Medicare requires both prongs: the patient needs the aid of a supportive device or another person or has a condition that makes leaving home medically contraindicated, and leaving home requires a considerable and taxing effort. Document patient-specific evidence when homebound status is assessed, and ensure the longitudinal record continues to support both Medicare homebound criteria.
Evidence from this system that supports homebound status
Weakness and reduced endurance from undernutrition that limit the ability to leave home without assistance.
Dependence on enteral feeding and the associated equipment.
A functional or cognitive limitation on obtaining and preparing food that requires support.
The need for frequent skilled nutritional assessment and intervention.
Homebound paragraph — example
Patient remains homebound. Weakness from poor intake limits endurance, and the patient requires the assistance of another person and a device for safe ambulation; obtaining and preparing food independently is not possible without support. The nutritional status is being closely monitored and managed. Leaving home therefore requires a considerable and taxing effort.
