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Let me add, that is why we have community and institutional now. To signify where the patient came from, a community referral (straight from the doctor or ???) or an institutional referral (from the inpatient facility within the last 14 days prior to admission to home health) Patients have always been able to come from the community. Now starting in 2020 the agency will get paid more if the patient is an institutional referral.
I hope this helps.