MEDICARE HOME HEALTH REQUIREMENTS
Patient must be homebound.
(*see below Medicare Homebound Status Criteria)
Care must me medically necessary.
(usually for conditions that are acute and serious vs. chronic
Care must be part-time or intermittent.
The patient requires at least one skilled professional service.
(nurse: RN/LVN, Physical Therapist, Speech Therapist)
Care must be provided by a Medicare-Certified Home Care Agency.
Must have a signed Physician’s Order for requested services.
Services must be delivered in the patient’s primary place of residence.
MEDICARE HOMEBOUND STATUS CRITERIA
Leaving the home wound require “considerable and taxing effort”. Examples: Medical condition or symptoms like dyspnea, weakness, frailty, confusion, pain, or the need for significant assistance from another person to leave the home
The patient can leave the home only for infrequent, short absences. Example: Medical appointments, short walks, hairdresser appt. or to attend religious services.
A person may temporarily homebound while recovering from surgery, serious illness or trauma.
WHEN TO REFER TO HOME HEALTH?
* Wounds & skin ulcers
* Exacerbation of condition
* New diagnosis
* Medication changes & compliance issues
* Recent falls at home
* Special diet, weight loss, nutrition and bowel problems
* Home procedures such as catheterization and/or injections