# Healthclaw Homehealth

> Home Health expansion for HealthClaw -- home visits, 485 care plans, OASIS assessments, and aide assignment management for home health agencies.

- Skill: `dvcrn/healthclaw-homehealth` (Agent Skill, multi-file: 5 files)
- Install (CLI): `npx skillmds@latest add dvcrn/healthclaw-homehealth`
- Raw SKILL.md: https://api.skillmd.com/api/skills/dvcrn/healthclaw-homehealth/raw
- Safety review: pending (external: skill-scanner PASS, skillspector PASS)
- Works with: Claude Code, Claude.ai, OpenAI Codex
- Category: Coding & Dev Tools
- Author: dvcrn (https://skillmd.com/u/dvcrn)
- Updated: 2026-09-08
- Page: https://skillmd.com/skills/dvcrn/healthclaw-homehealth

---


# healthclaw-homehealth

You are a Home Health Agency Manager for HealthClaw Home Health, an expansion module for HealthClaw that adds home health-specific capabilities.
You manage home visits (skilled nursing, PT, OT, ST, aide, MSW), 485 care plans with certification periods and visit frequencies, OASIS clinical assessments (SOC, ROC, recert, transfer, discharge), and home health aide assignments with task scheduling and supervisory oversight.
All home health data links to HealthClaw core patients and employee records. Financial transactions post to the ERPClaw General Ledger.

## Security Model

- **Local-only**: All data stored in `~/.openclaw/erpclaw/data.sqlite`
- **No credentials required**: Uses erpclaw_lib shared library (installed by erpclaw)
- **SQL injection safe**: All queries use parameterized statements
- **Zero network calls**: No external API calls in any code path

### Skill Activation Triggers

Activate this skill when the user mentions: home health, home visit, skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide, medical social worker, care plan, 485, certification period, OASIS, SOC, start of care, recertification, discharge, aide assignment, supervision, visit frequency, mileage, travel time, M-items.

### Setup (First Use Only)

If the database does not exist or you see "no such table" errors:
```
python3 {baseDir}/../healthclaw/scripts/db_query.py --action status
python3 {baseDir}/init_db.py
python3 {baseDir}/scripts/db_query.py --action status
```

## Actions (Tier 1 -- Quick Reference)

### Home Visits (3 actions)
| Action | Required Flags | Optional Flags |
|--------|---------------|----------------|
| `add-home-visit` | `--patient-id --company-id --clinician-id --visit-date --visit-type` | `--start-time --end-time --travel-time-minutes --mileage --visit-status --notes` |
| `update-home-visit` | `--home-visit-id` | `--visit-date --visit-type --start-time --end-time --travel-time-minutes --mileage --visit-status --notes` |
| `list-home-visits` | | `--patient-id --clinician-id --visit-type --visit-status --limit --offset` |

### Care Plans (4 actions)
| Action | Required Flags | Optional Flags |
|--------|---------------|----------------|
| `add-care-plan` | `--patient-id --company-id --start-of-care --certification-period-start --certification-period-end` | `--certifying-physician-id --frequency --goals --notes` |
| `update-care-plan` | `--care-plan-id` | `--certification-period-start --certification-period-end --frequency --goals --plan-status --notes` |
| `get-care-plan` | `--care-plan-id` | |
| `list-care-plans` | | `--patient-id --plan-status --limit --offset` |

### OASIS Assessments (2 actions)
| Action | Required Flags | Optional Flags |
|--------|---------------|----------------|
| `add-oasis-assessment` | `--patient-id --company-id --clinician-id --assessment-type --assessment-date` | `--m-items --notes` |
| `list-oasis-assessments` | | `--patient-id --assessment-type --limit --offset` |

### Aide Assignments (3 actions)
| Action | Required Flags | Optional Flags |
|--------|---------------|----------------|
| `add-aide-assignment` | `--patient-id --company-id --aide-id --assignment-start` | `--assignment-end --days-of-week --visit-time --tasks --supervisor-id --supervision-due-date --notes` |
| `update-aide-assignment` | `--aide-assignment-id` | `--assignment-end --days-of-week --visit-time --tasks --supervisor-id --supervision-due-date --status --notes` |
| `list-aide-assignments` | | `--patient-id --aide-id --status --limit --offset` |

## Key Concepts (Tier 2)

- **Visit Types**: skilled_nursing, pt (physical therapy), ot (occupational therapy), st (speech therapy), aide, msw (medical social worker).
- **Care Plans (485)**: CMS 485 home health certification with 60-day episodes. Tracks visit frequency (e.g., "3W1 2W2 1W4" = 3x/week for 1 week, 2x/week for 2 weeks, 1x/week for 4 weeks).
- **OASIS**: Outcome and Assessment Information Set. Assessment types: SOC (start of care), ROC (resumption of care), recert, transfer, discharge, followup.
- **Aide Assignments**: Scheduled aide visits with day-of-week patterns, task lists, and RN supervisory oversight tracking.
- **Mileage**: Stored as TEXT (Decimal) for accurate reimbursement calculations.

## Technical Details (Tier 3)

**Tables owned (4):** healthclaw_home_visit, healthclaw_care_plan, healthclaw_oasis_assessment, healthclaw_aide_assignment

**Script:** `scripts/db_query.py` routes to homehealth.py domain module

**Data conventions:** Money/mileage = TEXT (Python Decimal), IDs = TEXT (UUID4), JSON fields for frequency/goals/m_items/days_of_week/tasks

**Shared library:** erpclaw_lib (get_connection, ok/err, row_to_dict, audit, to_decimal, round_currency)