Hey Susan,

Your definition of the home bound criteria is not accurate.  The homebound 
criteria allows for one to "be driven somewhere, like to a doctor's 
appointment."  From the HIM 11(Basicaly the definition of homebound criteria 
from the bureaucrats themselves):

"If the patient does in fact leave the home, the patient may nevertheless be 
considered homebound if the absences from the home are infrequent or for 
periods of relatively short duration, or are attributable to the need to 
receive health care treatment.  Absences attributable to the need to receive 
health care treatment include, but are not limited to, attendance at adult day 
care centers to receive medical care, ongoing receipt of outpatient kidney 
dialysis, and the receipt of outpatient chemotherapy or radiation therapy.  Any 
absence of an individual from the home attributable to the need to receive 
health care treatment, including regular absences for the purpose of 
participating in therapeutic, psychosocial, or medical treatment in an adult 
day-care program that is licensed or certified by a State, or accredited, to 
furnish adult day-care services in a State shall not disqualify an individual 
from being considered to be confined to his home."
"Any other absence of an individual from the home shall not so disqualify an 
individual if the absence is of an infrequent or of relatively short duration.  
For purposes of the preceding sentence, any absence for the purpose of 
attending a religious service shall be deemed to be an absence of infrequent or 
short duration.  It is expected that in most instances, absences from the home 
that occur will be for the purpose of receiving health care treatment.  
However, occasional absences from the home for nonmedical purposes, e.g., an 
occasional trip to the barber, a walk around the block or a drive, would not 
necessitate a finding that the patient is not homebound if the absences are 
undertaken on an infrequent basis or are of relatively short duration and do 
not indicate that the patient has the capacity to obtain the health care 
provided outside rather than in the home."

Jimmie

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of Spot_60
Sent: Thursday, April 14, 2005 9:23 PM
To: [email protected]
Subject: RE: [OTlist] Home Health Question


Since she seems to be doing pretty well, I am wondering:  What is qualifying 
her as "home-bound?"    Does she use an assistive device to ambulate?  Does she 
require assistance to leave the home? 

For instance, if she could safely and independently leave her home and be 
driven somewhere, like to the doctor's or to the store and not require 
assistance, she may not be truly homebound and Medicare is going to question 
why she's being seen by home health and then reimbursement becomes an issue.

Just something to toss out there.

Susan



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