When a doctor says you need a nurse, many families picture a hospital bed or a nursing facility. In many cases, though, skilled nursing at home in Tampa is an option. A licensed nurse comes to your house, gives the care your doctor ordered and teaches you and your family how to stay well between visits. This guide explains what skilled nursing at home is, what a nurse actually does on a visit, how it differs from home care, and who qualifies.
What is skilled nursing at home?
Skilled nursing is medical care that needs the training and judgment of a licensed nurse. At home, it is given by a registered nurse (RN) or a licensed practical nurse (LPN) who works for a home health agency. It always starts with an order from your doctor or another allowed practitioner, and it follows a written plan of care your doctor approves.
The word “skilled” matters. Helping someone bathe, cook or get dressed is important, but it is not skilled nursing. Skilled nursing is things like checking how a surgical wound is healing, giving an injection, caring for an IV line, or noticing that swelling in the ankles means heart failure may be getting worse.
What does a home health nurse do?
Every visit is guided by your plan of care, so no two patients get exactly the same visits. Depending on your needs, a home health nurse may:
- Check your blood pressure, pulse, breathing, oxygen level, weight and other signs tied to your condition
- Care for surgical incisions, wounds and ostomies
- Give IV antibiotics or fluids and care for IV lines, including PICC lines (see our guide to home IV therapy). We do not insert PICC lines; your hospital or infusion team places them and our nurses care for them at home.
- Give injections your doctor orders
- Care for urinary catheters (see our guide to home catheter care)
- Review every medicine in the home and set up a safe routine (see medication management at home)
- Teach you how to manage a chronic condition day to day
- Teach family caregivers what to do and what to watch for
- Report changes to your doctor and follow any new orders
RNs and LPNs: who does what
An RN usually does your first visit. They look at your health history, your medicines, your symptoms and your home, and they help build the plan of care with your doctor. RNs also handle the more complex parts of care and check how the plan is working over time. An LPN gives care under the supervision of an RN and follows the same plan. You may see one nurse or a small group of nurses, and they all share notes so your care stays consistent.
What a skilled nursing visit looks like
Home health is part-time or intermittent care. The nurse comes for a scheduled visit, does the work in your plan of care and then leaves. They do not stay for a shift. Visits are often more frequent at first, such as right after you come home from the hospital or after a big medicine change, and then they space out as you get stronger and more confident.
A typical visit might include a quick check of vital signs, a look at any wound or line, a review of how you have been feeling, and a short teaching session. Good teaching focuses on one or two skills at a time. Your nurse may ask you to show them how you use your inhaler or explain back what you would do if your blood sugar dropped. This “teach-back” step helps make sure the information sticks.
Your nurse also keeps your doctor informed. If something changes, such as a fever, new swelling or a blood pressure that keeps running high, the nurse reports it so your doctor can decide what to do.
Teaching for chronic conditions
A big part of skilled nursing at home is helping people live well with long-term health problems. The goal is not for the nurse to take over. The goal is for you and your family to feel confident handling things yourselves.
We have separate guides for some of the most common conditions:
- Diabetes management at home: blood sugar checks, insulin and foot care
- COPD management at home: inhalers, breathing techniques and oxygen safety
- Heart failure care at home: daily weights, salt and fluid limits, and warning signs
- Home health care for cancer patients: support between treatments
Two other conditions come up often in home health: high blood pressure and kidney disease.
High blood pressure
Home blood pressure readings help your doctor make decisions, but only if they are taken the same way each time. Your nurse can check that your cuff fits and works, and teach you to:
- Avoid caffeine, exercise and smoking for about 30 minutes before a reading
- Sit quietly for about 5 minutes with your back supported, feet flat and arm resting at heart level
- Take two readings a minute or so apart and write both down
- Bring your log to every doctor visit
Nurses also watch for medicine side effects, such as feeling dizzy when you stand up, which can lead to falls. If your reading is much higher than the range your doctor gave you, rest and check again, then call your doctor if it stays high. Call 911 if a very high reading comes with chest pain, shortness of breath, numbness or weakness, vision changes or trouble speaking.
Kidney disease
Chronic kidney disease affects fluid, blood pressure, diet and how your body handles medicines. A home health nurse can help by:
- Checking your weight and looking for swelling that may mean fluid buildup
- Monitoring blood pressure
- Reviewing the sodium, potassium, phosphorus and fluid limits your kidney doctor or dietitian set
- Reminding you to ask your doctor or pharmacist before taking any over-the-counter pain reliever, cold medicine or supplement
- Teaching care of a dialysis access in the arm, such as checking it each day the way your dialysis team showed you and keeping blood pressure cuffs, blood draws and tight sleeves off that arm
Call your doctor for new swelling, much less urine than usual, or redness, warmth or drainage at an access site. Call 911 for chest pain, severe trouble breathing, sudden confusion or bleeding that will not stop.
Skilled nursing at home vs. home care
These two terms sound alike but mean different things.
Skilled nursing at home (part of home health care) is medical care ordered by your doctor and given by licensed nurses and therapists. Visits are short and scheduled, care has clear goals, and it ends when those goals are met. Medicare and many other plans cover it when you qualify.
Home care, sometimes called private duty or companion care, is non-medical help: cooking, cleaning, errands, companionship or someone staying for a shift. It is usually paid out of pocket, and Medicare does not pay for it when it is the only help you need. Making Memories Home Health also offers this kind of help through our private duty in-home care.
Some people use both. A family might hire a companion for daytime help while a home health nurse visits a few times a week for wound care or teaching.
Who qualifies for skilled nursing at home?
Under Medicare, you qualify for home health care when all of these are true:
- A doctor or allowed practitioner is involved. A doctor, nurse practitioner, clinical nurse specialist or physician assistant certifies that you need care and reviews your plan of care.
- You need skilled care. That means part-time or intermittent skilled nursing, or physical therapy, speech-language therapy or continued occupational therapy.
- You are homebound. Leaving home takes considerable and taxing effort, for example because you need a walker, a wheelchair or another person’s help, or because your doctor advises against it. You can still leave for medical care, religious services or adult day care, and for short, infrequent outings.
- You had a face-to-face visit. Your doctor or allowed practitioner must have a face-to-face visit with you within 90 days before or 30 days after care starts, for a reason related to your home health care.
- The agency is Medicare-certified. Making Memories Home Health is.
People who often qualify for skilled nursing include those who just came home from the hospital or a rehab facility, had surgery and need incision care, have a new diagnosis or a big change in medicines, live with heart failure, COPD or diabetes that has been hard to control, or need IV therapy, injections or catheter care.
Medicare does not cover 24-hour care at home, meal delivery, or homemaker and personal care when that is the only care you need. Medicare Advantage plans may have their own rules, such as prior approval, and our intake team checks those for you.
Getting ready for the first visit
You can make the first visit smoother by having these things ready:
- Every medicine you take, including vitamins, inhalers, creams and over-the-counter pills
- Hospital discharge papers and any new instructions
- Names and phone numbers for your doctors and pharmacy
- Any logs you keep, such as weights, blood pressure or blood sugar
- Your scale, blood pressure cuff or glucose meter, so the nurse can check that it works
- A list of questions from you and your family
It also helps to have a family member there, especially if they will help with care between visits.
How Making Memories Home Health can help
Making Memories Home Health is a Medicare-certified, Joint Commission-accredited agency based in Tampa. Our skilled nursing team of RNs and LPNs visits homes across Hillsborough, Polk and Manatee counties, and our nurses teach in English and Spanish. On-call nursing is available 24/7 for current patients.
We accept Traditional Medicare, plus long-term care plans and private pay. Medicare Advantage coverage and our participation depend on your specific plan, so we verify both before care starts. Call (813) 931-0015 to verify your coverage. You can also see the plans we work with on our insurance page.
If you think you or a loved one may need skilled nursing at home, call us at (813) 931-0015. We will explain the next steps and can contact your doctor for you. Doctors and discharge planners can send a referral directly.
Frequently asked questions
Is skilled nursing at home the same as a skilled nursing facility?
No. A skilled nursing facility is a place you stay, with staff on site around the clock. Skilled nursing at home means a nurse visits you for a set amount of time and then leaves, while you keep living in your own home. Your doctor can help you decide which setting is safer for you.
Do I need a hospital stay before I can get a nurse at home?
No. A hospital stay is not required for Medicare home health. Your doctor or another allowed practitioner can order care after an office visit if you need skilled care, are homebound and meet the other rules.
Can a home health nurse change my medicines?
No. Only your doctor or another prescriber can start, stop or change a medicine. The nurse checks how you are doing, reports what they find and helps you follow any new instructions your doctor gives.
How long will I have a home health nurse?
Home health care is based on goals, not a fixed number of weeks. Your plan of care covers a set period, and your doctor can renew it if you still qualify and still need skilled care. When you and your family can manage safely on your own, the team plans your discharge with you.