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Criteria for Homebound Status

The following criteria are considered when determining homebound status. To be considered homebound, both criteria one and two must be met.

Criteria One

Beneficiary's medical condition restricts the ability to leave home without the assistance of another individual or without the assistance of a supportive device.

The beneficiary's medical condition should restrict the ability to leave home. If, however, the beneficiary chooses to leave home frequently, even though leaving home requires a considerable and taxing effort, the beneficiary would not be considered homebound.

Criteria Two

Beneficiary leaves home only to receive medical treatment that generally cannot be provided in the home OR leaves the home infrequently; for short periods for non-medical purposes or to attend a religious service or unique event.

If the beneficiary leaves home on an infrequent basis for a short period of time, or leaves home to attend a religious service or a unique event such as a funeral or graduation, and these absences do not indicate the beneficiary has the ability to obtain health care provided outside the home, then the beneficiary may still be considered homebound. To determine whether the beneficiary has the general inability to leave the home, look at the beneficiary's condition over a period of time rather than short periods within the home health stay

Posted: 09.27.11

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