Do patients with mental illness qualify for home health care?

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Medicare Services for Psychiatric Patients

Obstacles to care management include inadequate discharge planning and medication non-adherence.

Patients are eligible for home health services if they present with acute psychiatric symptoms and meet the qualifications for homebound.

Mental health disorders comprise four of the top 10 causes of disability in the U.S. and include clinical depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder.

Depression alone affects more than 6.5 million Americans age 65 and older. It’s the single most significant risk factor for suicide in the elderly population.

Obstacles in Care Management

Increasingly shorter hospital and facility stays aren’t meeting the needs of patients struggling with mental illness. Hospitalized psychiatric patients often end up being readmitted after discharge, largely due to:

  • Inadequate discharge planning
  • Medication non-adherence
  • Lack of systems to ensure outpatient behavioral health follow-up
  • Impairment to patients’ ability to care for themselves
  • Lack of access to community services and family support
  • Substance abuse

Source: Agency for Healthcare Research and Quality

The Role of Home Health

Home health care offers comprehensive psychiatric nursing services to patients in their home or specialized place of residence. Under a physician’s plan of care, the home health care team collaborates with you to provide skilled nursing services, education, and community support to accommodate the individual needs of your psychiatric patients. Services are designed to improve patient management and satisfaction, reducing the need for urgent and emergent inpatient psychiatric care.

Services should include:

  • Skilled observation and detailed assessment (using AIMS, Hamilton, MMSE, and Cranial Nerve Evaluation tools)
  • Supportive care education of disease process to patient, family, and caregivers
  • Home safety and emergency education
  • Medication assessment, instruction, and supervision to ensure compliance
  • Nutrition education
  • Restorative therapy (physical, occupational, speech)
  • Therapy evaluation for safety/safe environment
  • Medical social services for community resources
  • ADL assistance in conjunction with medical social work intervention

Are Your Patients Eligible?

Your patients are eligible for home health services if they present with acute psychiatric symptoms and meet the qualifications for homebound. Homebound is defined as an individual having a medical or psychiatric condition that restricts their ability to leave home safely without the assistance or supervision of another individual or without the assistance of a supportive device. And the patient leaves home only to receive medical/psychiatric treatment or leaves home infrequently for non-medical purposes.