Baystate Health print this page

When is it Time for Home Health Care?

Patients may benefit from home health services if:

 

  • They have recently been hospitalized
  • They have been newly 

          diagnosed with a chronic illness

  • They are trying to manage a chronic illness
  • They are recovering from surgery
  • They have had a heart attack or stroke
  • They have had a hip or knee replacement
  • They have been diagnosed

          with a life-limiting illness.

 

Home Care Admission Criteria 

include:

  • Patient needs skilled health care — nursing, physical therapy or speech therapy.
  • Patient needs part-time care on an intermittent basis.
  • The attending physician will sign the initial  plan of care.

 

Medicare and some other insurance plans also require that the patient be homebound (see right).  As of January 2011, Medicare also requires that the attending physician has had a Face-to-Face Encounter with the patient either:

  • 90 days prior to the start of

          home care services or 

  • Within 30 days after the start of care 

 

and that the face-to-face was related 

to the primary reason for home care.

 

  

GUIDE TO 

HOMEBOUND STATUS

 

Some insurance plans, including Medicare, require a patient who is receiving home health care to be "homebound.  This does not mean that they are bed bound!  Consider:

 

Does the patient have trouble getting to the physician's office and require someone to accompany him or her?

 

Does leaving the home require "considerable and taxing effort" for the patient?

 

Does the patient require assistance (human and/or a device such as a walker or cane) to leave home?

 

Are most absences from home due to medical reasons?

 

When leaving home for non-medical reasons, are the absences "infrequent and for short duration," such as attending religious services or beauty salon visits?

 

 

 

For more information, to make a referral, or

for a consultation to see if a patient is

appropriate for home health care,

call 800-249-8298