Our definition:

Leaves home infrequently for non-medical reasons with difficulty or considerable taxing effort due to functional limitations such as weakness, endurance, mobility, shortness-of-breath, or pain

Points to remember:

1. Is the patient homebound? If the patient can get out of his home regularly, at will, for whatever reason he or she desires, even if it takes great effort, he or she will not be considered homebound.
   
   Example:
   If the patient can leave home once a week for a social purpose, he or she will not be considered homebound because he or she has demonstrated the ability to regularly leave the home.
   
   Homebound status should be related to a physical or medical condition. If the patient decides to stay home so he qualifies for Medicare coverage and he or she has no physical or medical limitations, he or she is not considered homebound.
   
   
2. The patient with a “psychiatric problem, if his illness is manifested in part by a refusal to leave his home environment or is of such a nature that it would not be considered safe for him to leave home unattended, even if he has no physical limitations” could be considered homebound
   
   
3. Environmental factors may also restrict the patient to his home. Factors such as three flights of steps, hilly terrain, and steep inclines, and winter conditions can limit the performance of a patient and render him homebound.
   
   “Can only walk one flight of steps before exhausted and dyspneic. Lives in a third floor walk-up apartment”
   
   
4. Absences from home should be infrequent and of short duration or for the purposes for receiving medical care.
   
   Covered example: A client goes to radiation treatment every day, travels via wheelchair and becomes very fatigued upon return time (leaves home for medical treatment).
   Non-covered example: Client reports to you that he goes every Wednesday to play bingo at the Senior Center and he is very fatigued and dyspnic on return home (leaves home on regular basis for non-medical reason).

Please note: any absence for religious service is deemed to be an absence of infrequent or short duration and does not negate homebound status.