Finding and Managing Home Health Care: A Family's Guide (2025)

When a doctor orders home health services, it sounds straightforward. A nurse or therapist will come to the house. Simple, right?

Except it's not. Families quickly discover they need to coordinate schedules, communicate with multiple providers, track progress, manage insurance approvals, and troubleshoot problems—all while caring for their loved one.

Medicare covers home health services when medically necessary and ordered by a physician, including skilled nursing, physical therapy, occupational therapy, and speech therapy. But getting those services set up, keeping them running smoothly, and knowing when something needs to change requires organization and persistent follow-through.

Understanding What Home Health Actually Includes

Home health isn't one service—it's a collection of different types of care delivered at home.

Services Medicare Covers When Medically Necessary

Skilled nursing care: Registered nurses provide wound care, medication management support, monitoring of chronic conditions, IV therapy, and teaching families how to provide ongoing care.

Physical therapy: Therapists work on mobility, strength, balance, and reducing fall risk. They create exercise plans families can continue independently.

Occupational therapy: OTs help with daily activities like dressing, bathing, meal preparation, and adapting the home environment for safety and independence.

Speech therapy: Speech-language pathologists address swallowing difficulties, communication challenges after stroke, and cognitive issues affecting safety.

Medical social services: Social workers help with emotional adjustment, community resources, financial assistance applications, and care planning.

Home health aide services: Aides assist with personal care like bathing, dressing, and grooming. Medicare covers this only when skilled services are also provided.

What Medicare Doesn't Typically Cover

Companion care, meal preparation beyond medical necessity, housekeeping, transportation, and 24-hour care usually require private payment or other insurance.

How to Find Quality Home Health Providers

Not all home health agencies provide the same quality of care. Choosing carefully makes a significant difference in outcomes.

Start with Medicare's Comparison Tool

Visit Medicare.gov/care-compare and search for home health agencies in your area. The site shows:

• Quality star ratings (1-5 stars)
• Patient satisfaction scores
• How often patients improve with therapy
• Rates of hospitalization
• Timely care initiation

Ask for Referrals from Trusted Sources

• The hospital discharge planner
• Your primary care doctor
• Physical or occupational therapists
• Friends or family who've used home health
• Local senior centers

Questions to Ask Before Choosing an Agency

A 15-minute phone call can reveal whether an agency is the right fit.

Service and Staffing Questions

• Do you provide all the services the doctor ordered?
• How quickly can you start services?
• Do you have staff available for the days and times that work for our schedule?
• Will we see the same nurses and therapists each visit, or does it rotate?
• What happens if our regular provider is sick or unavailable?

Communication Questions

• How do you communicate with the ordering physician?
• How often will you update our family on progress?
• Can we reach someone after hours if we have concerns?
• Do you provide written care plans we can review?

What to Expect During the Initial Visit

The first home health visit sets the foundation for everything that follows.

The Intake Assessment

A nurse will conduct a comprehensive assessment covering:

• Medical history and current conditions
• Medications and side effects
• Physical abilities and limitations
• Home environment and safety
• Caregiver support and concerns
• Goals for home health services

This usually takes 60-90 minutes. Have the medication list, recent hospital discharge papers, and insurance information ready.

Managing Multiple Home Health Providers

When a senior receives several types of therapy or nursing care, coordination becomes essential.

Create a Master Schedule

Keep one calendar with:

• All provider visit days and times
• Names of specific staff members coming
• What service each visit provides
• Phone numbers for each provider

Designate One Family Contact Person

Having one person handle all home health communication prevents mixed messages. This person should:

• Be present for visits when possible
• Track progress and concerns
• Communicate with all providers
• Update the rest of the family

Keep a Visit Log

Document each visit in a simple notebook:

• Date and time
• Provider name and service type
• What was done
• Instructions given
• Questions asked
• Next scheduled visit

Recognizing When Services Need Adjustment

Home health isn't static—needs change as recovery progresses or declines.

Signs That Services Should Be Increased

• The senior is declining despite current therapy
• New symptoms or complications develop
• Falls or safety incidents increase
• Caregiver burden becomes unsustainable
• Goals aren't being met within expected timeframes

Signs That Services Might Be Reduced

• Goals have been achieved
• The senior has plateaued and isn't making further progress
• Skills have been taught and family can continue independently
• The senior's condition has stabilized

Handling Common Home Health Challenges

Even with good agencies, problems arise. Knowing how to address them prevents small issues from becoming major disruptions.

Inconsistent Scheduling or Missed Visits

• Document every missed or late visit
• Contact the agency's supervisor immediately
• Request a plan for preventing future problems
• If it continues, ask for reassignment to a different care team

Services Ending Before Family Feels Ready

Medicare has specific criteria for when home health should end. If you disagree with discharge:

• Request a written explanation
• Ask the physician to justify continued services to Medicare
• Understand what private-pay options exist
• Look into other community resources for ongoing support

Planning for When Home Health Ends

Home health is temporary. Planning for what comes next prevents a gap in care.

Before the Last Visit

• Ensure all education is complete: Family members should feel confident continuing exercises, wound care, or monitoring tasks independently.
• Get written instructions: Request clear, written guidelines for everything you're expected to do after services end.
• Schedule appropriate follow-ups: Make sure appointments with the physician and any specialists are scheduled.

The Financial Side of Home Health Care

What Medicare Part A Typically Covers

When home health is medically necessary and ordered by a physician:

• 100% of covered skilled services (nursing, therapy)
• Medical equipment and supplies related to the care plan
• No copayments or deductibles for Medicare-covered home health