Medicare and Homebound

[KittyLovinRN]

How many "special events" do you let your patients get away with? I have a patient w deep (>5cm) abscess/fistula in her buttocks with no pain who was very active beforehand. I told her she unfortunately couldn't teach her volunteer German class that starts next week but I felt it was okay for her to go to a local college on Saturday for a special recognition in her honor.

Now she's telling me she has a once a year luncheon on Friday and asking if its okay for her to go....?

I know Medicare has special events exceptions and I'm trying to work w this patient but I'm starting to worry, she really needs the home care there's no way she could perform daily packing to a buttocks wound!

When would you put your foot down?

[Mom2boysRN]

The agency I work with just says to be "homebound" means it is a difficult or taxing effort to leave home. So it doesn't mean they can't leave, it just means it is difficult when they do. I would say that teaching a class would disqualify you, if you can do that then you probably aren't homebound. I don't worry about other special events that are for a single day. Unless it was a dancing marathon they were participating in.

[KittyLovinRN]

The agency I work with just says to be "homebound" means it is a difficult or taxing effort to leave home. So it doesn't mean they can't leave it just means it is difficult when they do. I would say that teaching a class would disqualify you, if you can do that then you probably aren't homebound. I don't worry about other special events that are for a single day. Unless it was a dancing marathon they were participating in. [/quote']

Thanks!! That makes sense! I'm still pretty new to HC and usually it's not even a question about home bound but this one was making me second guess myself. She won't be teaching the class that's for sure.