With the instruction to stay home for older Americans who are at greatest risk from COVID-19
issued through presidential updates, CDC, NIH, experts, home health is in a unique position to
both screen, education and care for patients who are restricted to home.  Many of the patients
have functionally not qualified for home health because of the ability to seek care at the
physician clinic. But physicians are quickly moving to telehealth visit to limit risk of exposure,
and home health can quickly shift to visits to help.  What about homebound?

One of the prongs to homebound eligibility is “medical restriction to remain home.”  This prong
stands alone even for those patients who are otherwise able to leave home. The physician must
place the medical restriction, but in this case, we have a medical restriction from just about
every governmental agency in the health care arena. I say home health should expand their
opportunities in the short future.  Here’s how they can do it.

Alert physicians and hospital referral entities that they are available to provide clinical care and
education to the Medicare population at this time. The physician who orders the care must
state that there is a medical restriction in place and provide some additional information as to
how the patient is compromised and should not leave the home. This should be documented in
the physician’s encounter note or in the telehealth visit note. The agency should also address
the underlying issues that make the patient at greater risk for infection and the fact that there
is a medical restriction in place.”