the visit will be documented on paper.

5. Telephony visit staff will continue to complete and turn in a Home Health Encounter Form or ‘Daily.’ • The form will indicate the actual times for visits and travel. • The form should match the times entered into Telephony.

Passwords

1. The Telephony system requires each user to have a Telephony User ID and password. • Each Telephony user will be assigned a Telephony User ID. • Each Telephony user will select their password. Passwords have to be changed every 60 days .

2. The Telephony system will automatically notify the Telephony User when a password change is required,

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3. The Telephony password change voice prompt is misleading . The prompt states “Use any number up to 10 digits”, but the prompt is wrong.

4. Password instructions: • Use a password that has between 5-9 numbers. • Do not use 10 numbers for a password. • Do not use ‘0’ as the first number of the password. • Use a number that can be remembered easily. • Contact your supervisor if you have problems changing your password.

5. See also EVA instructions regarding the use of passwords and security.

Visit Schedule

1. Printed schedules/assignment will be given to visiting staff at least weekly.

2. The employee will be notified of any schedule changes.

3. Telephony users can check their schedule via telephony daily, if desired or as instructed.

4. When a telephony call is made, the telephony system will indicate the number of visits assigned/completed for the day. If the telephony system schedule is different from the printed schedule and you have not been notified of changes, you may need to call your supervisor. • Your subunit/office may choose to use the Telephony system to notify you of changes through the use of Telephony messaging or through the schedule maintained in Telephony. If these methods are used, then you will not need to call for every change.

5. Telephony works with the scheduling system so when a telephony arrival call is made, the scheduling programs indicates you are in the home by showing the visit as “In Progress”. When the departure call is made, the scheduling system shows the visit completed.

6. All schedule changes will be made immediately in the scheduling system so that visit staff will receive accurate information via telephony for their schedule read. Changes can’t be made to visits that are “In Progress”.

Visit Assignment

1. The Home Health Aide visit assignment is completed and printed from Horizon.

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• Exception: If the Home Health Aide is to visit on the same day as the admission, the Home Health Aide Assignment Sheet will be completed and left in the home for the Home Health Aide to use. • The Home Health Aide assignment will also be entered into Horizon for future visits. The Telephony Care Plan Worksheet will be printed and taken to the home.

2. The Telephony Care Plan is the part of Horizon used to assign visit tasks. The Telephony Care Plan Worksheet is the name of the printed form and will be used as the Home Health Aide written assignment.

3. The Telephony Care Plan Worksheet will be taken and left in the home for the visit staff, the patient and care person to use to view and understand the assigned tasks. • The Home Health Aide assignment will be updated at a minimum of every 60 days. • Each time the assignment changes, the Telephony Care Plan Worksheet will be printed and taken to the home .

Documentation of Assigned Tasks

1. The tasks heard when making the departure call match the tasks assigned on the Telephony Care Plan.

2. Documentation for assigned tasks will be marked with a ‘Status’ of either Completed or Not Completed.

3. Documentation for tasks ‘Not Completed’ will also have a ‘Reason Not Completed’ code listed.

4. Reason Code 70, Patient Refused, 71 Not Needed, and 72 Per Patient Request, should be used by the Home Health Aide.

Per Patient Request Tasks

1. Certain tasks designated as Per Patient Request (P.P.R.) do not have to be completed every visit if the patient requests that the task not be done. Ex: shampoo.

2. Per Patient Request tasks are designated with P.P.R. listed after the task.

3. Per Patient Request tasks in Horizon match the Per Patient Request task listed on the Telephony Care Plan/HBS-267, Home Health Aide Assignment Form.

4. Document P.P.R tasks that were not completed by using Reason Code 72, Per Patient Request. The Home Health Aide documentation for that task will read:

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Status: Not Completed Reason Not Competed: Per Patient Request

Baths

1. Only one type of bath can be assigned per the Conditions of Participation. Complete the bath type that is assigned by the RN. If the patient requests a different type of bath than the type assigned, call the office and report to the Supervisor/Nurse Care Coordinator. You must get a verbal OK to complete a different type of bath. • Complete a Code 500 report indicating the phone call and the change in the plan of care. • The RN giving the OK will also complete a case communication note and update the Home Health Aide assignment if applicable .

Tasks that Require Entry of Results

1. If the task requires the entry of results, the user is prompted between tasks to enter the information. • The Prompt will say: “501, Temperature.” • Hit the pound key, #, to complete the task. • After hitting the pound key, #, to complete the task, you will be prompted to enter the results. • All result entries are entered by using numbers on the phone keypad. • Example: Task is temperature that requires the entry of results.
Prompt says “501, Temperature.”
Hit the pound key, #.
Select the keys on the phone keypad that correspond with the actual temperature. For a temperature of 98.6, enter 9, 8, *, 6. Use the * key for the decimal point. Press #.
The system will read back the results and prompt for confirmation.
Select 1 to confirm and complete the task.

2. Task 549- Monitor and Record Date of Last BM requires the entry of a numeric date. • Enter the date as an 8 digit number. Example: September 4, 2010 would be entered as 09042010. • If the patient/care person cannot remember the date, as it has been over three days, enter 4 ‘0’s’ and complete a Case Communication/Code 500 report to inform the patient’s nurse care coordinator.

Example 1: You ask the patient when they last had a BM. The patient states yesterday. You document this task with yesterday’s date recorded as 8 numbers. (Ex:12022010)

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Example 2: You ask the patient when they last had a BM. The patient states last week but they cannot remember the exact date. Document this task as 0000 and complete a Case Communication/Code 500 Report to inform the Nurse Care Coordinator of the problem.

3. Task 551 ‘MD Visit Since Last HHA Visit’ requires entry of yes or no. • You ask the patient if they have been to the doctor since the last HHA visit was made. If the patient answers yes, respond with a 1. • If the patient answers yes you will have to notify the case manager by filling out a 500 form. • If the patient has not been to the MD, respond with a 2.

Case Communication/Home Health Aide Code 500 Report

1. The Code 500 Report serves as a case communication note and supplements the Telephony call.

2. Complete the report for attempted visits, when the patient condition needs reporting to the nurse, or when assigned tasks can’t be completed as noted below. • Report uncompleted tasks not designated as P.P.R. tasks each visit. • Report any patient problems or issues to the nurse care coordinator or supervisor verbally and document on the Code 500 report. • When participating in a patient’s case conference, report assigned tasks that the patient never lets you perform to promote patient specific task assignment.

Home Health Aide Assist Visit

1. The Home Health Aide assist visit will be scheduled in Horizon so that it is available from Telephony.

2. Make the arrival and departure call as per the service visit instructions.

3. The assist visit will not have a Telephony Care Plan associated with the visit so, no tasks codes will be present for the visit.

4. Skip the care plan tasks response by pressing the pound, #, key.

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MAKING TELEPHONY CALLS

SUMMARY

Horizon Telephony will be used to: • Electronically document Home Health Aide visits, attempted visits and travel time and mileage. • Check the daily visit schedule. • Obtain messages from the office.

ROLES

Telephony visit staff will use the Telephony system to document all visits and to receive messages unless the system is not functioning.

Telephony visit staff will make all arrival and departure calls from the patient’s home unless a phone is not available in the home. The supervisor will monitor all calls not made from the patient’s home and actual times the arrival and departure calls are being made.

PROCESS DOCUMENTING THE VISIT

CRITICAL ALERT: DO NOT HANG UP THE PHONE DURING A TELEPHONY CALL. ALWAYS END THE CALL BY SELECTING THE # KEY UNTIL EITHER A DIAL TONE OR “Thank you for calling Horizon Homecare Telephony” IS HEARD.

Making the Arrival and Departure Call

1. Completing a visit in Telephony consists of two parts, an arrival call and a departure call.

2. Once an arrival call has been made for a visit, then the departure call must be made for that patient before another arrival call for another visit can be made.

3. When possible, all arrival and departure telephony calls need to be made at the time of arrival to the home and departure from the home.

4. All Telephony calls need to be made from the patient’s home unless specific circumstances prevent this.

5. Arrival calls should be made on arrival to the patient’s home and departure calls should be made when leaving the patient’s home. Do not make these calls at the same time unless specific circumstances prevent this.

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6. Should circumstances arise that prevent calls from being made during the visit, the calls should be made as soon as possible after the visit.

7. The caller is allowed to attempt entry of data three times before the system terminates the call.

8. The message heard upon an invalid entry or retries is “Invalid entry. Please try your call again” or “Sorry you are having difficulty, please try your call again.” If you get either message, dial into the Telephony system again to complete the call. Call your supervisor for any unresolved problems.

9. A data error could be due to non-entry, incomplete entry, or erroneous entry.

10. Invalid entry responses occur in any of the following instances: • Invalid user entry. • Invalid entry match against the Horizon database or some other data invalidation. • A 30 second time out period occurred where no data was entered.

11. If you are in the middle of a phone call and you lose your place, stay on the line. The system voice prompt will respond by telling you where you are at in the call and prompt you for the next response.

12. Remember: Do not hang up the phone during a Telephony call. Always end the call by selecting the pound, #, key until either a dial tone or “Thank you for calling Horizon Homecare Telephony” is heard.

13. The Telephony operator will guide you through the process of making a call and documenting the visit. It is possible to initiate and complete the Telephony call by following the voice prompts. The following instructions are provided as a guide but they may not capture every situation encountered. Always follow the voice prompts as directed.

Basic Instructions for Making an Arrival Call

1. DIAL 1-866-858-4466 . The Telephony System will say “Thank you for calling Horizon Homecare Telephony.”

2. Enter your Employee ID followed by the pound, #, key.

3. Enter your Password followed by the pound, #, key.

4. If any messages are assigned, there will be a voice prompt at this point to listen to the assigned message. Listen to and confirm any messages by following the voice prompt.

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• If the message is not confirmed, it will remain assigned to the user and the user will be prompted to listen to it during the next call.

5. At the prompt, select Visit Processing by pressing 1.

6. The Telephony system will match the patient’s home phone number to the patient assignment for that day. If a match is found, the user is prompted with the patient’s name, ID, service description and the actual arrival date and time. If the information is correct, press 1 to accept the information. • If the information is accepted, the arrival is completed and the system will say “Thank you, your arrival information has been recorded and saved.” • The user is prompted to preview the care plan, if available. See number 14. • Can skip instructions 7-13 or use as needed if changes are needed to the defaulted arrival call information.

7. If no match is made to the schedule by the system, the call will proceed by prompting the user with the arrival date.

8. Record Arrival Date by pressing 1 to accept current date.

9. Once an arrival date is verified, a visit/order can be selected for arrival processing.

10. Select the appropriate Patient and Episode ID by pressing the pound, #, key.

11. The Arrival Time defaults to the current time. Press 1 to accept or press 2 to override. • Time should match time recorded on the Home Health Patient Encounter Form (HBS-286.) • Do not override the current time unless the Telephony call is being made later than the actual arrival time. • The Telephony system will not allow the user to enter a future time.

12. The system recognizes if the call is not being placed from the patient’s home phone. If applicable, record the reason for not calling from the Patient’s home phone, as prompted. • If the patient has no phone, press 1. • If the patient’s phone is not working, press 2. • For any other reason, press 3. • Your supervisor will monitor calls not made from the patient’s home. Notify your supervisor regarding reason code 3 as directed by the supervisor.

13. Save arrival call information by pressing the pound, #, key. The system will say “Thank you, your arrival information has been recorded and saved.”

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14. The Telephony Care Plan Worksheet/Home Health Aide Assignment Sheet will be left in the home in order to review tasks assigned. If desired the Telephony Care Plan (assignment) can be previewed from Telephony as desired. • Follow the prompts to preview the Telephony Care Plan using Telephony.

15. Exit Telephony by pressing pound, #, key.

Basic Instructions for Making the Departure Call

1. Complete the Home Health Aide Telephony Code 500 Report as needed.

2. Call the office if needed to report any immediate concerns related to abnormal vital signs or changes in the patients condition documented on the Code 500 Report.

3. DIAL 1-866-858-4466 . The Telephony System will say “Thank you for calling Horizon Homecare Telephony.”

4. Enter your Employee ID followed by the pound, #, key.

5. Enter your Password followed by the pound, #, key.

6. If any messages are assigned, there will be a voice prompt at this point to listen to the assigned message. Listen to and confirm any messages by following the voice prompt. • If the message is not confirmed, it will remain assigned to the user and the user will be prompted to listen to it during the next call.

7. After the system verifies the password, it checks for any visits with a status of ‘In Progress.’ If an ‘In Progress’ visit is found, the system initiates a departure call for that visit.

8. The system recognizes if the call is not being placed from the patient’s home phone. If applicable, record the reason for not calling from the patient’s home phone, as prompted. • If the patient has no phone, press 1. • If the patient’s phone is not working, press 2. • For any other reason, press 3. • Your supervisor will monitor calls not made from the patient’s home. Notify your supervisor regarding reason code 3 as directed by the supervisor.

9. Record Travel Time: Enter Service Code 2029, followed by the pound, #, key. • The System prompts you to enter Start/Stop time or Units.

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• Select 1 for entering Start and Stop time and record your travel time by entering the actual time it took to travel from the last patient’s home or your base/home to the present patient’s home. • Time entered into Telephony should match the Home Health Patient Encounter Form (HBS-286.)

10. Record Mileage: Enter Service Code 2001 followed by the # key. • Enter the total mileage from the last patient’s home or your base/home to the present patient’s home. • Example - 26.5 miles is entered as 26 *(star) 5. • Mileage entered into Telephony should match the mileage entered on the Home Health Patient Encounter Form (HBS-286).

11. Record Assigned Task Responses: Each task on the care plan requires a response during the Departure Call. The call cannot be completed until a response is provided for every assigned task.

12. Each task will be read by the voice prompt. After each task is presented, the user is prompted to respond as follows: • Specify completed by pressing the pound, #, key. • Specify not completed by entering a 2 digit reason code followed by the pound, #, key. • Reason codes that can be used are 70-Patient Refused, 71- Not Needed, 72- Per Patient Request. • See also sections Task Assigned and Case Communication/Home Health Aide Code 500 Report.

13. If the task requires the entry of results, the user is prompted between tasks to enter the information.

14. The system will notify the user when all tasks assigned are completed.

15. Enter any additional tasks associated with the visit. • If the Code 500 Report was needed, be sure to enter the 500 task code, indicating the Report was completed.

16. The system will ask the user if they want to review the information entered. Review as needed. • To review, add, or delete visit information press 1. • The voice prompt will speak back all information about the visit and allow the user to reenter/correct a task code. • If a task code was entered incorrectly, the system will announce that the task code has been deleted. • Reenter the correct task code. • If no additional task code is to be recorded, then enter “Code 550 Task Removed. “

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17. Record Departure Date: The departure date defaults to the recorded arrival date. Press 1 to accept the defaulted departure time.

18. Record Departure Time: The departure time defaults to the current time. Press 1 to accept or press 2 to override. • Time should match time recorded on the Home Health Patient Encounter Form (HBS-286). • Do not override the current time unless the Telephony call is being made later than the actual departure time. • The Telephony system will not allow the user to enter a future time.

19. Complete the departure call by pressing the pound, #, key after hearing the message, “Your departure information has been recorded and saved.” Always press the # key to end the call prior to hanging up the phone.

Making the End of the Day Call for Travel Time and Mileage

1. A call at the end of day will be needed so that travel time and mileage from the last patient to base or home can be recorded in Telephony.

2. Dial 1-866-858-4466. The system will say “Thank you for calling Horizon Homecare Telephony.’’

3. Enter Employee ID followed by the pound, #, key.

4. Enter Password followed by the pound, #, key.

5. After the greeting, Press 2 for non patient related activities, DO NOT press 1 for visit processing.

6. Enter the following Service Code: 2030 followed by the # key, to record Travel Time. • The system prompts you to enter Start/Stop time or units. • Select 1 for entering Start and Stop time and record your travel time by entering the actual time it tool to travel from the last patient’s home to base/home. • Time entered into Telephony should match the Home Health Patient Encounter Form (HBS-286.)

7. Enter 2002 followed by the # key to enter Mileage. • Press 2 to enter total units (mileage) after verifying correct begin and end date. • Enter the total units (mileage) from the last patient’s home to base/home. • Example: 26.5 miles is entered as 26 *(star) 5.

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• Mileage should match mileage recorded on the Home Health Patient Encounter Form (HBS-286).

8. Press the pound, #, key to save the information.

9. End the call by pressing the pound, #, key.

Telephony Messaging

1. ‘Telephony Messaging’ allows the office to send a voice message to the telephony user.

2. When a message is assigned in telephony, the next time a telephony call is made, the user will be prompted to listen to the voice message.

3. Once the user hears the message, telephony records the message as delivered.

4. The message is recorded as confirmed, when the user chooses this option after listening to the message.

5. The user has several choices after hearing the message: • Confirm the message. (The voice message will not be repeated on the next phone call.) • Skip confirmation. (The user will be prompted again to listen to the message on each phone call until the message is confirmed.) • Repeat the message. (The user can listen to the message again.) • Exit message review.

6. Follow the telephony prompts when using telephony messaging.

7. All messages need to be confirmed in order not to be prompted to listen to the recorded message on each phone call.

The Information Only Telephony Call Listening to the Daily Schedule

1. Telephony allows the user to listen to their schedule for the day and beyond.

2. Telephony users can also listen to the number of visits assigned, patient address, directions to the home, and the patient’s phone number.

3. Call the Telephony System to obtain the days schedule as directed or as desired before leaving home or at the first patient’s home.

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4. Dial 1-866-858-4466. The system will say “Thank you for calling Horizon Homecare Telephony. ’’

5. Enter Employee ID followed by the pound, #, key.

6. Enter your password followed by the pound, #, key.

7. After the greeting, listen and confirm any assigned messages.

8. Press 3 for schedule information.

9. Press 1 for a list of assigned visits for the date specified.

10. Confirm current date by pressing 1.

11. Follow the voice prompt to listen to the desired information.

12. The Telephony System will list all assigned orders for the day. • Every order will say “Scheduled at 12:00 midnight.” (see below exception). • Visits are not listed in a specific order. You will make your visits in the most appropriate order to conserve time and travel. • If the Home Health Aide is to meet the nurse for a Direct Aide Supervisory Visit, the Telephony System may give a specific time to make that visit so that you are in the patient’s home at the same time as the nurse.

13. After obtaining and listening to the desired information, press the pound, #, key.

Documenting the Attempted Visit

1. Dial 1-866-858-4466 . The system will say “Thank you for calling Horizon Homecare Telephony.’’

2. Enter your Employee ID followed by the pound, #, key.

3. Enter your Password followed by the pound, #, key.

4. After the greeting, press 2 for non patient related activity.

5. Enter the Service ID: 2027 HH Aide Attempted Visit.

6. Enter Begin Date.

7. Enter End Date.

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8. The Arrival Time defaults to the current time. Press 1 to accept or press 2 to override. • Time should match time recorded on the Home Health Patient Encounter Form (HBS-286.) • Do not override the current time unless the Telephony call is being made later than the actual arrival time. • The Telephony system will not allow the user to enter a future time.

9. Enter Start and Stop Time.

10. Enter Service Code 2030, followed by the pound, #, key to record Travel Time. • The System prompts you to enter Start/Stop time or Units. • Select 1 for entering Start and Stop time. • For Start Time: Record the time you started to travel to the (attempted) patient’s home from the last patient’s home or your base/home. • For Stop Time: Record the time you arrived at the present patient’s home. • Time entered into Telephony should match the Home Health Patient Encounter Form (HBS-286).

11. Enter Service Code 2002 followed by the pound, #, key to record Mileage. • Mileage will be entered in units. • Enter the total mileage from the last patient’s home or your base/home to the (attempted) patient’s home. • Example - 26.5 miles is entered as 26 *(star) 5. • Mileage entered into Telephony should match the mileage entered on the Home Health Patient Encounter Form (HBS-286).

12. Complete the Home Health Aide Code 500 Report and turn in with the Encounter Form.

13. Complete the call by pressing the pound, #, key. Always press the pound, #, key to end the call prior to hanging up the phone.

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