Home bound status

[Becky RN]

Does anyone out there find that home bound statis is a bit rigid as written in the regs? Some patients even though they shouldn't leave home do go out. And there are the cases where the 80yo cancer patient lives 80 miles from the oncology clinic but he still can get on the tractor and do light duty but there's no way he could drive 160 mile round trip every other day to have his chemo IV changed. I just get really frustrated sometimes when I do evals when I can't admit someone who truly needs home health and the regs don,t permit. Oh yes I'm human I do "look the other way" sometimes if I feel strongly about a case. Becky RN

[Mary Lynn]

I'm trying to learn to regard homebound in a more positive light. My organization can offer home health care for private pay or fee schedule payment from families who don't meet the homebound criteria. Few patients will accept help if it has to be paid for from their own resources. So they learn ways to manage without home health. There's nothing more we can do. I believe the homebound criteria is too strict, but I'm learning to live with it rather than risk charges of fraud or rather than my agency going under because of having to make major returns of cash to Medicare.