Examples of Skilled Need

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Skilled need for skilled home care can in rare instances be an ongoing process. It is most often a short-lived situation. It is always provided as intermittent visits and not as in-home shift care. 

The able and willing caregiver will be taught the care as quickly as possible and skilled visits kept to a minimum. Skilled care may also be provided on a short term basis in lieu of hospitalization. Skilled home care is never custodial and is not intended to be a long term process. 

Some of the more common skilled needs for home care, which demonstrate the medical necessity, include instruction and interventions for:
  • wound care
  • incision care
  • drain care
  • aftercare for surgery for reconditioning and restorative care
  • aftercare for surgical AND non-surgical fracture repair
            (i.e. ORIF or joint replacement)
  • anti-coagulant care, monitoring PT/INR, and teaching after surgery or accident
  • post hospitalization care for disease process (i.e. pneumonia, sepsis, or other acute illness)
  • instruction in new disease such as Diabetes or Heart Disease (including new/changed medications, diet, lifestyle changes, s/sx to report and treatment)
  • symptom control (including Palliative Care) for pain, N/V, anxiety related to disease process and/or treatments such as chemo and radiation
  • Foley catheter care and maintenance (monthly and PRN changes)
  • instructing in G-tube care and feedings and may include changing depending on the type of tube
  • IV antibiotics in lieu of hospitalization (including line and site care and instruction in managing pumps)
  • home safety (including evaluation for DME, grab bars, clutter, ADL and IADL training, etc.)
  • home exercise program for safety, strengthening and/or post injury, illness or surgical care
  • oxygen safety
  • energy conservation instruction
  • training new caregivers in specific skilled care as well as general pt care and safety precautions (i.e. using a new hoyer lift, care of a bedbound patient, diabetic care, etc.) 

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