HOME HEALTH- Medicare Requirements

Thinks to look for when referring to Home Health

Shows signs of weakness

Falls frequently or is a fall risk

Has pressure ulcers or needs wound care

Has increased or uncontrolled pain and/or is in need of pain management

Has confusion with medication

Needs teaching or education for a new diagnosis:

Information Needed for New Referrals

  1. Current demographics information (primary contact phone and address)
  2. Insurance information
  3. Current medications list
  4. Qualifying Face-to-Face encounter with referring provider:
    • Progress note from a Face-to-Face visit that includes medical conditions related to the need for Home Health AND clinical findings which support the patient's homebound status. Progress note should answer the question:  Why Home Health? Why Now?
  5. Specific Home Health orders:
    • Must be signed by MD, DO, DPM, PA or NPP
    • If wound care, please include specific wound care orders

HOSPICE- Referring Your Patients

Signs and Symptoms that may indicate decline and need for hospice care

Multiple hospitalizations/frequent ER visits

Progressive weight loss

Decreasing appetite

Dysphagia

Increased weakness or fatigue

Decline in cognitive status

Increasing pain, increasing difficulty managing pain

Increasing dyspnea

Recurring infections

Information Needed for New Referrals

  1. Current demographics information (primary contact phone and address)
  2. Insurance information
  3. Current medications list
  4. Recent progress note and reason for referral

If you have any doubt about whether the requirements for Hospice care have been met, please contact us for a Hospice informational visit.