1615 Vollmer Road

Flossmoor, IL 60422
Ph:708-798-0800
 800-444-7028
Fax:708-798-0870
3401 16th Street
Suite 5
Moline, IL 61265
Ph:309-762-7900
 866-541-0900
Fax:309-762-6909
7810 N University Street

Peoria, IL 61614
Ph:309-589-0888
 866-725-0888
Fax:309-589-0889
1740 Mediterranean Drive
Suite 101
Sycamore, IL 60178
Ph:815-895-9898
 877-895-9898
Fax:815-895-3232
421 S Grand Ave W
Suite 2B West
Springfield, IL 62704
Ph:217-753-2260
 877-753-2210
Fax:217-753-2270
4231 Progress Blvd
Suite #3
Peru, IL 61354
Ph:815-220-8808
 877-220-8808
Fax:815-220-8828

Medicare Homebound Criteria for Home Care

Does the patient leave home fequently for non-medical purposes?

  •  NO (any character) causes a transition to the Requires Assistance state.
  •    YES leads to the Not Eligible

Does the patient require assistance when leaving home?

  •    NO (any character) is allowed.
  •  YES (any character) causes a transition to the Considerable Effort state.

Does the patient require considerable and taxing effort when leaving home?

  •    NO (any character) is allowed.
  •  YES (any character) causes a transition to the Skilled Nursing state.

Does the patient have a skilled need for nursing?

  •    NO (any character) is allowed.
  •  YES (any character) causes a transition to the Assess Skilled state.

Continue to assess for PT or ST skilled need

  •    NO (any character) is allowed.
  •  YES (any character) causes a transition to the Assess Skilled state.

Make a referral for skilled nursing care

Make a referral for therapy services

Not Eligible for Referral

Not Eligible for Referral

Not Eligible for Referral

Not Eligible for Referral

A need for Skilled Nursing Services may occur due to one or more of the following:

* Hospitalization
* Recent, New, or Exacerbated DX
* Change in Medications in the last 60 days
* New Medication in the last 30 Days
* Change in Primary Caregiver with a knowledge deficiency

Skilled Nursing Care related to a treatment of an illness or injury that must be performed by a nurse:

* Medication Administration (other than oral)
* Parenteral/Enteral Nutritional Support
* Urinary Catheter Care
* Diabetic Care
* Wound Care
* IV Therapy

Does the patient require PT or ST due to the following:

* Recent marked decline in functional status
* E.g. speech, ambulation, strength, endurance
* Recent falls, fractures, stroke
* Need for Home Maintenance Program to maintain current level of function