“Tis the Season"
By Christina DeFrancisco, DNP, APN, FNP, CWS
It’s that time again to make a list and check it twice! No, I’m not talking about Christmas and Santa coming to town. Now is the time to make your list of residents requiring an Annual Wellness Visit (AWV) before the end of the year!
*Deep breath in* I know what you’re thinking; how do I perform an Annual Wellness Visit in long-term care for my residents and make it meaningful? Let’s discuss this more.
As a result of the Affordable Care Act, Medicare will cover an Annual Wellness Visit on eligible patients with no additional cost as of 2011. The goal of the AWV is to analyze patient information which includes medical and family history, health risk assessment, and screening information to then formulate a personalized preventative plan and complete advance care planning.
Before exploring how to approach this within the long-term care population let’s discuss the who, what, when, and why of AWVs:
Who - Physicians (Doctor of Medicine or Osteopathy), physician assistants, nurse practitioners, certified clinical nurse specialists, and allied medical professionals (to include health educators, registered dietitians, nutrition professionals, or other licensed practitioners as part of the medical professional team) can complete an Annual Wellness Visit.
What - This resident-specific preventative plan is formulated via thorough review of the following components of the medical record: demographic information, health risk assessment, health status overview, assessment of psychosocial and behavioral risks, activities of daily living, medical and family history, current providers and suppliers, vital signs, screening assessments (e.g., depression, cognitive, falls risk, substance use disorder), and safety. Additionally, as part of the safety evaluation, a hearing impairment screening is performed with all initial Annual Wellness Visits.
By analyzing this data, a personalized preventative plan is created, which includes screening schedules, risk factors, interventions, health advice, and referrals when appropriate. I encourage you to visit the Medical Learning Network - Medicare Wellness Visit to learn more about the specific requirements of initial and subsequent AWV visits.
