Skilled nursing brings licensed clinical care into the patient’s home when medical needs require professional assessment, treatment, monitoring, or education.
At-Home Health nurses work under a provider-directed plan of care and coordinate with the patient’s physician or allowed healthcare provider. Each visit is based on the patient’s condition, current needs, and ordered services.
How This Service May Help
- Monitor changes in health status and symptoms
- Provide medication education and safety guidance
- Support management of serious or chronic conditions
- Provide post-hospital and post-surgical nursing care
- Perform ordered treatments and clinical procedures
- Educate patients and caregivers about the plan of care
- Communicate clinically relevant changes to the ordering provider
- Help identify concerns that may require further medical attention
Who May Benefit
Skilled nursing may be appropriate for eligible patients in situations such as these.
- Returning home after a hospital stay
- Returning home after surgery or rehabilitation
- A significant change in health
- A need for intermittent clinical monitoring or ordered treatment
- A need for education to manage safely at home
Services depend on eligibility, medical necessity, provider orders when applicable, coverage requirements, staffing availability, and the individualized plan of care.
Coordinated Around the Plan of Care
The nurse evaluates the patient’s response to care, documents findings, communicates with the ordering provider, and coordinates with therapists, medical social workers, and home health aides when those services are included in the plan of care.
Ask About Home Health Services
Call At-Home Health to discuss the patient’s needs, referral status, and possible next steps. Services depend on eligibility, provider orders, clinical need, coverage requirements, staffing availability, and the individualized plan of care.
For medical emergencies, call 911.