For case managers, discharge planners and physician offices
Complex and specialty care at home.
BREMA accepts complex, high-acuity home health referrals: first-dose IV medication and inotropes, injections, new diagnosis teaching, ostomy care, wound care and wound VAC, and in-home PT/INR testing. Fax the packet and you’ll have a yes or no within 30 minutes, Monday–Friday, 8 a.m.–5 p.m.
Medicare-certified since 2009 · CCN 747205 · Medicare plus 28 other health plans
First-dose IV & inotropes
First-dose IV medication in the home, ongoing IV therapy and inotrope infusions for patients with heart failure.
IV therapyInjections & medication administration
Injections and other medications given as ordered, with a full medication review after discharge.
InjectionsNew diagnosis teaching
Plain-language teaching and management for a new diagnosis such as diabetes or heart failure.
New diagnosesOstomy care
Pouch changes, skin care and hands-on teaching until the patient or caregiver can manage on their own.
Ostomy careWound care & wound VAC
Surgical, pressure and diabetic wound care, including negative pressure wound therapy.
Wound carePT/INR testing
In-home PT/INR checks for patients on warfarin, with results sent to the prescriber.
PT/INRInfusion
Can BREMA give a first dose of IV medication at home?
Yes. BREMA nurses give first-dose IV medication in the patient’s home when the physician orders it, along with ongoing IV medication and inotrope infusions for patients with heart failure. The physician orders the medicine, an infusion pharmacy delivers it, and the nurse gives it, checks the line and teaches the patient and family what to watch for.
What we provide
- First-dose IV medication in the home
- Ongoing IV medication on the ordered schedule
- Inotrope infusions for patients with heart failure
- IV line checks and dressing care
- Patient and family teaching: warning signs and when to call
Send with the referral
- Signed orders with medication, dose, route, frequency and length of therapy
- Infusion pharmacy name and contact
- IV access type and placement date
- History and physical or discharge summary, and face-to-face documentation
- Front and back of insurance cards
If the patient qualifies for home health, Medicare covers the nursing visits. The IV medicine and pump may be billed separately, depending on the drug and the plan.
Medications
Can a BREMA nurse give injections at home?
Yes. BREMA nurses give injections and other medications at home when the physician orders them, and teach the patient and family how to manage them. After a hospital or facility stay, the nurse checks every medicine against the discharge orders and contacts the physician with any questions.
What we provide
- Injections and medication administration as ordered
- A full medication review after a hospital or facility stay
- Help sorting old and new medicines and setting up a routine
- Pain assessment and help managing pain medicines
Send with the referral
- Current medication list and any changes made at discharge
- Orders for injections or medication administration
- History and physical or discharge summary, and face-to-face documentation
- Front and back of insurance cards
Teaching
Does BREMA help patients with a new diagnosis?
Yes. BREMA nurses teach patients and families about a new diagnosis, such as diabetes or heart failure, in plain language: the medicines, daily care, and the warning signs that mean it’s time to call the doctor. Teaching follows the physician’s plan of care.
For families: help with a new diagnosis at home
- Plain-language teaching on the diagnosis and its medicines
- Daily self-care routines, such as checking weight or blood sugar
- Warning signs and when to call the physician
- Updates to the physician on how the patient is managing
Ostomy
Does BREMA provide ostomy care and training at home?
Yes. BREMA nurses provide ostomy care and training at home, including pouch changes, skin care, stoma checks and hands-on teaching, and keep teaching until the patient or caregiver can manage the ostomy with confidence, within the plan of care.
What we provide
- Pouch changes and skin care
- Checks of the stoma and the skin around it
- Hands-on teaching for the patient and caregivers
- Teaching on food, fluids and daily activities with an ostomy
- Updates to the surgeon or physician about any concerns
Send with the referral
- Surgical and ostomy care orders
- Operative note or discharge summary
- Type of ostomy and current supplies
- Face-to-face documentation
- Front and back of insurance cards
Under Original Medicare, the supplies used in your home health care are included. Other plans vary, and we explain any costs before your first visit.
Wound care
Can BREMA manage a wound VAC at home?
Yes. BREMA nurses provide negative pressure wound therapy at home, including wound VAC dressing changes and device checks, as ordered by the physician. We also care for surgical, pressure and diabetic wounds with dressing changes, measurements and teaching.
What we provide
- Wound checks and measurements at each visit
- Dressing changes as ordered
- Wound VAC dressing changes and device checks
- Care for surgical, pressure and diabetic wounds
- Updates to the ordering physician or wound clinic
Send with the referral
- Wound care orders, including dressing type and how often to change it
- Wound VAC settings and the equipment supplier
- Most recent wound notes
- History and physical or discharge summary, and face-to-face documentation
- Front and back of insurance cards
A wound VAC and its supplies may be billed separately from the home health visits, depending on the device and the plan.
Anticoagulation
Does BREMA do PT/INR testing at home?
Yes. BREMA nurses check PT/INR in the patient’s home on the schedule the prescriber orders and send the results to the prescriber who manages the blood thinner. The prescriber decides on any dose change, and the nurse helps the patient follow the new instructions. A blood draw alone doesn’t qualify a patient for Medicare home health. The patient also needs another qualifying skilled need, such as skilled nursing, physical therapy or speech therapy.
What we provide
- PT/INR checks at home on the ordered schedule
- Results sent to the managing prescriber
- Teaching on the medicine, and the foods and other drugs that can change INR
- Teaching on signs of bleeding and when to call
Send with the referral
- Order with testing frequency and target INR range
- Name and fax number of the prescriber managing the blood thinner
- Current dose
- History and physical or discharge summary, and face-to-face documentation
- Front and back of insurance cards
Not sure a patient fits?
Ask before you send the packet.
Tell us the health plan, the area and the care needed, with no patient names or details. We’ll call you back with a yes or no.
Common questions
Questions from referral partners
Does BREMA accept high-acuity home health referrals?
Yes. BREMA accepts referrals for first-dose IV medication and inotropes, injections, new diagnosis teaching, ostomy care, wound care and wound VAC, and PT/INR testing, along with skilled nursing and physical, occupational and speech therapy.
Does BREMA provide home inotrope infusions?
Yes. BREMA provides inotrope infusions at home for patients with heart failure, with nursing visits, monitoring and family teaching as ordered by the physician.
Who decides on a dose change after a home INR check?
The prescriber does. BREMA sends the result to the prescriber, who decides whether the dose should change, and the nurse helps the patient follow the new instructions.
Can a patient get home health for PT/INR checks alone?
No. A blood draw alone doesn’t qualify a patient for Medicare home health. The patient also needs another qualifying skilled need, such as skilled nursing, physical therapy or speech therapy.
Does Medicare cover complex care at home?
Yes, if the patient qualifies for home health. Medicare covers the skilled nursing visits. IV drugs and wound VAC equipment may be billed separately, depending on the item and the plan.
How fast will I know if BREMA can take the patient?
You’ll have a yes or no within 30 minutes of sending the referral, Monday through Friday, 8 a.m. to 5 p.m.
Make a referral
Send the packet. Get an answer in 30 minutes.
Fax the referral packet to 214-339-2733 or call intake at 214-339-9466, Monday–Friday, 8 a.m.–5 p.m.
What to sendSource: Medicare.gov, Home health services (opens in a new tab)