Medicare requires that a patient be Homebound and have a Skilled Need to qualify under Medicare for Home Care services - nursing services and/or therapy services.
Medicare.gov states that, "Skilled Need is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It’s health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care".
The patient must have a "SKILLED NEED" that requires the skills of a licensed nurse, or physical therapist to perform.
Examples of skilled nursing needs include: complex wound dressings, rehabilitation, tube feedings or rapidly changing health status. A number of patients may have a health status that changes quickly. This includes accident victims or people who've developed or contracted a serious illness. People who have experienced strokes often require rehabilitation and must learn how to talk, walk, or feed themselves all over again.
Once a skilled need is established, a secondary discipline such as a medical social worker, home health aide or occupational therapist may be involved in providing patient services.
Medicare will NOT PAY FOR PERSONAL CARE SERVICES IN THE ABSENCE OF A SKILLED NEED.
Please click on the link below for the official government booklet with detailed information on Home Health Care services.