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In order to qualify for certain home healthcare services, patients must qualify as “homebound.” In this article, we’ll define the term homebound and explain how it relates to nursing home abuse. 

Key Takeaways

  • Homebound patients are those who need assistance leaving the home and have a difficult enough time doing so that they rarely leave
  • To qualify for Medicare’s home health benefit, a doctor must evaluate a patient and declare that they are homebound
  • Homebound patients may leave their homes for things like medical treatments, funerals, and walks
  • Patients who are dependent on the care of others should be aware of the risk of abuse 

What Does It Mean to Be Homebound?

Medicare, as well as some other insurance providers, require patients to be “homebound” in order to receive certain home care services. According to Medicare, homebound patients are those who:

  1. Need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave the home – or people whose doctors believe that their health could get worse if they leave the home
  2. Find it difficult to leave the home and typically can’t do so

For example, people in any of the following scenarios may be considered homebound:

  • A person who has been weakened by illness or surgery
  • A person with a psychiatric illness who refuses to leave the home
  • A blind person who needs help leaving home
  • A person who has an injury or weakness in the arms or hands that make it difficult to safely use handrails and needs another person’s help to get around
  • A heart disease patient who must avoid stress or physical activity
  • A stroke survivor who is confined to a wheelchair
  • A person with dementia

Doctors must evaluate patients in order to determine whether or not they are homebound. If a patient qualifies for Medicare’s home health benefit, their plan of health will certify that they are homebound. After they begin receiving home health care, they will be re-evaluated and have their plan of care recertified every 60 days. 

Note that homebound patients are not confined to the home. They can still leave the home without putting their homebound status at risk for things like:

  • Medical treatment
  • Religious services
  • Attending an accredited adult daycare center 
  • Family reunions
  • Funerals
  • Graduations 
  • Trips to the barber or beauty parlor
  • Taking a walk for fresh air or exercise

Medicaid does not have a homebound requirement for home health services. Private insurance varies in their coverage of home health services and the homebound requirement. 

Homebound and Nursing Home Abuse

Patients who require care from healthcare providers or other caretakers in or outside of the home, as well as their loved ones, should be aware of the risk of abuse. Homebound individuals and nursing home patients are in a particularly vulnerable position of dependence on caretakers, putting them at risk of mistreatment and harm. 

If you or a loved one have experienced mistreatment in or outside of a nursing home at the hands of a caretaker, you may be eligible for compensation for your suffering. It is recommended that you report the situation to the relevant authorities before speaking to a nursing home abuse lawyer who will be able to guide you regarding your next steps.

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