War-game a visit frequency cut by proving each schedule lane has a named owner, a measured age-out, and a reverse path before draft clocks start governing every home care visit plan.
Visit frequency cuts fail when "reduced" means a status without a decision artifact, when teams dual-count a draft schedule as both aspirational and live, and when high-acuity visit families still pin to one thin coordinator because the lane inventory is incomplete. The review needs one written inventory of visit lanes, one owner who can deny a risky shortcut, and a documented consequence when a failed cut ages past the deadline.
Freeze one visit family first
State which visit families the cut covers, the effective date, which schedule lanes change, how versions are stored, and what happens to patients already in flight. Name the agencies that feel it first and the care promises that depend on coherent visit handling. If the memo mixes a visit frequency cut with a home health hand-off and a rehab length target, split them.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed lane, agency gap, or patient deadline that would force a visit frequency rollback within a stated window.
| Lane | Owner | Age-out | Reverse path |
|---|---|---|---|
| Skilled nursing visit | Named coordinator | Measured days | Documented restore |
| Therapy visit | Therapy ops | Measured days | Documented restore |
| High-acuity dual visit | Care management | Measured days | Documented escalate |
Fill the table from stored exports, not from memory. Empty cells are blockers, not notes for later.
Failures to surface before go-live
- A high-acuity visit class stays soft while the aggregate frequency dashboard stays green.
- Two teams claim the same lane ownership and neither can force a freeze at week end.
- A restore has already left a case without a trusted visit state.
- The primary frequency export lags beyond the planned observation window.
- An operator skips a visit gate because a payer cutoff is near.
For each failure, require detection time, agency impact, containment, and the authority to force a visit frequency cut rollback. Commands and export links belong in the runbook.
Hostile chairs on the schedules
Feed Pingpong the cut memo, the lane exhibits, and seating briefs for home care ops, care management, therapy ops, and utilization review. First pass steelmans the cut. Later passes attack from those seats. Final pass turns surviving objections into phased lane rules, mitigations, or a changed recommendation. Agreement across passes is not proof. Keep the objections that still have evidence gaps.
Pair with the home care ops lead seat, a home health hand-off, a rehab length target, and the care management lead seat. More operating decisions live in the war-game decisions hub.
Ship the cut only when approved and blocked schedule labels can be reproduced from stored visit exports without a verbal override.