A registered nurse gets to know you.
The nurse asks about your health, your goals and your daily routine, and checks your vital signs.
Skilled nursing
Skilled nursing at home.
Skilled nursing at home is care from a registered nurse (RN) or licensed vocational nurse (LVN) that your doctor orders. The nurse visits on a set schedule, checks how you’re doing, gives treatments and teaches you and your family how to manage your health between visits.
A nurse visit
What does a home health nurse do during a visit?
A home health nurse checks your health, reviews your medicines, gives the treatments your doctor ordered and teaches you how to care for yourself between visits. The nurse also keeps your doctor up to date, so your plan of care can change when you need it to.
How often the nurse comes depends on your doctor’s orders and your needs. Visits are often more frequent at the start and fewer as you get stronger.
What happens at a visit
- Health checks, such as blood pressure, heart rate, breathing, weight and pain
- Watching for early signs that a condition is getting worse, and calling your doctor
- A review of every medicine, with teaching
- Teaching for long-term conditions such as heart failure, COPD and diabetes
- Care after surgery, including incision checks
- Working with your doctor, therapist and aide on one plan
What to expect at the first nurse visit
Every medicine gets a review.
The nurse goes over each medicine with you and compares it with your doctor’s or hospital’s orders.
Your plan of care takes shape.
The nurse builds the plan of care with your doctor and explains the visit schedule.
Medicare covers skilled nursing at home when your doctor orders it, you’re homebound and you need part-time or intermittent skilled care from a Medicare-certified agency. Who qualifies and what Medicare pays · Source: Medicare.gov (opens in a new tab)
Home or facility?
Is skilled nursing at home the same as a skilled nursing facility?
No. A skilled nursing facility (SNF) is a place you move into for a while, with staff there day and night. Skilled nursing at home means a nurse comes to your home for visits, and you keep living at home between them. Both are called “skilled nursing,” which is why people mix them up.
Skilled nursing at home
- You live in your own home
- A nurse comes for visits on a schedule your doctor orders
- You and your family handle daily care between visits, with teaching from the nurse
- Does not include 24-hour care
Skilled nursing facility (SNF)
- You stay at the facility, often after a hospital stay
- Nurses and aides are on site day and night
- Staff handle meals, medicines and daily care
- When you leave, home health can help you settle in at home
You choose. You can choose any Medicare-certified home health agency that serves your area, and you can ask your doctor or case manager for BREMA by name.
Medicines
Can a home health nurse give injections and manage medicines?
Yes. A BREMA nurse can give injections and other medicines at home when your doctor orders them, and teach you and your family how to manage them. After a hospital or facility stay, the nurse checks every medicine against the discharge orders and contacts your doctor with any questions.
What your nurse does
- Gives injections and other medicines as ordered
- Does a full medication review after a hospital or facility stay
- Helps you sort old and new medicines and set up a routine
- Contacts your doctor with any questions about your medicines
How your family can help
- Put every medicine in one place before the first visit, including vitamins and ones you buy without a prescription
- Keep the hospital or facility discharge papers close by
- Write down questions as they come up, so you can ask at the next visit
IV therapy
Can a nurse give IV antibiotics at home?
Yes. When your doctor orders IV medicine, such as antibiotics, a BREMA nurse can give it in your home, check the IV line and teach you and your family what to watch for. Your doctor orders the medicine, an infusion pharmacy delivers it, and the nurse gives it.
This is medicine your doctor prescribes for an illness. It is not the IV hydration or vitamin drips some businesses sell.
IV medicines at home
Antibiotics and other IV medicines are given on the schedule your doctor orders. The nurse checks the IV line, cares for the dressing and teaches you the warning signs that mean it’s time to call.
A first dose at home
Sometimes the very first dose of a new IV medicine is given at home instead of in the hospital. When your doctor orders this, a BREMA nurse gives the first dose in your home and checks how you respond.
Inotropes for heart failure
Inotropes are IV heart medicines that help a weak heart pump. Some people with heart failure get them at home through a small pump. BREMA nurses provide inotrope infusions at home, with nursing visits, monitoring and family teaching as the doctor orders.
If you qualify for home health, Medicare covers the nursing visits. The IV medicine and pump may be billed separately, depending on the drug and your plan.
Blood thinners
Can a nurse check my PT/INR at home?
Yes. If you take a blood thinner such as warfarin, a BREMA nurse can check your PT/INR at home on the schedule your doctor orders and send the results to the doctor who manages your blood thinner. PT/INR is a blood test that shows how long your blood takes to clot.
Your doctor decides on any dose change, and the nurse helps you follow the new instructions.
A blood draw alone doesn’t qualify you for Medicare home health. You also need another qualifying skilled need, such as skilled nursing, physical therapy or speech therapy.
What your nurse does
- Checks PT/INR at home on the ordered schedule
- Sends results to the doctor who manages your blood thinner
- Teaches you about the medicine, and the foods and other drugs that can change your INR
- Teaches you the signs of bleeding and when to call
Ostomy care
Can a nurse help with ostomy care at home?
Yes. A BREMA nurse can help with ostomy care at home, including pouch changes, skin care, stoma checks and hands-on teaching, and keeps teaching until you or your caregiver can manage the ostomy with confidence, within the plan of care. An ostomy (or stoma) is an opening made during surgery so stool or urine can leave the body into a pouch.
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.
What your nurse does
- Pouch changes and skin care
- Checks of the stoma and the skin around it
- Hands-on teaching for you and your caregivers
- Teaching on food, fluids and daily activities with an ostomy
- Updates to your surgeon or doctor about any concerns
New diagnosis
What help is there at home after a new diagnosis?
A BREMA nurse teaches you and your family 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 your doctor’s plan of care.
A new diagnosis can feel like a lot to learn at once. The nurse goes one step at a time and checks what you’ve learned at each visit.
What teaching covers
- 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 your doctor
- Updates to your doctor on how you’re managing
Pain assessment
How does a home health nurse help with pain?
At each visit, your nurse asks about your pain, how it affects your day and how your pain medicines are working. The nurse shares what you report with your doctor, so your care plan can be adjusted if needed.
Things to tell your nurse
- Where it hurts and how bad it is, from 0 to 10
- What makes it better or worse
- Whether pain keeps you from sleeping, eating or moving
- How your pain medicine is working, and any side effects
Between visits
When should I call the agency, the doctor or 911?
Call 911 for an emergency. Call BREMA when something changes and you’re not sure what to do, and call your doctor about the things your doctor asked you to report. Your nurse goes over this with you at the first visit.
Call 911
- Trouble breathing or chest pain
- Signs of a stroke, such as a drooping face or sudden weakness
- Bleeding that won’t stop, or a bad fall
Call BREMA
- A new or worse symptom that isn’t an emergency
- A question about a medicine, an IV line or a supply
- A visit you need to move
(214) 339-9466, Monday–Friday, 8 a.m.–5 p.m.
Call your doctor
- Anything your doctor asked you to report, such as a weight gain or a blood sugar out of range
- Questions about changing a dose or starting a new medicine
Outside office hours, follow the instructions your nurse gives you at the first visit or call your doctor. In an emergency, always call 911.
Related care
Need wound care or therapy, too?
Nurses also care for wounds at home, and therapists can visit under the same plan of care.
Wound care and wound VAC
Dressing changes, wound VAC and care for surgical, pressure and diabetic wounds at home.
Wound care at homePhysical therapy
Build strength, work on balance and move with more confidence around your home.
Physical therapy at homeAll home health services
Occupational and speech therapy, medical social work and home health aides.
Our careFor case managers and physician offices
Referring a patient for skilled nursing?
BREMA accepts skilled nursing referrals, including first-dose IV medication, inotropes, injections, ostomy care and PT/INR testing. Fax the referral packet to 214-339-2733 or call intake at 214-339-9466, and you’ll have a yes or no within 30 minutes, Monday–Friday, 8 a.m.–5 p.m.
See what to send for IV, injections, ostomy care and PT/INR on our complex and specialty care page
Common questions
Questions about skilled nursing at home
How often does a home health nurse visit?
It depends on your doctor’s orders and your needs. Visits are often more frequent at the start and fewer as you get stronger. Your nurse explains the schedule at the first visit.
Does Medicare cover a nurse coming to my home?
Yes, if you qualify for home health. Medicare covers skilled nursing at home when your doctor orders it, you’re homebound and you need part-time or intermittent skilled care from a Medicare-certified agency. Under Original Medicare, you pay $0 for covered home health visits. See who qualifies.
Will a home health nurse stay with me all day?
No. Home health nurses come for visits, not shifts. Medicare does not cover 24-hour care at home, or personal care alone when it’s the only care you need.
What is the difference between an RN visit and an LVN visit?
A registered nurse (RN) does the first assessment and builds the plan of care with your doctor. A licensed vocational nurse (LVN) may handle follow-up visits under that plan.
Can a nurse give IV antibiotics at home?
Yes. When your doctor orders IV antibiotics or other IV medicine, a BREMA nurse can give it at home, check the IV line and teach you what to watch for. An infusion pharmacy delivers the medicine.
Can I get home health just for PT/INR checks?
No. A blood draw alone doesn’t qualify you for Medicare home health. You also need another qualifying skilled need, such as skilled nursing, physical therapy or speech therapy.
Can a home health nurse help with heart failure or COPD?
Yes. BREMA nurses check symptoms such as weight, swelling and breathing, review medicines, and teach you which warning signs mean it’s time to call your doctor.
Can I choose which agency provides my home health?
Yes. You can choose any Medicare-certified home health agency that serves your area. Tell your doctor or hospital case manager you want BREMA.
Have questions about skilled nursing at home?
Call us Monday–Friday, 8 a.m.–5 p.m. We can tell you if home health may help, whether we serve your address and if we take your plan, even if you haven’t talked to your doctor yet. You choose your home health agency, and you can ask for BREMA by name.