Medical Appliances, Home Health Aide, Physical Therapy, Occupational Therapy services

Medical Appliances and Supplies

Medical appliances and supplies may be provided, including drugs and biologicals. Only drugs as defined in §1861(t) of the Act and which are used primarily for the relief of pain and symptom control related to the individual’s terminal illness are covered. Appliances may include covered durable medical equipment as described in 42 CFR 410.38 as well as other self-help and personal comfort items related to the palliation or management of the patient’s terminal illness. Equipment is provided by the hospice for use in the patient’s home while the patient is under hospice care. Medical supplies include those that are part of the written plan of care.

Home Health Aide Services

Only individuals who have successfully completed a home health aide training and competency evaluation program or competency evaluation program as required in 42 CFR 484.36 may provide home health aide services. Home health aides may provide personal care services. Aides may also perform household services to maintain a safe and sanitary environment in areas of the home used by the patient, such as changing the bed or light cleaning and laundering essential to the comfort and cleanliness of the patient. Aide services must be provided under the general supervision of a registered nurse.
“General supervision” of a registered nurse is further clarified in the Medicare State Operations Manual, Appendix M, CFR 418.82, L 191, and L105.

Physical Therapy, Occupational Therapy, and Speech-Language Pathology

Physical therapy, occupational therapy, and speech-language pathology services may be provided for purposes of symptom control or to enable the individual to maintain activities of daily living and basic functional skills. Also, see §40.4 regarding waivers available under certain conditions for provision of these services.