Mountain States Home Care and Hospice is committed to providing quality home care services. Acting as an extension of your physician's practice, we provide comprehensive, professional care.  One call can provide all your home care and hospice needs.

Who is eligible for Home Care?

Home Health may be appropriate for you or a member of your family if:

  1. You are homebound and cannot easily leave your home
  2. You require skills of a nurse or therapist such as:
  • Additional care following your discharge from a hospital or nursing home
  • Monitoring of medications or a long-term illness
  • Skilled nursing care or short-term observation due to a recent illness
  • Care for recurrent heart problems or diabetes
  • Rehabilitation services to regain or improve your mobility or to enable you to improve independent living skills

    3.  You are under the care of a physician. 

I have Medicare. Am I eligible for Home Care?

  1. Is Patient Confined to His Home? - In order for an individual to be eligible to receive covered home care services under Medicare, the law requires that a physician certify that the individual is home bound. An individual does not have to be bedridden to be considered homebound. However, the condition of the patient should be such that there exists a normal inability to leave home and, consequently, leaving the home requires a considerable and taxing effort.

    When the patient does leave the home, the absences from home will usually be for the purpose of receiving medical treatment. However, occasional absences for non-medical purposes, e.g., an occasional trip to the barber, or to attend church, do not necessarily mean the individual is not homebound.
  2. The patient must need the skilled health services of a nurse or therapist.
  3. Services must be ordered by a physician.
  4. Services are reasonable and necessary to the treatment of illness or injury.
  5. Frequency of visits is determined by individual need and must be intermittent.

Team members of the agencies of MSHA are available to discuss your eligibility under the Medicare program.
TennCare, VA Medicaid, Medicare Advantage Programs (HMO) and commercial insurance companies often provide coverage for home care services; the coverage amounts and deductible arrangements vary depending upon the insurance. The agency will contact your insurance company to determine your eligibility, deductible and co-pays.

In order to avoid extra charges, you must notify us if your insurance changes. Otherwise you may be liable for the charges.

Admission, Discharge, Transfer 

Admission to home health generally occurs after admission criteria are met and within 24-48 hours after the agency is notified. During admission the nurse or therapist will work with you to develop a plan of care to meet your needs. Your input is needed to complete this plan. A physical assessment will be completed.

Transfer or Discharge from the agency occurs under several situations:

  • Treatment goals are met
  • The patient's needs change and can no longer be met by the agency
  • The home is not safe for the patient or agency staff
  • The patient is non-compliant
  • The patient's needs do not meet Medicare or other insurance coverage guidelines
  • Non-payment of charges
  • The agency does not have the resources to care for the patient 

Notice of Non-Coverage

  • Medicare patients receive a notice of non-coverage approximately 2 days before discharge. This notice identifies date of discharge from the agency and provides information related to appealing the discharge. 

Advance Beneficiary Notice (ABN)

  • Medicare patients receive this document when the patient's situation has changed significantly and the agency believes care will no longer be covered under Medicare benefits. The ABN provides information on the appeal process.