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Who to Refer

two elderly seniors with a womanMedicare patients qualify for home health if they are restricted in their ability to leave home and there is a need for skilled nursing or physical therapy or speech therapy.

A patient who qualifies for home health may:

  • require assistance of another person
  • use a supportive device such as a cane or walker
  • leave their home as needed for medical treatment
  • leave their home only infrequently and not for long periods of time
  • leave their home against medical judgment
  • generally leaving the home requires a taxing effort

A patient may need skilled nursing for:

  • Recent hospitalization or stay in a skilled nursing facility
  • Primary caregiver has changed recently and has a knowledge deficiency
  • New or exacerbated DX
  • New medication in the last 30 days
  • Medication changes in the last 60 days
  • Need for care that must be performed by a nurse
    • IV Therapy
    • Chemo Therapy
    • Wound Care
    • Diabetic Care
    • Urinary catheter care
    • Medication administration (non-oral)
    • Parenteral / Enteral nutrition
    • New Colostomy / ileostomy

A patient may need Physical, Occupational, or Speech Therapy for:

  • Recent decline in functional status such as
    • Ambulation
    • Speech
    • Endurance/Strength
  • Recent
    • Falls
    • Fractures
    • Stroke
nurse consulting the health of an elderly man