Provider Questions

Provider Questions: 

1) An HHA asked how to answer questions on the DC from the agency assessment, particularly the health literacy question when the nurse does not go to the patient's home to complete the assessment. The example given was when the insurance and/or doctor said no more visits are needed/approved and the HHA reaches out to the patient to ask if they could return to the patient’s home one more time to complete the DC assessment (and informs them they would be billed privately for this), the patient often declines to have the nurse return.  

In this situation and for questions like A1250: Transportation, would the proper response be ‘patient unable to respond’ or ‘patient declines to respond’?  A dash is not a valid response for this item.   

My thoughts are the response ‘patient unable to respond’ means exactly that.  The patient was asked but could not respond for whatever reason.  I don’t feel this would be a proper response to this situation.  If the patient was asked to allow the nurse to return to do the assessment and the patient declines to allow this, wouldn’t the best response be if the patient declines to respond? 

2) Can a recertification be submitted outside the last 5 days of a certification period (days 56-60)?