Coverage Criteria
Liberty HomeCare & Hospice Services accepts patients for treatment when the patient’s medical, nursing, and social needs can be met adequately by our team in the patient’s place of residence. In order to determine whether a patient is eligible for home care or hospice coverage, we rely on the following criteria.
Qualifying for Home Care
We can accept a referral for home health and help determine if an individual qualifies. A physician must then order services. Once this determination and order have been made, we work directly with that physician and his or her staff to develop a custom home care plan for the patient. Conditions that generally meet coverage criteria include:
- A new diagnosis
- Recent exacerbation of a previous diagnosis
- New medication or medication dosage change
- Recent fall
Additional criteria can include:
- Patients are homebound, meaning the person has an illness, medical condition or injury that restricts the ability to leave home without the assistance of others; the aid of supportive devices such as crutches, canes, wheelchairs or walkers; the use of special transportation; or those instances where leaving the home is medically contraindicated.
- The patient requires part-time (intermittent) skilled care provided by a nurse, physical therapist, speech therapist and/or occupational therapist.
To qualify for home health care services under Medicare or Medicaid, an agency must be Medicare- and/or Medicaid-certified. Home health care services may be covered under Medicare Part A or Part B.
Qualifying for Hospice Coverage
Patients of any age can qualify for hospice services. The patient does not need to be homebound, but must meet the following criteria:
- The patient’s physician uses his or her best clinical judgment to certify the patient is terminally ill with a life expectancy of six months or less, if the disease runs its normal course.
- The patient chooses to receive hospice care rather than curative treatments for the illness.
- The patient enrolls in an approved Hospice Program.
Liberty can provide hospice services in the home, an assisted-living community, a nursing center or in a hospital.
