Home Care

Home care nursing delivers skilled care where the patient lives, so assessment includes both the patient and the conditions shaping the plan: caregiver availability, medication organization, fall hazards, infection risks, and access to food, transportation, and follow-up. A symptom may carry greater risk at home because professional monitoring and emergency support are not continuously present. In the United States, a home-health agency must be state licensed and meet the Medicare Conditions of Participation. Medicare-covered patients must meet applicable eligibility requirements, such as homebound status. The agency must provide the required qualified RN or NP supervision of skilled nursing services and maintain complete clinical records. At start of care, all patients receiving Medicare-covered home-health services must be assessed with OASIS-D. The assessment captures functional status, the medication list, wound characteristics, and risk-screening items. Missing or inaccurate information can obscure clinical risk and contribute to claim denial. The LVN/LPN performs assigned care within the applicable state nurse practice act, agency policy, education, and competence. A home visit is not routine simply because it occurs in a home. Establish the patient's usual status,...