St. Mary’s at Home Service Area: Vanderburgh Warrick Posey Gibson Dubois Perry Spencer
Resource Guide
St. Mary’s At Home St. Mary’s Medical Equipment
St. Mary’s Medical Equipment Service Area: Indiana: Vanderburgh Warrick Posey Gibson Dubois Perry Spencer Kentucky: Henderson
stmarys.org/homecare | stmarys.org/medequip
stmarys.org/homecare stmarys.org/medequip
Item# 4042/MISC (rev. 06-16)
St. Mary’s At Home 6840 Logan Drive | Suite F | Evansville, IN 47715 Phone: 812.774.9760 | Fax: 812.475.1739
ST. MARY’S MEDICAL EQUIPMENT Notes:___________________________________________________________ _________________________________________________________________
• • • •
Intermittent in home skilled care Nurse on-call 24/7 Nursing visits provided in the evening Nursing visits provided on the weekends and holidays
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________
In Home Services Provided by St. Mary’s At Home Skilled Nursing • Assessments and evaluations • Disease process education and compliance assessment • Procedures and treatment (example - wound Care, catheter care) • Infusion therapy
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________
Physical Therapy/Occupational Therapy/Speech Therapy • Gait training • Home safety • Strengthening • Dysphagia • Endurance • Cognitive • Balance • Post orthopedic surgery • Transfers
_________________________________________________________________
Home Health Aide • Personal care in conjunction with skilled care
_________________________________________________________________
_________________________________________________________________ _________________________________________________________________
_________________________________________________________________ Social Worker Dietician Potential Referrals for Home Care • Medication related issues - multiple medications/prescribers • New diagnosis management and education • Chronic disease management and education • Post surgical patients • Patients with wounds/drains/catheters/feeding tubes • Infusion therapy • Patient with decline in mobility/ADL’s or recent fall • Home safety evaluation and assessment • Reconciliation • Education/compliance assessment • Hospital skilled care transition back to home
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
ST. MARY’S MEDICAL EQUIPMENT Enteral Feeding Call 485.4600 to order or Fax Order to 485.6513. 1. The detailed written order must include: • Qualifying diagnosis- long term >90 days, chronic illness or trauma or permanent damage to an internal body organ or function. There must be a functional impairment to the digestive or alimentary tract (mouth, esophagus, stomach, intestines or anus) • The enteral feeding must be the patient’s only source of nutritionsupplemental feedings are NOT covered. • Route for feeding • Name of feeding • Amount of feeding to be given daily • Documented reason for pump- nausea and vomiting, diarrhea and blood sugar • If no pump needed, will need to state bolus or gravity • Patient’s height and weight • Rate of pump and hours/day
Nebulizers Available at all of the St. Mary’s Medical Equipment locations. 1. Face to Face: Prescriber must provide a copy of the F2F examination (office note, H&P) stating that the F2F occurred within six months prior to the date of the prescription. • The F2F examination must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the DME item ordered. • The prescriber must provide a copy of the F2F examination and the prescription for the item to the DME BEFORE the item is delivered 2. The Detailed written Order Must include: • Qualifying diagnosis must be a chronic lung condition (example: COPD, chronic bronchitis, asthma). Nebulizers are NOT coverd by Medicare for acute bronchitis, wheezing, pneumonia, etc. • What is the medication being prescribed? • How many times a day is the neb to be used with Medication? • Note: Medication cannot be obtained at DME. The patient must pick up nebulizer medications from a pharmacy. • Patient’s height and weight
St. Mary’s Medical Equipment Call 485.4600 to make a referral stmarys.org/medequip
Mobility Items • Canes • Walkers • Rollators • Transport chairs • Wheelchairs • Crutches • Knee walkers • Hospital beds • Lift chairs Mobility Accessories • Assistive mobility devices for cars, chairs, and beds • Cane grips • Cane tips • Walker skis • Walker baskets • Walker bags • Walker glide caps • Walker/Rollator cup and cane holders Braces • Back, knee, ankle, elbow and wrist Mother and Baby Care Items • Breast pumps • Breast pump accessories including breast shields, tubing, cleaning wipes, milk bags,lanolin cream, and more. • Diapers • Diaper bags and accessories • Swaddles • Baby/infant apparel • Baby socks • Baby blankets • Pacifier lanyards • My Breastfriend nursing pillows • Baby formula • Bulb syringes • BiliLights • Matriarch brace
Personal Care Equipment • Handheld shower devices • Shower chairs • Shower/transfer benches • Bedside commodes • Elevated commode seats • Grab bars • Bath sponges • Reachers • Leg lifters • Hip kits • Elastic shoe strings • Compression hose and socks Wound Care • Gloves • Alcohol wipes • Wound cleanser • Telfa • 4x4 gauze • 2x2 gauze • Cotton tip applicators • Abdominal pads • Kerlix or softroll • Tape • Tubigrip Respiratory Aids • CPAP/BIPAP and supplies • Nebulizers • Oxygen • Aeresol/trach supplies Other • Pulse oximeters • Biofreeze • Blood pressure cuffs • Medication dispensers • Medical alert bracelets Many items not listed.
St. Mary’s Medical Equipment Four Convenient Sites 485.4600 | stmarys.org/medequip
ST. MARY’S MEDICAL EQUIPMENT Hospital Beds (continued) • The prescriber must provide a copy of the F2F examination and the prescription for the item to the DME BEFORE the item is delivered 2. The detailed written order must include: • Qualifying diagnosis- CHF, COPD, or problems with aspiration a. Need to have patient’s head elevated >30 degrees. b. Pillows/wedges tried and failed c. Positioning needed for pain relief d. Equipment needed does not attach to regular bed e. Change in body position must be immediate f. Varying height of bed is necessary for bed to chair transfers • Conditions must last longer than one month • Total electric beds are NOT covered by Medicare
CPAP/Bi-PAP Coverage Call 485.4600 to order or Fax Order to 485.6513. Qualifications:
100 St. Mary’s Epworth Crossing Suite A 001 Newburgh, IN 47630 6840 Logan Drive Suite E Evansville, IN 47715 3700 Washington Avenue Evansville, IN 47714 2345 West Franklin Street Suite 102 Evansville, IN 47712
1. Face to Face: Prescriber must provide a copy of the F2F examination (office note, H&P) stating that the F2F occurred within six months prior to the date of the prescription. • The F2F examination must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the DME item ordered. • The prescriber must provide a copy of the F2F examination and the prescription for the item to the DME BEFORE the item is delivered. 2. The detailed written order must include: • Qualifying Diagnosis a. OSA for CPAP b. OSA, COPD, hypoventilation syndrome, restrictive thoracic disorders, central sleep apnea or complex sleep apnea for BiPAP • A sleep study is REQUIRED for ALMOST every diagnosis. • Patient’s height and weight • Spirometry, overnight oximetry, and ABG testing may be required for diagnosis other than those Apnea related. • Specific questions about coverage can be called to the Medical Equipment Respiratory Care Services area at 485.4600
ST. MARY’S MEDICAL EQUIPMENT
ST. MARY’S MEDICAL EQUIPMENT
Bedside Commode
Medicare Criteria for Equipment as follows.
Available at any of the St. Mary’s Medical Equipment locations.
Note: Medicare Managed, Commercial and Medicaid may additionally require a prior authorization prior to dispensing of any equipment.
1. The Detailed written order must include: • Qualifying diagnosis • Patient is confined to a single room or to a single level of the home and there is no bathroom on the that level or the patient is confined to a home without bathroom facilities • Patient’s height and weight
Oxygen Call 485.4600 to order or fax order to 485.6513. Note: Oxygen is prescriptive so the order should be very specific, like a medication. Qualifications:
CPM Call 485.4600 to order or Fax Order to 485.6513. Qualifications: Z96.651 R Knee Z96.652 L Knee Medicare only covers for total knee replacement 1. • • • • • • •
The detailed written order must include: Qualifying diagnosis Date of surgery (only paid for 21 days post operative) Was the CPM placed within 24 hours of surgery? Needs copy of notes when 1st applied Site of surgery (Left or Right) Specific range flexion and extension How many hours/day Patient’s height and weight
Hospital Beds Call 485.4600 to order or Fax Order to 485.6513. Qualifications: 1. Face to Face: Prescriber must provide a copy of the F2F examination (office note, H&P) stating that the F2F occurred within 6 months prior to the date of the prescription • The F2F examination must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the DME item ordered. (continued next page)
1. Face to Face: Prescriber must provide a copy of the F2F examination (office note, H&P) stating that the F2F occurred within 30 days prior to the date of the prescription. • The F2F examination must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the DME item ordered. • The prescriber must provide a copy of the F2F examination and the prescription for the item to the DME BEFORE the item is delivered 2. Respiratory or cardiac diagnosis 3. Pulse oximetry: • All oximetery must occur within 48 hours of discharge from hospital/ nursing home or within 30 days from outpatient setting. • Results: Must be =90 days, chronic illness or trauma or permanent damage to an internal body organ or function. There must be a functional impairment to the digestive or alimentary tract (mouth, esophagus, stomach, intestines or anus) • The enteral feeding must be the patient’s only source of nutritionsupplemental feedings are NOT covered. • Route for feeding • Name of feeding • Amount of feeding to be given daily • Documented reason for pump- nausea and vomiting, diarrhea and blood sugar • If no pump needed, will need to state bolus or gravity • Patient’s height and weight • Rate of pump and hours/day
Nebulizers Available at all of the St. Mary’s Medical Equipment locations. 1. Face to Face: Prescriber must provide a copy of the F2F examination (office note, H&P) stating that the F2F occurred within six months prior to the date of the prescription. • The F2F examination must document that the beneficiary was evaluated and/or treated for a condition that supports the need for the DME item ordered. • The prescriber must provide a copy of the F2F examination and the prescription for the item to the DME BEFORE the item is delivered 2. The Detailed written Order Must include: • Qualifying diagnosis must be a chronic lung condition (example: COPD, chronic bronchitis, asthma). Nebulizers are NOT coverd by Medicare for acute bronchitis, wheezing, pneumonia, etc. • What is the medication being prescribed? • How many times a day is the neb to be used with Medication? • Note: Medication cannot be obtained at DME. The patient must pick up nebulizer medications from a pharmacy. • Patient’s height and weight
St. Mary’s Medical Equipment Call 485.4600 to make a referral stmarys.org/medequip
Mobility Items • Canes • Walkers • Rollators • Transport chairs • Wheelchairs • Crutches • Knee walkers • Hospital beds • Lift chairs Mobility Accessories • Assistive mobility devices for cars, chairs, and beds • Cane grips • Cane tips • Walker skis • Walker baskets • Walker bags • Walker glide caps • Walker/Rollator cup and cane holders Braces • Back, knee, ankle, elbow and wrist Mother and Baby Care Items • Breast pumps • Breast pump accessories including breast shields, tubing, cleaning wipes, milk bags,lanolin cream, and more. • Diapers • Diaper bags and accessories • Swaddles • Baby/infant apparel • Baby socks • Baby blankets • Pacifier lanyards • My Breastfriend nursing pillows • Baby formula • Bulb syringes • BiliLights • Matriarch brace
Personal Care Equipment • Handheld shower devices • Shower chairs • Shower/transfer benches • Bedside commodes • Elevated commode seats • Grab bars • Bath sponges • Reachers • Leg lifters • Hip kits • Elastic shoe strings • Compression hose and socks Wound Care • Gloves • Alcohol wipes • Wound cleanser • Telfa • 4x4 gauze • 2x2 gauze • Cotton tip applicators • Abdominal pads • Kerlix or softroll • Tape • Tubigrip Respiratory Aids • CPAP/BIPAP and supplies • Nebulizers • Oxygen • Aeresol/trach supplies Other • Pulse oximeters • Biofreeze • Blood pressure cuffs • Medication dispensers • Medical alert bracelets Many items not listed.
St. Mary’s At Home 6840 Logan Drive | Suite F | Evansville, IN 47715 Phone: 812.774.9760 | Fax: 812.475.1739
ST. MARY’S MEDICAL EQUIPMENT Notes:___________________________________________________________ _________________________________________________________________
• • • •
Intermittent in home skilled care Nurse on-call 24/7 Nursing visits provided in the evening Nursing visits provided on the weekends and holidays
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________
In Home Services Provided by St. Mary’s At Home Skilled Nursing • Assessments and evaluations • Disease process education and compliance assessment • Procedures and treatment (example - wound Care, catheter care) • Infusion therapy
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________
Physical Therapy/Occupational Therapy/Speech Therapy • Gait training • Home safety • Strengthening • Dysphagia • Endurance • Cognitive • Balance • Post orthopedic surgery • Transfers
_________________________________________________________________
Home Health Aide • Personal care in conjunction with skilled care
_________________________________________________________________
_________________________________________________________________ _________________________________________________________________
_________________________________________________________________ Social Worker Dietician Potential Referrals for Home Care • Medication related issues - multiple medications/prescribers • New diagnosis management and education • Chronic disease management and education • Post surgical patients • Patients with wounds/drains/catheters/feeding tubes • Infusion therapy • Patient with decline in mobility/ADL’s or recent fall • Home safety evaluation and assessment • Reconciliation • Education/compliance assessment • Hospital skilled care transition back to home
_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
St. Mary’s at Home Service Area: Vanderburgh Warrick Posey Gibson Dubois Perry Spencer
Resource Guide
St. Mary’s At Home St. Mary’s Medical Equipment
St. Mary’s Medical Equipment Service Area: Indiana: Vanderburgh Warrick Posey Gibson Dubois Perry Spencer Kentucky: Henderson
stmarys.org/homecare | stmarys.org/medequip
stmarys.org/homecare stmarys.org/medequip
Item# 4042/MISC (rev. 06-16)
