For many older adults, home health care plays a crucial role in recovery after an illness, injury, or surgery. It can act as a bridge between a hospital or skilled nursing visit and caring for oneself. It’s also a way for homebound people to get the support they need. 

However, home health care is usually a short-term service. It’s meant to help stabilize health, rehabilitate, and teach new skills, but it doesn’t last forever.

Most funding sources (particularly Medicare) will stop covering home health care services when the patient recovers enough or sometimes if their progress stalls. This ending point may come too soon for some people, especially if they still have health needs or aren’t fully independent. 

The end of home health care doesn’t mean the end of support. There are still many options out there for getting the help you need. In this article, we’re highlighting options for care depending on your situation when home health care comes to an end.

Why home health care ends

Home health care provides skilled care that you’d typically need to go to a doctor, hospital, or specialist for. Offered services include the following, depending on your needs:

• Skilled nursing care (wound care, IV medication administration, etc.).
• Physical therapy.
• Speech therapy.
• Occupational therapy.
• Assistance with personal care (but only if your doctor deems it medically necessary and only if you need skilled care, too).
• Medical social services (only if you need skilled care, too).

Home health care services are not simply there to make your life easier. Providers travel to the patients because they have a short-term need for medical care after an injury, illness, surgery, or similar situation and are considered homebound (meaning leaving the home is very difficult or impossible).

This process is designed around medical necessity. This means you’re typically eligible for the services when you need them, particularly when visiting a doctor’s office would be difficult. 

Your needs will likely change as you go through home health care, and eventually, the funding will end. What you can do next will depend on your needs at that time.

Immediate next steps

Home health care won’t end suddenly. Your goals and progress will be assessed before any decision is made, and health care providers will work with you to determine the next steps. 

This process will typically involve talking about:

• Alternative sources of any care required.
• Plans for medication management.
• Follow-up appointments with specialists and your primary care physician.
• How to ensure progress continues.
• Local resources and services to support your recovery.

This is also your chance to ask questions. Doing so helps ensure that you’re fully informed about the next steps.

If your health has dramatically improved

This is the best possible outcome and the goal of home health care. 

However, you’ll still need to keep an eye on your health. This includes:

• Taking medications as prescribed.
• Continuing with any exercises recommended by physical therapists.
• Keeping up with personal hygiene.
• Eating well.
• Exercising at a level you are safe and comfortable with.
• Staying socially connected.

You may also want in-home support from a family member or a home care aide. While home care services don’t provide medical support, they can make self-care tasks much safer and easier and also assist with household tasks. 

If you still need support with recovery

When home health care ends, if your health has improved, you might be visiting specialists instead of having them come to you. 

Support options here include the following:

• In outpatient treatment, you can receive some services at your local hospital but are not admitted and can return home the same day.
• Your primary care provider will continue to provide support, recommendations, and health monitoring. 
• You can make follow-up appointments with specialists to continue your work.
• There may also be some programs in your local community, like chronic disease management groups and fall prevention classes. You may find support groups as well, which offer information and social support. 

If you still need help at home

Many people transition from home health care to nonmedical home care services. Although home care does not provide skilled medical care, it still provides substantial support, making it safer and healthier to remain at home. 

Funding options for home care are more limited than for home health care. You might find support through Medicaid waiver or other local programs, or you may need to pay for the service yourself. 

Family can also be helpful here, with family members often stepping up as caregivers. The home health care staff may have even taught them some skills and techniques to help with your care. 

If funding has ended but you still need home health care

The end of funding doesn’t have to mean the end of home health care. Sometimes you’ll simply need to look for other funding sources. 

Depending on your situation, you may be able to use the following to pay for home health care:

• Medicaid.
• Private insurance.
• Long-term care insurance.
• Veterans benefits.

You can also dispute the decision to end your home health care. This can be important because home health care agencies don’t always fully understand Medicare funding. They may even end care when you are actually still eligible.

Your provider is required to give you a notice of Medicare non-coverage when funding has ended. This includes details about how to file an expedited appeal and can help you fight any changes. 

If your needs exceed what family or home care can provide

Some people’s care needs end up exceeding anything that home care and home health care can provide. Family caregiving is also often unrealistic when the individual’s care needs are too high, as family members may not have the required skills and can quickly burn out from the workload.

In such cases, alternative living arrangements like those listed below may be necessary. 

Assisted living

Assisted living helps with daily tasks in a supportive environment. While medical support is limited, assisted living ensures there is always someone on hand to provide support and that any health issues are quickly noticed. These communities also have a variety of programs and services that continue to support residents’ nonmedical needs. 

For example, when a patient receives home health care after hospitalization for a hip fracture, the housekeeping, laundry, and meal services at assisted living can help the resident maintain quality of life and good nutrition if their recovery has left them with less mobility than before the fracture.

Nursing homes

Nursing homes are another 24/7 care environment that offers medical support as well as many nonmedical services. This is a good option for people with significant health challenges, helping to improve safety and quality of life. 

People who require long-term care in a nursing home often have one or more chronic conditions, physical limitations, or cognitive conditions that make it unsafe to live at home. Staffed with licensed nursing professionals, trained caregiving staff, attending physicians, and visiting specialists, these facilities provide the greatest access to skilled care outside a hospital setting.

Memory care

Memory care focuses on people with dementia and provides specialized support to improve their lives. This care may be provided in a stand-alone memory care facility or in another setting, such as a nursing home, assisted living, or even in the individual’s home. 

To decide the next step, you’ll need to think about current needs and how these might change in the future. Primary care physicians are important here. They’ll often be able to inform you about possible future changes and what such changes mean for care needs. If you’re considering different senior care options, contact your local Oasis Senior Advisor for information and guidance.