Home health physical therapy meaning

Deborah C. Escalante

Home health physical therapy encompasses a wide range of services that PTs and PTAs provide in the home.

If you practice physical therapy in a home setting, we have resources to support you.

The APTA Home Health Section is specifically dedicated to those who share a common interest in the delivery of physical therapy in the home and other alternative settings within the community.

Home health care can be cost-efficient, convenient, and as effective as the care patients get in a hospital or skilled nursing facility. Home health PTs and PTAs work one-on-one with patients in their own environment, making services completely relevant to the patient’s needs and goals.

by Dr. Erin Carr, June 22, 2015

Home Physical Therapy vs. Home Health Physical Therapy

You would think home physical therapy and home health physical therapy are the same thing.  After all they do sound the same.  However, they are very different. Gaining a better understanding of physical therapy and the meanings of these different types of physical therapy in home treatments can be very helpful. Especially for a patient looking for help in their own healing process. Once you have gained a better understanding of these terms.  You will be able to selct the appropriate type of home physical therapist for you.

What are the differences?

The basic concept of the term “home physical therapy” usually refers to what is more officially known as “outpatient” private practice physical therapy in the home. Similar to the home physical therapy treatments Dr Carr Integrative Physical Therapy provides. Private practice home physical therapy treatments offer more freedom or greater abilities of what private practice physical therapists can do to help heal their patients.

In contrast, home health physical therapists are more limited in the type of treatments they provide. In general they focus on more basic “exercise only” styles of treatment.  These exercise only treatments offer no “hands on” methods or more advanced PT treatment beyond exercise.  Home health physical therapy is usually prescribed immediately after a patient is released from the hospital. The patient may be considered more fragile by the medical industry, and thus not ready for the more progressive extensive healing treatments that an outpatient private practice home physical therapist may use. A home health physical therapist may be part of a larger home health team. Such as a home health nurse or other home health medical practitioners. Generally, home health physical therapists are part of larger corporate agencies.  Home health PTs are there to help with a patient’s short term basic recovery. In addition patients must be discharged from their home health services before they are able to receive treatment from outpatient private practice home physical therapy doctors.

There is a gray area that is worth mentioning. Since the definition of Outpatient Therapy basically means:

“a form of therapeutic treatment that is offered to people who do not need to be hospitalized.”

This is the gray area, as home health physical therapy is for people who were recently discharged from the hospital… Since they were hospitalized but are no longer, a person could argue that by definition home health could be considered under the outpatient category…

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But for our sake, when trying to find the right in home physical therapy for you. This is more semantics than reality. When you personally are looking for the appropriate physical therapist for your home. Simply ask if they are a home health physical therapist, or if they are an in home physical therapist. For absolute clarity you could add; “private practice home physical therapist”.  Or, to be more literal you could ask if they provide; “private practice outpatient home physical therapy”. But most PTs will understand exactly what you mean by simply asking if they provide home health physical therapy or in home physical therapy.

Here is an expanded explanation:

In Home Physical Therapy

Standard hospital doctors do not usually prescribe outpatient private pratice home physical therapy after a patient is discharged from the hospital. However, home physical therapy can be prescribed by a patient’s primary care doctor, or a specialist. Also, patients can self refer, without a prescription, if they feel they need it.  If a patient wants to self refer, they simply can call a physical therapy clinic themselves and ask for an Initial Consultation.  The pt clinic should be able to help you gain a better understanding, of the initial steps to take, in order to start physical therapy.  (there are some caveats to this, in terms of medical insurances and out of network treatments, which are specific to each persons situation as well as the PT they choose.) In home physical therapy is more of an all-encompassing advanced healing experience. It is provided by expert progressive physical therapists in home.  In home physical therapy isn’t just for patients returning home from the hospital. But people of all ages with many types of injuries. Whether a youth, adult or beyond. Home physical therapy molds to the specific needs of the patient. If you have an acute injury… The gentle hands on healing treatments can be used to help heal the injured area(s) of the body by enhancing visceral balance and blood flow. Our home physical therapy integrates these advanced methods with functional strength, balance and range of motion exercise specific to the patients needs. As the physical therapists in home treatments progress. The PT will utilize the patient’s indoor and outdoor home environment to help promote additional optimal healing and recovery.

Home Health Physical Therapy

Home health PT focuses on walking, simple strengthening, and range of motion exercises in the home. This can help a patient who has recently been hospitalized for an injury or condition. It is prescribed by a doctor immediately after the patient is discharged from the hospital.  This type of prescription focuses on patients who need physical therapy due to weakness, a loss of range of motion, strength or impaired function after hospitalization. For example, a patient who had a knee replacement will often be sent home and prescribed home health physical therapy several times a week for about a month. They focus on knee range of motion; walking and simple exercises that help the patient start moving again. Once they get to a certain level of function, they are then discharged from home health PT. Home health physical therapy is basically designed to be short-term to help a patient transition from hospital to home.

If you would like to find out more about the benefits or definitions of home physical therapy at all stages of recovery… Or to discuss enhancing your particular injury recovery situation you can contact Dr. Carr directly.

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If you have a problem that results in pain or loss of functional mobility, you may benefit from the skilled services of a physical therapist. Your therapy will be focused on helping you restore normal mobility so you can get back to the things you enjoy.

A PT working with a man in his home

Stígur Már Karlsson / Heimsmyndir / Getty Images

Physical therapy care may be provided in a variety of different settings. Obviously, if you are hospitalized, your therapy may be provided by a physical therapist who works at the hospital. If you require sports therapy, you may go to an outpatient PT clinic.

Some patients have difficulty leaving the house to go to physical therapy. These people may still enjoy the benefits of physical therapy in their home. A physical therapist may come to their house to work with them to restore normal functional mobility.

So what is in-home physical therapy, who how might you benefit from PT in your home?

What Is Home-Care PT?

Home-care physical therapy occurs when a physical therapist comes to your home to provide rehabilitation services. This type of service is reserved for patients who are unable to leave the house to attend PT. This can occur for a variety of reasons, including:

  • Your condition is acute or severe and leaving the home presents a health risk
  • Your functional mobility is limited and you cannot travel to therapy
  • You lack adequate transportation or access to transportation to get to your physical therapy
  • You simply desire a private PT session in your home

Most physical therapy services in the United States are covered by insurance, and certain rules apply to home-care physical therapy to be covered by your insurance carrier.

For most insurance plans, physical therapy in your home will be a covered service if you are able to demonstrate significant barriers to you leaving the house. These barriers may be due to your injury or illness or due to your inability to travel.

If you choose to have PT at home just because it is convenient for you, your insurance company may not cover the service and you will have to pay for the therapy yourself.

How Do You Get In-Home PT?

If you suffer an injury or illness that limits your ability to move around normally, you may benefit from PT. And if you cannot leave the house, home-care physical therapy may be the best option.

Most patients who receive home-care physical therapy are referred to the service by their healthcare provider. Your healthcare provider can make the referral to a local visiting nurse service that offers physical therapy, and he or she can attest that home services are medically necessary. This medical necessity report will likely also state that home-care physical therapy is needed because you are unable to leave the house due to your condition or circumstances.

If you feel you may benefit from physical therapy at home, you can also call your local physical therapy clinic or visiting nurse association. Those organizations can help you navigate the pathway to receiving home-care PT.

Who Can Benefit From It?

So how do you know if you can benefit from home-care physical therapy? In general, if you have any problem that results in a loss of functional mobility, you may benefit from working with a physical therapist. And if you are having difficulty leaving the house, a PT can come to your home. Conditions that may require home-care physical therapy may include:

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If you have a problem that keeps you from moving normally and if it is burdensome to leave your home for therapy treatment, you may benefit from having your rehab in your home.

What If I Don’t Qualify?

Sometimes, patients want to have home-care physical therapy, but their insurance company denies coverage. This may happen if your insurance company determines that your condition does not warrant in-home physical therapy. It may also occur if you have not proven that you are unable to leave your home or if leaving your home for PT presents a significant burden.

If home-care services are denied, you may have a right to appeal. Call your insurance company and ask about an appeals process. You may also wish to call your healthcare provider’s office to explain your situation. Your healthcare provider may be able to help you navigate the appeals process.

If you do not qualify for home-care PT, you can attend physical therapy at a local outpatient clinic. Of course, you will have to travel to the clinic for treatment. Your outpatient physical therapist should be able to provide you with home exercises to do in order to limit your trips to their facility for rehab.

You may also wish to simply pay a private home-care physical therapist to come to your house for therapy if you do not qualify for services. However, this option may be financially burdensome.

Is In-Home PT Effective?

Many people wonder if home-care physical therapy is effective. Why? Because many believe that you need expensive, heavy equipment and exercise tools to engage in an effective rehab program. This is not necessarily true. Your home-care physical therapist is trained to utilize available resources to maximize your rehab experience. He or she can also bring light equipment to your home to ensure you get the most out of your physical therapy.

A 2016 study published in the journal Orthopaedic Nursing examined the functional outcome of patients after total knee replacement surgery. Some of the patients in the study had home-care physical therapy followed by outpatient PT, while other patients attended outpatient PT only. The authors of the study found no difference between the two groups when looking at function and range of motion (ROM) measurements. Having PT at home after knee replacement did not provide significant benefit, but it also did not contribute to a negative outcome.

Another small study found that patients who suffered upper extremity hemiparesis and weakness after a stroke had an improved outcome and satisfaction with outcome after receiving in-home therapy services. This study only included six patients, so it is not considered very powerful. Still, it indicates that there may be a positive benefit to home-care physical therapy.

While having home physical therapy, you will hopefully get better. As your condition improves, your functional mobility may improve, and you may be able to start leaving the home regularly. If this happens, your home-care physical therapist may discontinue in-home services. At that time, you may continue your rehab in an outpatient PT facility.

A Word From Verywell

Working with a physical therapist after illness, injury, or surgery can help you recover full functional mobility. This can allow you to return to your normal work and recreational activities. Sometimes, your injury or your personal circumstances may prevent you from safely leaving your home to attend physical therapy. If this is the case, you may benefit from home-care physical therapy. Working hard at home with your PT can help you have a positive outcome to regain maximal functional mobility.

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