Requirements for Home Health Care

Prerequisites for Medicare Entitlement for Home Health Care.

• Patient is under the care of a physician.
• Patient requires skilled nursing, physical therapy, occupational therapy, or speech therapy on an intermittent basis.
• Care is medically reasonable and necessary.
• Patient is homebound. "Home-bound" implies that the patient is unable to leave home or that leaving home requires a considerable and taxing effort. Patients may be considered homebound if absences from the residence are infrequent, are of relatively short duration or are for the purpose of receiving medical treatment. A patient who is unable to leave home without the help of assistive devices or who has a mental illness that may preclude leaving the home would also be considered home bound.
• Patient's needs can be met on an intermittent or part time basis.
• Patient resides in a home or facility that does not perform skilled care.
• A plan of care is rendered under the guidance of a physician.

Physician's Role in Home Care

The physician is an important member of the home care team. To receive home care services, the patient must be under a physician's plan of care. While other health professionals may provide consultation in the development of the plan of care, the physician is ultimately responsible for approving each client's specific plan.