How wound care alongside home health works
Wound care alongside home health means two teams with different jobs looking after the same wound. The home health agency sends nurses to carry out ordered care at home, such as dressing changes, teaching and checking for problems. A wound care clinician examines the wound, makes the diagnosis, performs procedures when needed and writes or updates the wound orders.
Gateway arranges the wound clinician’s visits with partner clinicians and handles communication between the two teams. Your home health service is not replaced. For a side-by-side comparison, read home health vs mobile wound care.
Who this helps
- People whose wound is not improving under the current dressing orders
- People sent home from a hospital or rehabilitation stay with a wound and a home health referral
- People whose nurse has noticed a change and wants a clinician to look
- Family caregivers who are hearing different instructions from different people
What each team does
The home health nurse usually sees the wound most often. Nurses follow the plan of care, change dressings as ordered, teach you and your family, and report changes. The treating wound clinician may measure and document the wound, look for causes of slow healing, remove unhealthy tissue, change the dressing plan, and order tests or supplies.
Home health nurses work from a plan of care signed by a physician or other allowed practitioner, often your primary care clinician. When the wound clinician changes the wound orders, the agency needs them in writing before nurses can follow them. Getting that paperwork where it belongs is a large part of what we do.
Where wound plans drift apart
Most problems come from missed handoffs, not from anyone’s mistake:
- Hospital discharge orders and newer wound orders that say different things
- Dressing changes happening on a schedule that no longer matches the orders
- Supplies ordered by two sources, or by no one
- A nurse’s concern that never reaches the wound clinician
How Gateway coordinates with your home health agency
Once we know which agency is visiting, we:
- Collect the current wound orders and recent nursing notes.
- Schedule the wound clinician’s visit and, where possible, line it up with a planned dressing change so the wound is not uncovered more often than needed.
- Send the clinician’s findings and updated orders to the agency after each visit.
- Clarify which team is ordering dressings and equipment.
- Make sure the nurse knows how to report changes between visits.
Agency staff can find details on our page for home health agencies and in our guide to home health and wound specialist roles.
In assisted living and other facilities
Home health agencies also visit people who live in assisted living, independent senior living and some memory care communities. There, the community’s own staff are a third group, and we make sure they know when visits happen and what the current orders are.
In a skilled nursing facility, the facility’s own nurses provide wound care, so a home health agency is usually not part of the picture. Read about mobile wound care for skilled nursing and assisted living.
Keeping primary care and other clinicians informed
Your primary care clinician often signs the home health plan of care and manages the conditions that affect healing. Gateway helps make sure wound visit findings and order changes reach that office, along with any surgeon or specialist following the wound. If you also need a medical follow-up visit after a hospital stay, ask us about transitional care after discharge.
When home health ends
Home health is usually ordered for a set period and has its own eligibility rules, which the agency and the ordering clinician confirm. Wound visits arranged through Gateway may continue after the agency’s nurses stop coming, if the treating clinician decides follow-up is still needed.
Before the last nursing visit, ask who will change dressings and where supplies will come from. We can help you plan for dressing changes at home.
What to report and how to start
Between visits, tell your home health nurse or the treating clinician about spreading redness, rising pain, more drainage, a new odor, fever or chills. Gateway is not an emergency service. For an emergency, call 911.
Call 314-325-0126 or request care online. The form asks only for a name and phone number. Agencies, discharge planners and practices can refer a patient or fax 314-786-7966.
Common questions
Can I have home health and a wound care clinician at the same time?
In many cases, yes, because the two services are different. One is nursing care under a plan of care. The other is a clinician’s evaluation and treatment of the wound. Whether both are available to you depends on your plan, the treating provider and the care ordered. We can help you work out what to ask your plan.
Who writes the orders my home health nurse follows?
A physician or other allowed practitioner does. Home health nurses do not choose wound treatments on their own. When the wound clinician recommends a change, it is written as an order and sent to the agency. Gateway follows up to confirm the agency received it.
What if my nurse and the wound clinician tell me different things?
Say so right away. Tell either one, or call us. It usually means an order update has not reached everyone yet. We check which orders are current and get the same version to both teams. Until it is cleared up, ask the nurse or clinician which instructions to follow instead of guessing.
I do not have home health. Can Gateway still help?
Yes. You do not need a home health agency to ask about wound care. We arrange visits with a partner clinician at home or in your facility. If the treating clinician or your primary care clinician thinks nursing visits would help, they can make a home health referral, and the agency determines whether you are eligible.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.