Who qualifies for home health care services?

June 14, 2022 at 7:00 AM
Old woman smiling.

Deciding to get your loved one home health care services is a significant step toward preserving their independence, health, and happiness. Ultimately, there’s nothing more important than getting them the help they need. However, determining who qualifies for home health care services can be difficult. Fortunately, we’re here to help.

Here is a guide to who qualifies for home health care services:

People with doctor’s orders

Determining who qualifies for home health care services first requires considering whether or not you have doctor’s orders. To obtain orders, the patient must meet with their doctor to evaluate their needs.

Things that signal eligibility can include a new diagnosis, the worsening of an existing condition, medication changes, or frequent visits to their doctor or hospital. When they meet with their doctor, they will assess whether they need:

  • Intermittent skilled nursing
  • Physical therapy
  • Speech therapy
  • Occupational therapy

Essentially, the doctor will decide between regular, long-term care, and home health care. If eligible, the doctor then determines which home health services they need.

People who are ‘homebound’

To qualify for home health care, the patient must be ‘homebound,’ which means they cannot leave their home. Being homebound has unique criteria. Essentially, this means it is incredibly difficult to leave home alone and without help.

While evaluations can vary, doctors often determine if your loved one is homebound by whether they need a supportive device like a cane, walker, or wheelchair to leave the house or if they fear their condition will worsen if they leave the house.

However, doctors also consider a patient homebound if it requires considerable effort to leave home, resulting in them not leaving unless it’s for something they must accomplish.

People who are under a doctor’s care

Being under a doctor’s care is also another eligibility requirement. This entails receiving services under an established plan of care that is regularly reviewed by their doctor.

The patient’s certification of eligibility also requires that the doctor or a healthcare professional who works with a doctor records that they have had face-to-face encounters with the patient within pre-designated time frames.

Moreover, these face-to-face records must show that these appointments were for the specific reason the patient requires home health care.

People who can receive care from a certified health agency

It’s also imperative to find a home health agency that is certified. A key consideration for who qualifies for home health care services is whether or not they have access to a certified health agency. There are special federal regulations and requirements to obtain certification.

Other eligibility requirements

There are many more eligibility requirements for home health care. Firstly, your loved one must live in the service area and their living space must be suitable for proper and safe care.

Moreover, their living space must be suitable for the staff member and have storage space for all the necessary equipment. There must also be a reasonable expectation that the provider will receive payment privately or through insurance.

The patient also needs a family member or significant other competent, capable, and trained to administer care if the agency can’t staff a shift, and there must be a plan of action in case of medical emergencies.

Lastly, your loved one must be willing to undergo a complete medical evaluation.

Contact us now for an assessment!

If you are still wondering who qualifies for home health care services, at Miami Valley Homecare, we have the answers. With us, assisted living has never been so easy. As the premier home health care service provider in Centerville, Kettering, Xenia, Beavercreek, Fairborn, Dayton, and Oakwood, Ohio, our number one concern is each patient’s health and happiness. Contact us now for an assessment!