Research shows that most short-term rehab patients will benefit from a home safety evaluation (HSE) to increase safety and independence as they return to their prior living arrangement. Director of Operations Tracy Milius, OT emphasizes this, saying, “You can provide therapy all day in a facility, but it is incomplete if you don’t ensure everything you have taught the patient can carry over to their home.” Returning patients to a safe home environment is also important when meeting the new skilled nursing (SNF) facility quality measures, particularly the percentage of short-term stay residents who are re-hospitalized after discharge.

So when is the right time to complete an HSE, and what disciplines should be included?

Sherri Judah, OT suggests completing an HSE at least two weeks before your patient returns to their home. The two-week time frame accomplishes three things.

1. It ensures your patient is functioning at a level that will allow your assessment to be accurate.
2. It provides you adequate time to work on specific activities your patient may have struggled with during the HSE or areas that you have determined to be unique to their home situation. This allows you to come back to the hospital or SNF and simulate their situation or practice tasks that need to be mastered for a safe return home.
3. It allows the family time to complete any recommendations you have made as part of the HSE, i.e. install grab bars or railings, remove clutter or items such as throw rugs, obtain a bath seat, new bed, Lifeline, etc.

It’s important for the family to accompany therapists during the assessment so they have a better understanding of whether the home is even accessible and changes that may need to be made.

It is more common for a single occupational therapist or physical therapist to complete the HSE, however, some patients may benefit from an HSE attended by both disciplines. For example, a physical therapist accompanied by a certified occupational therapy assistant, or an occupational therapist assisted by a physical therapist assistant.

“Depending on the home environment, for example, if there are a number of stairs outside or within the home, sometimes physical therapy is the better choice due to concern about general entry or quality of mobility in the house,” says Tracy. “If occupational therapy is going they could be more focused on activities of daily living and identifying equipment the family needs to install or buy in order to modify the house.”

By involving multiple disciplines in an HSE, you can complete a more thorough assessment with pertinent information that is significant to both areas of expertise and still provide documentation inclusive of all areas in the home.