When getting to an appointment is the hard part
Some people skip wound appointments because the trip itself is too much. Stairs, a wheelchair that does not fit in the car, oxygen, pain when sitting, or no one free to drive can turn a short visit into an all-day effort. Wound care for homebound patients in St. Louis is meant for that situation: the clinician comes to you.
Gateway arranges these visits with partner clinicians. The treating clinician does the assessment and decides on treatment. We handle the request, scheduling, records, supplies and communication.
What homebound means, and why you can call either way
People use the word homebound loosely, but it also has a specific meaning. Medicare uses it to decide who qualifies for home health care, and the definition looks at how much effort and help it takes for you to leave home.
You do not have to work that out before calling us. A clinician’s home visit and a home health agency’s services follow separate rules, and the treating clinician and the agency decide what applies to you. Our guide explains what homebound means for care at home.
What a home wound visit may include
The visit happens where you are most comfortable, often a bedroom or a recliner. Depending on what the treating clinician finds, it may include:
- A review of your health history, medications and how the wound started
- An examination of the wound, with measurements to track change
- A check of circulation, swelling, sensation and pressure points
- Cleaning the wound and, when appropriate, removing unhealthy tissue
- A dressing plan, with orders for how often it is changed
- A look at your bed, chair, cushion and footwear, since these often affect healing
Our guide to what happens during a home wound care visit describes a typical visit.
How Gateway arranges wound care for homebound patients
After you call, we ask for records from the hospital, your doctor or a previous wound clinic. We confirm that a partner clinician is available for your address, since availability depends on location, and set a visit time with you or your caregiver.
We also ask the practical questions: which door to use, whether there are pets, and whether you need help getting to the door. After the visit, we send orders where they need to go and schedule follow-up at the interval the clinician sets. Our page on mobile wound care in St. Louis describes the service more broadly.
Getting supplies to the house
A person who cannot get out cannot run to the pharmacy for dressings. When the treating clinician orders dressings, compression items or equipment such as a pressure-relieving cushion, we send the order and documentation to a supplier and track it to your door.
What your plan pays for depends on the plan, the supplier and the item. Our page on wound supplies and DME coordination explains how orders are followed.
When a trip out is still needed
Most follow-up can happen at home, but not everything can. The treating clinician may order a circulation study, imaging or a specialist visit that requires a lab or office.
When a trip is needed, we help make it count. We coordinate the appointment time, work on transportation arrangements that fit your mobility, and make sure records arrive before you do. Results go back to the clinician who ordered the test.
Primary care, home health and family
With your permission, visit notes go to your primary care clinician. If you no longer have one you can get to, ask us about primary care for homebound adults, which can be arranged alongside wound care.
If home health is ordered, its nurses may change dressings between clinician visits, and we keep both working from the same orders. We also update the family member or caregiver you name, which matters most when you live alone.
How to start and what to report
Call Gateway at 314-325-0126, or fill in the request care form with a name and phone number and we will call you back. A family member or caregiver can call for you, with or without a referral.
Between visits, call the treating clinician’s office about spreading redness, more drainage, a new odor, fever or increasing pain. For heavy bleeding, chest pain, trouble breathing or sudden confusion, call 911.
Common questions
Do I have to be officially homebound to get wound care at home?
You do not need to prove anything before you call. Homebound status is a rule tied mainly to home health benefits, and the clinician and agency involved determine whether it applies. Tell us what makes leaving home hard for you. We will confirm what is available at your address and help you ask your plan about coverage.
I live alone and cannot change my own dressing. What happens between visits?
Say so when you call, because it shapes the plan. The treating clinician may choose a dressing that stays on longer, order home health nursing if you qualify, or teach a relative or neighbor you trust. We coordinate whichever option is ordered. If a dressing change is missed, call us so the clinician knows.
What should I have ready before the first home visit?
Gather your medication list, insurance cards, any discharge papers and the dressings you are using now. Clear a spot with good light where the clinician can reach the wound, and keep pets in another room. Our checklist for getting ready for a home wound care visit covers the rest.
What if my wound gets worse and I cannot get out?
Call the treating clinician’s office and describe what changed. The clinician decides whether you need an earlier visit, a change in orders or care somewhere else. For heavy bleeding, a high fever with chills, chest pain, trouble breathing or sudden confusion, call 911. Paramedics come to you, so being unable to leave home should never delay emergency care.
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.