Glossary
A home health scheduling glossary, in plain words.
Medicare paperwork, agency shorthand and routing mathematics all land on the same schedule. Each term defined simply, with what it means for the shape of your day and week.
Home health scheduling borrows words from three places at once: Medicare paperwork, agency operations and the mathematics of routing. A new nurse, therapist, aide or scheduler hears "recert due", "LUPA risk" and "that window is hard" in the same morning huddle, and nobody stops to define them. This glossary explains each term in plain words and says what it means for the shape of a day or a week. Payment and compliance rules change and differ by payer and state, so treat the regulatory entries as orientation, not as guidance; your agency's policies and cms.gov are the sources to check.
Admission, assessment and the episode
| Term | What it means | Why the schedule cares |
|---|---|---|
| Referral | The request to admit a patient, usually from a hospital, physician or facility, often arriving by fax. | The clock to the first visit starts here. See what a referral fax costs you. |
| SOC (start of care) | The first billable visit and comprehensive assessment. | Commonly expected within 48 hours of referral or discharge home, or on a date the physician orders; it is often the longest visit of the week. |
| ROC (resumption of care) | The assessment when a patient comes home after an inpatient stay. | Usually due soon after the patient returns, so it arrives unplanned and has to be fitted into a day already set. |
| Recert (recertification) | Re-assessment at the end of a 60-day certification period, for patients continuing care. | Generally falls in a short window near the end of the period (commonly the last five days), so it is a dated task, not a floating one. |
| OASIS | The Outcome and Assessment Information Set: the standard data set Medicare-certified agencies collect at certain time points. | An OASIS visit runs much longer than a routine one. Planning it as a normal slot is how a day overruns. |
| Plan of care | The physician-signed plan listing disciplines, visit frequencies and goals (historically on form CMS-485). | It is the source of every frequency order on the week. |
| NOA (notice of admission) | A Medicare filing that tells the payer a home health period has started. | An office deadline after the SOC rather than a field task, but a late SOC visit pushes it. |
Frequency and payment words
- Frequency order (2w4, 3w2, 1w8). Visits per week for a number of weeks: 2w4 is two visits a week for four weeks. It is a promise about the week, which is why the week has to be planned before the day. Therapy orders are covered in home health physical therapy scheduling.
- PRN visit. "As needed": a visit ordered for a condition, such as a catheter problem, rather than on a fixed frequency. It cannot be planned, only made room for.
- Missed visit. An ordered visit that did not happen. Agencies usually require a note and a physician notification; the schedule's job is to make up the visit within the same week where possible.
- PDGM. The Patient-Driven Groupings Model, Medicare's home health payment system since 2020, which pays in 30-day periods inside the 60-day certification.
- LUPA. A low utilization payment adjustment: when a 30-day period has fewer visits than a threshold for its group, it is paid per visit instead. This is why an office worries when visits are cancelled late in a period. The thresholds vary; check current CMS rules.
- Per-visit pay vs salary. Many clinicians are paid per visit, which makes the drive between visits unpaid time in practice. See scheduling for independent contractors.
Field and operations words
- EVV (electronic visit verification). A federally required system, implemented differently by each state, that records the time and place of Medicaid-funded personal care and home health visits. Obillions is not an EVV vendor; most agencies use a state-approved system alongside their scheduling. More in the aide scheduling guide.
- IDT / IDG. The hospice interdisciplinary team (or group): nurse, physician, social worker, chaplain, aide and others, who review each patient's plan on a regular cycle. See hospice scheduling.
- Territory. The area a clinician covers. A tight territory is the single biggest saving in driving.
- Windshield time. Time spent driving between visits. It is real work time and often unpaid; the Windshield Tax calculator puts a number on it.
- Mileage reimbursement. What an employer pays per mile driven for work. Some states require it; the IRS standard rate is a common reference, but rates and rules vary, so check irs.gov and your state. This is not tax advice. See mileage reimbursement.
Routing words
- Time window. The earliest and latest a visit may start. A hard window cannot be broken (insulin before breakfast, a timed draw); a soft one is a preference. See time windows.
- Fixed or agreed time. A time the patient has been told. It is a promise, unlike a suggested time, which is still a draft. See confirmed vs suggested.
- TSP. The travelling salesperson problem: the shortest order to visit a set of places once. A day with no windows is roughly this.
- VRPTW. The vehicle routing problem with time windows: the same question with windows, visit lengths, a break and a shift end. It is what a home health day actually is, and why sorting by address alone fails.
- Dropped visit. A visit the route cannot hold without breaking a window or the shift. A good planner says so with a reason rather than hiding it.
- Clustering. Putting patients who live near each other on the same day. It is decided at the week level, before any single day is ordered, as in how to plan a route by hand.
If you want software that speaks this language, with windows, frequencies, agreed times and the drive in one place, see home health scheduling software. Obillions is in private testing on iPhone, and none of this glossary needs it.
Questions people actually ask
What does 2w4 mean in home health?
It is a frequency order: two visits a week for four weeks. Other common forms are 3w2 (three a week for two weeks) and 1w8. The plan of care sets them, and the weekly schedule has to meet them.
What is the difference between SOC and ROC?
SOC is the start of care, the first visit and comprehensive assessment when a patient is admitted. ROC is the resumption of care, the assessment when an existing patient comes home after an inpatient stay. Both are usually longer than routine visits and have timing expectations; check your agency's policy.
When is a recertification visit due?
Generally near the end of each 60-day certification period, commonly within its last five days, for patients who continue care. The exact rules come from CMS and your agency, so confirm the window with your office.
What is a LUPA and why does the office worry about it?
A low utilization payment adjustment applies when a 30-day period has fewer visits than a threshold, and the period is then paid per visit. A late cancellation can tip a period under it, which is why offices try to make missed visits up. Thresholds vary and change; check current CMS rules.
Is EVV the same as scheduling software?
No. EVV records when and where a visit happened, and is required for many Medicaid-funded visits, with each state choosing how. Scheduling software plans which visits happen when. Many agencies use both, side by side.
What is VRPTW in plain words?
The vehicle routing problem with time windows: finding the order and timing of visits that drives least while keeping each visit inside its window and the day inside the shift. It is the mathematical name for planning a home health day.
Obillions
A voice agent for a day of visits. You say what changed and the day re-plans itself: the order, the drive times, and who nearby could take the hour a cancellation just freed. Nothing changes until you confirm, and your voice and photos never leave your phone.
In private testing now. A public TestFlight comes next, then the App Store.