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Discussion

Homebound Status

If a patient can leave the home for medical reasons, I read that they are not "homebound". So, can somebody answere these questions for me? If a patient leaves the home twice a week for chemo, do they get home health? If a person leaves the home Monday through Friday to get chemo/radiation, do they qualify?

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    • Expert

    It was my understanding for the above situations that they would still qualify. Assume that they have assistance for these visits and are not driving themselves to and from the appointments and that they are thoroughly pooped out by the appointments, especially the chemo. Homebound criteria has been discussed before on the forum, have to search for the particular posts.

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    Yes - medical appts are allowable - but like Caliotter said - needs to be a taxing effort, needs assistance, residual weakness from disease processes, a MD order to be homebound, etc, etc. Always document homebound status on visits to help verify your declaring them to be homebound. Hope the following link to CMS website q&a will help you..

    http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=9070&p_created=1207329475

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    • Author

    The CMS website was exactly what I was looking at.

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    Quite often, chemo/radiation are the cause for the homebound status, either via their debilitating effects or their neutropenic effects. Quite often, these patients leave home only for their treatments and are unable to function much otherwise. So yes, even if they're getting chemo/radiation 5 days/week, they are homebound.

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    Like everyone else said.....medical appts are allowed. Even daily appts. I would assume that the chemo IS what makes them homebound since it would take a considerable and taxing effort to get to those appts. Even going out to get an occasional haircut is ok as long as it's not a every week kinda thing and they are not driving themselves. Thats what I think anyway, but I am new to HH.

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    I understand that Medicare patients can also go to church and still be considered homebound. The key is, that leaving home must be a considerable and taxing effort.

    Most of my patients have Medical Assistance (in Minnesota). Some of them have part-time jobs,so the requirements for MA must be much less than for some other forms of insurance.

    Pooksmom1996

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