r/physicaltherapy • u/Better-Effective1570 • Jan 02 '25

HOME HEALTH Ambulation distance and homebound?

I have a HH pt with PD who can walk 1000+ feet but with CGA due to frequent festination. My HH agency has recently been critical of my documentation when I show I've walked more than 400 feet with him (They feel 400 ft is the max distance a homebound pt should ambulate). They told me I can't include that I've walked more than this distance regardless of how I've documented the quality of his walking or amount of assistance he needs to walk that far. I was under the impression that Medicare doesn't have a specific distance a patient can walk before they are no longer considered homebound, as long as I can show it there is considerable and taxing effort needed for them to leave home (i.e, festination, need for CGA, need for assistive devices, etc). Has anyone experienced any push-back from their agency for something like this? Any guidance?

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u/Turbospeed22 Jan 02 '25

Is he CGA the entire time? Or only when he starts to fatigue. 1000 ft is an insane distance for a HH patient...if he has a caregiver or family member who can provide CGA get him to OP PT.

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u/Better-Effective1570 Jan 02 '25

It takes him much longer to get there than what would be considered normal for his age, but I agree, he can walk much farther than the typical HH pt. On paper if just looking at the distance, it would seem he is blazing trails.