THE STATUS OF BEING HOMEBOUND
Not being able to do things on your own or go on necessary trips outside of the home could be frustrating to many people. Homebound patients are unable to leave home due to a number of reasons that prevents them from ambulating outside of the home independently.
Homebound patients are considered to be confined at home for the following reasons:
- When a patient is seriously ill or physically unable to go out of the house due to an injury that prevents them from independently doing it on their own.
- Requires the need for medical assistive devices such as a walker, crutches, wheelchair, or a special kind of transportation.
- Requires the need for assistance from another person in order to go out of the house.
- An individual has a disability and that prevents him/her from leaving the house since it is too physically or mentally demanding when done alone.
Centers for Medicare & Medicaid Services also defines homebound as leaving home infrequently and only for short durations, which includes receiving medical care, attending religious activities, going to adult daycare programs, and other unique events.
According to CMS, two criteria must be present in order for an individual to be considered confined to home.
For Criteria One, at least one of these factors must be met:
- Requires the need for supportive devices, special transportation, or another person’s assistance in order to leave their house due to an injury or illness
- Leaving the home is contraindicated as it may pose harm to the individual
For Criteria Two, these two factors must be met:
- The existence of a normal inability to leave home
- Considerable effort is needed in order to leave home
To be eligible to receive Medicare Home Health Services, one must be considered homebound with a need for medical services and under a physician’s care. One must also receive treatments in accordance with a set care plan after being examined by the physician with whom they’ve had a face-to-face encounter, or authorized by a non-physician practitioner (NPP). This must all be arranged by a Medicare-participating Home Health Agency (HHA).
(Centers for Medicare & Medicaid Services, 2015)
HOW BEING HOMEBOUND IMPACTS THE LIFE OF PATIENTS
For people with functional limitations, managing their chronic illnesses could be harder since going on trips to their primary care physician on their own can be taxing, and to some, may even seem impossible. Their health could be on the line due to their homebound status. Aside from their physical health, social isolation could also affect their mental health and thus, affecting the quality of the life that they live.
According to a study conducted in 2018, the “co-existence of social isolation and homebound statuses may synergistically increase risk of mortality.” (Sakurai et al., 2018).
THE IMPORTANCE OF HOME HEALTHCARE FOR HOMEBOUND PATIENTS
When homebound patients need urgent medical care, they typically call an ambulance to seek emergency services. The problem in this situation is that, while emergency care can help them with their immediate needs, the healthcare providers are unfamiliar with the patient’s medical history, which may lead to fragmented care. To address this healthcare gap, homebound patients need a healthcare provider who can constantly and consistently work with them to manage their chronic illnesses. Home healthcare can be one of the best decisions for homebound patients for them to be able to get the best possible care they can for their health. Home healthcare providers can help patients monitor, treat, and manage their illnesses, and patients are ensured that help can arrive at home whenever needed. They provide a comprehensive assessment of a patient’s functional status, and with interdisciplinary care, patients are assured of receiving the best care from their home healthcare provider.
If a chronic illness or injury is adequately managed at home, trips to the emergency room could be prevented and minimized. Home healthcare is also beneficial for a patient’s overall wellbeing, as evidenced by a study conducted in 2016 which states that “Patients and caregivers described a feeling of “peace of mind” knowing that they had someone to reach if anything were to happen.” (Shafir et al., 2016).
INTERDISCIPLINARY COLLABORATION FROM THE HOME HEALTH TEAM
Home healthcare aims to improve the health of homebound individuals. Home healthcare providers work with the patients to help them achieve their goals, both short-term and long-term.
Patient-centered care is focused on goal-planning and treatment, different for each patient, which makes this personalized care the best option for patients confined to the home, with limited access to typical outpatient care.
The home healthcare team consists of these skilled professionals:
- Physicians
- Nurses
- Physical Therapists
- Occupational Therapists
- Speech Therapists
- Home Health Aides
- Social workers
Patients can regain some independence with the help of the home healthcare team. Through this interdisciplinary approach, they work together to achieve the common goal for their patient – helping them improve their functional abilities and manage their illnesses properly in order for them to have better health outcomes.
With the rising need for home healthcare, outsourcing home health medical coding is one way to address the ongoing shortage of medical healthcare workers. Administrative services are one of the tasks offered by home health medical coders to help medical health workers on the field focus on providing the best care for their patients instead of getting held back by tedious administrative tasks. Deciding to outsource home health medical coding can be tough as you have to make sure you have the right agency to be in partnership with.
LKN offers reliable Home Health and Hospice Coding and QA delivered by a team of health professionals who are highly knowledgeable with ICD-10-CM coding and OASIS review. LKN will guide you every step of the way as we create a custom solution that will guide you through the challenges brought by a constantly-changing industry and prepare you for success no matter what.
REFERENCES:
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- Sakurai, R., Yasunaga, M., Nishi, M., Fukaya, T., Hasebe, M., Murayama, Y., Koike, T., Matsunaga, H., Nonaka, K., Suzuki, H., Saito, M., Kobayashi, E., & Fujiwara, Y. (2018). Co-existence of social isolation and homebound status increase the risk of all-cause mortality. International Psychogeriatrics, 31(5), 703–711. https://doi.org/10.1017/s1041610218001047
- Shafir, A., Garrigues, S. K., Schenker, Y., Leff, B., Neil, J., & Ritchie, C. (2016). Homebound patient and caregiver perceptions of quality of care in home-based primary care: A qualitative study. Journal of the American Geriatrics Society, 64(8), 1622–1627. https://doi.org/10.1111/jgs.14244
- Centers for Medicare & Medicaid Services. (2015, January 1). Certifying Patients for the Medicare Home Health Benefit.
https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2014-12-16-HHBenefit-HL.pdf
