When to Refer the ALF Resident to Home Health

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Assisted living facilities can allow their residents to age in place and avoid unnecessary transfers to higher skilled facilities by utilizing home health services earlier in the disease process.

Residents may benefit from home health services if they:

  • Are experiencing an exacerbation of a chronic condition
  • Have a health issue that could get better through therapy
  • Have hard-to-heal wounds
  • Have trouble managing multiple medications
  • Suffer chronic UTIs
  • Make frequent or unscheduled visits to physician offices or emergency rooms
  • Are at risk for falling (Common risk factors for falling include: increasing age, weakness, having suffered a prior fall, incorrect ambulation, foot issues, fear of falling,  medication usage, having a chronic disease/condition, increasing need for assistance with activities of daily living .)


Residents must qualify for homebound status, which meansLeaving their residence requires “considerable and taxing” effort, as well as assistance from another person or device. Remember, a resident does not need to be bedridden to be homebound.