Medicare-certified home health from Pathways. A nurse, a therapist, an aide, and a plan built on your own doctor’s orders — brought to the place where your strength actually returns.
A licensed nurse, a physical or occupational therapist, a speech therapist, a social worker, or a home health aide — coming to your house on a schedule built around your recovery, not an office’s hours.
The patient is the focus. The home is the setting on purpose. Recovery happens faster in the rooms a person already knows. Sleep is better. Infection risk is lower. Falls happen in unfamiliar buildings more than in the spaces walked for thirty years. Home health lets the medical work meet the patient where the recovery actually has to land.
Pathways Home Health is Medicare-certified, state-licensed across six states, and operates in coordination with your primary care physician or specialist throughout the episode. Care is ordered by a physician; we execute the plan and report progress back — faithfully, every visit.
Home health is appropriate for any patient with a skilled care need who is homebound (going out is a meaningful effort) and whose physician has ordered the service. Below are the common reasons we see — none of them a checklist; eligibility is always a clinical judgment.
Total knee, total hip, spine, cardiac, abdominal, breast. PT to restore strength and gait, OT for ADLs, RN for wound and pain. The protocol can be tailored to your surgeon’s specifics.
Pneumonia, sepsis, AKI, exacerbations, new diagnoses. Medication reconciliation, transition-of-care coordination with your PCP, monitoring for the change-in-condition that sends people back to the ED.
CHF, COPD, diabetes, ESRD, post-MI. Weights, vitals, breath sounds, glucose, medication titration, teaching, early-warning detection. We catch what would have become a hospital readmission.
Pressure injuries, surgical incisions that aren’t healing, diabetic foot ulcers, ostomy education, drain management, wound vacs. Skilled wound nurses, photo tracking, communication with your wound clinic.
IV antibiotics, hydration, biologics, blood products in appropriate settings. PICC and port management, line draws, pump teaching, on-call coverage for any line concern.
Patients recovering from a fall, after a hospital deconditioning, with new mobility limits. Home safety assessment, fall-prevention training, structured PT/OT, equipment recommendations and ordering.
Not sure if home health is right? Call 800.939.1855. Our admissions nurse will ask a few questions, talk with your physician’s office, and have you set up the same day. Most referrals come from a hospital, a PCP office, or a specialist; patients and families can also call directly.
On day one, an RN comes for the admission assessment. Within twenty-four hours of intake, your plan of care is built, ordered by your physician, and visits begin. The mix of disciplines depends on what your recovery needs.
Your primary clinical contact. Wound care, IV therapy, medication management, vital signs, teaching, escalation when something changes. Communicates with your physician throughout.
Gait, strength, balance, exercise program, mobility, transfer training. Equipment recommendations: walkers, canes, grab bars. Home safety assessments to prevent the next fall.
Activities of daily living — dressing, bathing, eating, cooking. Energy conservation, adaptive equipment, getting back to the day-to-day. Critical for stroke and post-op recovery.
Swallow safety, voice and speech recovery after stroke, cognitive-communication rehab. Aspiration-risk evaluation. Diet and texture recommendations to your physician.
Bathing, dressing, light grooming, mobility support. Aide hours are added when the skilled team determines they’d support the plan of care — in support of family caregiving, not in place of it.
Insurance navigation, community resource referrals, advance directives, family-system coordination. Available when a recovery’s biggest variable isn’t medical — it’s logistical.
For patients who meet eligibility (homebound + skilled need + physician order), Medicare Part A or B covers home health services at no out-of-pocket cost: nursing, PT, OT, ST, social work, and aide hours under the plan of care. Some equipment — a walker, a hospital bed — can carry a Medicare coinsurance, so we verify your specific coverage at intake and tell you exactly what is and isn’t covered before we start — no surprise bills.
The patient feels off. The wound looks different. The medication isn’t agreeing. The breathing is harder than yesterday. Home health is not just the scheduled visits — it is the line you call when something is different and you’re trying to figure out whether to wait, do something at home, or go to the ED.
One phone number. A real nurse on the line — not voicemail, not a triage answering service. Knows the patient’s chart, knows what was happening this morning, can make a decision.
Often the right answer is a teaching call: yes, that’s normal at day five; here’s what to watch for; we’ll come tomorrow morning. Sometimes it’s a same-night visit. Sometimes it’s “go to the ED now — we’ll call them and tell them you’re coming.”
For wound concerns, IV issues, medication reactions, post-op pain that isn’t responding — an on-call nurse comes to the home. Often the difference between staying home and going back to the hospital.
We don’t go around your PCP. Whatever happens overnight, your physician’s office gets a note the next morning. The relationship between your doctor and your home health team is the engine of why this works.
Most rehospitalizations are not inevitable. They are the cost of not having someone you can call.
— From our team manual.
Recovery puts pressure on families. Home health is what lets the family go back to being the family — not the medical team. We come with the protocols, the equipment, and the clinical eye; you bring the people, the meals, the schedule.
Yes. Home health is physician-ordered. Your PCP or specialist remains the attending; we execute the plan and report back. We do not replace your primary care relationship.
For patients who qualify (homebound + skilled need + physician order), Medicare Part A or B covers home health services — nursing, therapy, social work, and aide visits — at no out-of-pocket cost. Most commercial plans include home health benefits. We verify coverage at intake and tell you exactly what’s covered before we start — no surprise bills.
The Medicare home-health episode is 60 days. Near the end, we re-evaluate progress with your physician. Most patients are discharged because they’ve met goals; some are re-certified for another 60 days; some transition to palliative care or hospice if the trajectory has changed.
Yes. All visits happen wherever the patient lives. We bring the supplies, the equipment, and the team. Visits are scheduled around your day — mornings, afternoons, evenings, weekends.
That’s common. We adjust. The plan of care is reviewed weekly. If you need different therapy intensity, a different discipline added, or a shift in approach — we change it. If we’re finding that the medical picture has shifted in a way that home health isn’t the right service anymore, we say so and coordinate the right next step.
Same day in most cases. Once the physician’s order is in, our admissions nurse calls, the assessment visit gets scheduled, and care begins the same evening or next day. Discharges from hospital go straight to home with our team often waiting to do the assessment that afternoon.
Call 800.939.1855 — our admissions nurse will guide you. Or ask your physician (PCP, surgeon, hospitalist) to send a referral. Most referrals come through directly from hospital discharge planners.
Most home health patients recover and discharge. A subset whose serious-illness picture is more complex benefit from palliative care alongside home health, and a smaller number whose disease trajectory has turned transition to hospice. The team carries across without handoff.
Medicare-certified, intermittent skilled care after a hospital stay, surgery, or for managing a chronic condition. The goal is recovery and independence at home.
Physician-led symptom management and care planning for serious illness, alongside curative or active treatment. Patients are not yet eligible for hospice.
See Palliative →End-of-life care focused on comfort and presence. For patients whose disease can no longer be cured but whose remaining time can still be lived well at home.
See Hospice →We come to you. We stay with you. Whatever you need — and whatever comes next.
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Whether you’re a hospital discharge planner, a PCP, a specialist, a patient, or a family figuring out next steps — one call. A real admissions nurse picks up, asks the right questions, and tells you exactly how home health would work for this patient. No sales script. No “we’ll call you back tomorrow.”
