Home health

Skilled medical care delivered in the home by nurses, physical therapists, occupational therapists, or speech therapists — typically following hospitalization or during the management of a serious condition. Medicare covers home health when ordered by a physician and the patient is homebound.

What it means in practice

Medicare's home-health benefit (Part A) covers intermittent skilled care delivered in the patient's home, when three conditions are met:

1. **Physician order**: a doctor must certify the need + sign a face-to-face encounter form 2. **Homebound status**: leaving home requires a "considerable and taxing effort" (the patient can leave for medical appointments, religious services, occasional outings — they don't need to be confined to bed) 3. **Skilled need**: the patient needs intermittent skilled nursing OR skilled therapy (PT, OT, SLP)

What's covered: • RN visits (wound care, IV antibiotics at home, education, assessment) • PT, OT, SLP for rehabilitation • Medical social work • Home health aide hours — but ONLY while skilled care is also being provided (when skilled care ends, aide coverage ends) • Some DME related to the home-health episode

What's NOT covered: • 24-hour care • Meal delivery • Homemaker services (cleaning, laundry) • Non-medical companion care • Long-term aide hours after skilled care has ended

Typical duration: 4-8 weeks following hospitalization. The agency conducts an OASIS assessment, develops a care plan, sends a mix of disciplines for visits over the certification period, then either re-certifies for another period (if continued skilled need exists) or discharges.

Choosing a home-health agency: at hospital discharge, the case manager will typically recommend agencies. Medicare's Care Compare (medicare.gov/care-compare) rates home-health agencies on a star system + quality metrics. Higher-rated agencies have better outcomes for hospital readmission avoidance, improvement in ADLs, and patient experience.

The family's job: be present at the first visit if possible (the OASIS assessment shapes the entire care plan). Verify the medication reconciliation matches what the patient is actually taking. Confirm visit schedule. Get the agency's after-hours number for urgent questions. If care plan doesn't match what the patient needs, raise it with the agency — and if that doesn't resolve, contact the ordering physician.

When you'll hear it

At hospital discharge ("home health will start visits at home"). Distinct from home care or companion care, which is non-medical ADL support and is generally not Medicare-covered.

Is this the same as…?

Terms families frequently confuse with home health.

Related terms

• Home health aide — A trained but unlicensed worker who provides hands-on assistance with bathing, dressing, toileting, meal preparation, and medication reminders in the home.
• Medicare Part A — The federal program that covers hospital stays, skilled nursing facility (SNF) stays after qualifying hospitalizations, hospice, and some home health care for people 65+ (and some younger people with disabilities).
• Durable medical equipment — Reusable medical equipment for long-term use at home: wheelchairs, walkers, hospital beds, oxygen concentrators, CPAP machines, glucose meters, lift chairs, etc.
• Hospice — A type of care for people with a life expectancy of about 6 months or less, focused entirely on comfort rather than cure.
• Case manager — A nurse or social worker employed by the hospital whose job is to coordinate care across the system — most importantly, discharge planning.
• Observation status — A hospital classification (NOT admission) where the patient is in a hospital bed but is technically an outpatient.

Where this comes up in caregiving

See also: all glossary terms · conditions by name · step-by-step playbooks