Home Health & Hospice

Insider’s scoop | Documentation of homebound status

Homecare Insider, April 25, 2016

Editor’s note: This week’s Insider’s scoop is from The Home Health Guide to Medicare Service Delivery, 2016 Edition. Newly updated to reflect the 2016 home health PPS final rule, this ubiquitous resource offers a one-stop solution for home health professionals looking for answers to their Medicare compliance questions. Click here for more information.

Documentation of homebound status consists of four essential components:

1.       The functional limitation(s) that restricts the patient’s mobility: This is an objective but broad description of the patient’s limitation, which correlates to the functional limitations listed in Locator 18 on the plan of care.

2.       The medical or physical reason(s) for the limitation(s): The patient must be homebound because of the effects of an illness or injury.

3.       Impact of the limitations(s) on the patient’s activity: This supports the specifics of the patient’s situation. Include the use of assistive devices or the help of another person and detail any “considerable or taxing effort.”

4.       Absences from home (number and reason): This supports the fact that the patient is confined to home.

Document all four components in the initial assessment and the progress notes and/or summary reports. The frequency of this documentation is completely dependent on each patient. For example, a patient who is suffering from a chronic, debilitating illness that is not expected to chance may only need this documentation every episode. However, postoperative patients or those suffering from an acute illness that is expected to resolve may require this documentation every visit. Selected OASIS data elements identify the patient’s functional limitations.