How is a referral made for home care?

• A. The physician must approve the referral
• B. The hospital discharge summary is sufficient
• C. The consumer can self-refer
• D. The consumer must be assessed by an independently contracted nurse

Answer: (D)

Understanding how home-care referrals are made centers on who determines the actual need for services. A formal, up-to-date assessment by a qualified professional is the key step that triggers eligibility and plans for home care. An independently contracted nurse performs a comprehensive evaluation in the home (or another setting), looking at medical status, daily living abilities, safety risks, caregiver support, and the home environment. This assessment builds the care plan, specifies what services are needed, how often, and for how long. That objective, on-site evaluation is why the referral is based on an independent nurse assessment.

While a physician can provide medical input or authorization and a discharge summary can inform the plan, neither alone initiates or finalizes eligibility in most systems. Self-referral by the consumer isn’t typically sufficient to establish services without this professional assessment in place.