NoGo's for non-homebound

I know about 10 years ago, I was told that same thing ***if a client is able to drive, even if it is a specially equipped automobile, he or she does not satisfy the homebound requirement.***
Several years ago, that became, a patient can drive infrequently and that does not mean they do not meet the homebound status. A patient can still be considered homebound as long as when he drives it is infrequently, and it is a taxing effort for him to leave home. If they can not find someone to drive them to the doctors office for an appointment, but it is a taxing effort for them to drive, they are still considered homebound. Just because a patient doesn't leave home does not make him homebound either. The operative word in homebound status whether they drive or not is, is it a "taxing" effort for the person to leave home. Do they, when they go to the doctor's office (again, whether they drive or not) do they become S.O.B. and have to take frequent rest periods when they are out, or become extremely fatigued (do they go home and have to sleep for half a day). Homebound status like I said does not just mean the patient stays home and doesn't go anywhere, it means that if they do go out it is a taxing effort for them to leave. This is the way I understand it. I could be wrong but that is how the agency I work for looks at it.

I have worked in homecare for 18 yrs. I have always been told that if the pt can (and do) drive they are NOT homebound!

As I understand MCS/Medicare regs, in the past 2 decades the rules for homebound status have changed from 1) if you say you are homebound, then you are homebound, because Medicare didn't really require as much checking (this obviously led to many abuses and lots of very wealthy HH agency owners), to 2) if you ever leave your home, you are non-homebound, meaning if you drive ever you are non-homebound, to 3) the "taxing effort" definition which has no relationship to driving ability and only assesses pt's ability-not-willingness to go out of the home on a regular basis. This definition allows for rare but important family events, doctor's appts, even regular worship services (not 5 times a week, but a sermon on Sunday then home is ok -- as long as the patient is not breezing through this and it is a taxing effort).

Paddler, that's very good of you to probe to the answer before making a decision. I have found it very helpful to ask "so, how does it go when you have to go to the doctor?" "Are you able to go on to the pharmacy and get your prescriptions?"

Usually my homebound ones say "No way, my daughter has to bring me home and go back out for them" or something like that.