Which visit is the first visit establishing patient care eligibility?

• A. RN Assessment Visit
• B. Start of Care Visit
• C. Documentation Requirement
• D. Insurance Change

Answer: (B)

The first visit that officially starts a home health episode and establishes eligibility for care is the Start of Care visit. This visit is when the agency confirms medical necessity for skilled services, verifies the patient’s homebound status, and initiates the plan of care with the appropriate physician orders and payer documentation. It sets the formal beginning of the home health services episode and ties together the assessment data (often including the initial OASIS) with the justification for services to eligible payers.

The RN Assessment Visit can be part of the initiation process, but the Start of Care is the formal step that establishes eligibility and begins care. A documentation requirement or an insurance change is not a patient visit and does not by itself establish eligibility for ongoing home health services.