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It defines which homelessness scenarios qualify, how to verify months using Epic encounters, and how to record verified ranges versus unverified dates as “Unknown.” A complete example letter and a fillable template are provided with attestations, patient identification fields, and an itemized visit record.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/homeless-verification-letter-guidance-and-template/280794/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/homeless-verification-letter-guidance-and-template/280794.png","ImageObject",442,249,{"name":88,"@type":89},"\tJames","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-18","2026-09-16",true,{"@type":98,"interactionType":99,"userInteractionCount":20},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"When is a Homeless Verification Letter required?","Question",{"text":108,"@type":109},"A Homeless Verification Letter is required when a patient experienced homelessness within the last four years but the period does not automatically populate in the 2010E (typically because they were not residing in a DHS shelter). Any manually entered homeless period also requires a letter.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How do you determine the number of homeless months to verify?",{"text":113,"@type":109},"For each encounter documented in Epic during the reported homeless period, count one encounter as one month. Encounters are listed in the letter, and the verified dates map to the corresponding month ranges within the reported period.",{"name":115,"@type":106,"acceptedAnswer":116},"What should be recorded in 2010E when dates cannot be verified?",{"text":117,"@type":109},"Verified homelessness periods should be listed as “Homeless” in 2010E. Any dates that cannot be verified must be marked as “Unknown,” rather than entered as hospital stays.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},280794,1790443498,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":20,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},2336474466412,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Appendix 4: Homeless Verification Letter Guidance  \nHomeless Verification Letters are required for patients who have experienced periods of homelessness within the last 4 years but because they were not residing in a DHS shelter, these periods do not automatically populate in the 2010E.  \nAny homeless period that is entered manually requires a Homeless Verification Letter. This includes periods of street homelessness or stays in non-DHS shelters (i.e., medical respite, DV shelters, HERRC shelters, etc. ) This *does not * include patients who are couch surfing, which is not considered homeless and is instead categorized in the 2010E as “staying with friends or family.”  \nOne healthcare encounter while the patient was homeless = one month of homelessness. When a patient reports they were homeless, look in Epic to see if there were any encounters that took place during their reported homeless period. Refer to these encounters in the Homeless Verification Letter.  \nFor example:  \n• John Doe reports that he was street homeless from January 15, 2020 through April 20, 2020: this equals 3 months and 5 days that you need to verify (January 15 – February 14; February 15 – March 14; March 15 – April 14; April 15 – April 20)  \n• In Epic, you see that John Doe has the following encounters:  \no January 17, 2020: Metropolitan Outpatient Primary Care visit  \no February 2, 2020: Woodhull ED visit  \no March 12, 2020: Queens ACT Team visit  \no March 17, 2020: Queens ACT Team visit  \no April 25, 2020: Metropolitan outpatient primary care visit  \n• Each visit equates to one month homeless, so the Homeless Verification Letter would include the January, February, and March encounters. The April encounter falls outside of the date range and therefore should not be included.  \n• For any homeless period that you are able to verify in the Homeless Verification Letter, list those periods as homeless in the 2010E. Do not list them as hospital stays. Any dates that cannot be verified should be listed as Unknown.  \n• In this example, the 2010E would list John Doe’s history as the following:  \no January 15 – February 14: Homeless (verified by the January 17th and February 2nd encounter)  \no February 15 – March 14: Homeless (verified by the March 12th encounter)  \no March 15 – April 14: Homeless (verified by the March 17th encounter)  \no April 15 – April 20: Unknown (not able to be verified)  \n• The Homeless Verification Letter would state that John Doe was homeless from January 15, 2020 – April 14, 2020 and include the following visits:  \no January 17, 2020 (covers the period of January 15 – February 14)  \no February 2, 2020 (covers the period of January 15 – February 14)  \no March 12, 2020 (covers the period of February 15 – March 14)  \no March 17, 2020 (covers the period of March 15 – April 14)  \nYou do not have to have known or worked with the patient during every encounter you include. If the patient experienced periods of homelessness before you knew them, and there are visits documented in Epic during those dates, you can include them.  \nIf there are dates of homelessness that you cannot verify, you must mark those dates as “Unknown.”  \nHomeless Verification Letter Example: John Doe  \nJune 25, 2025  \nTo Whom It May Concern:  \nJohn Doe (DOB 7/6/1955) is a patient of NYC Health + Hospitals. He reported that he was homeless from January 15, 2020 to April 14, 2020.  \nDuring the below visits to H+H they reported they were homeless. Documentation of homelessness is included in patient notes for appointments. While homeless, they primarily slept on the subway.  \nBelow is a complete record of the dates that John Doe received care at H+H during his reported homeless period:  \n• January 17, 2020: Metropolitan Outpatient Primary Care visit  \n• February 2, 2020: Woodhull ED visit  \n• March 12, 2020: Queens ACT Team visit  \n• March 17, 2020: Queens ACT Team visit  \nI attest to the best of my knowledge the information and observations on this individual’s homeless s","cbCait9LkoblDDB3","https://ap.wps.com/l/cbCait9LkoblDDB3","pdf",202548,"English","# Homeless Verification Letter Guidance\n## When a letter is required\n## Verification rules using Epic encounters\n## Recording results in 2010E\n# Homeless Verification Letter Example\n# Homeless Verification Letter Template","[{\"question\":\"When is a Homeless Verification Letter required?\",\"answer\":\"A Homeless Verification Letter is required when a patient experienced homelessness within the last four years but the period does not automatically populate in the 2010E (typically because they were not residing in a DHS shelter). Any manually entered homeless period also requires a letter.\"},{\"question\":\"How do you determine the number of homeless months to verify?\",\"answer\":\"For each encounter documented in Epic during the reported homeless period, count one encounter as one month. Encounters are listed in the letter, and the verified dates map to the corresponding month ranges within the reported period.\"},{\"question\":\"What should be recorded in 2010E when dates cannot be verified?\",\"answer\":\"Verified homelessness periods should be listed as “Homeless” in 2010E. Any dates that cannot be verified must be marked as “Unknown,” rather than entered as hospital stays.\"}]","Homeless Verification Letter Guidance and Template | PDF",1789557841]