Home health referrals are recommendations or orders that connect patients with skilled in-home healthcare services, such as nursing, therapy, medical social work, or other medically necessary support. For home health agencies, a strong referral process helps improve intake efficiency, confirm eligibility, reduce incomplete documentation, and build stronger relationships with hospitals, physicians, discharge planners, payers, and community partners.
To grow home health referrals, agencies need more than a broad referral network. They need clear intake processes, reliable referral sources, strong care quality, and staff training that supports consistent performance across home-based care.
Key takeaways
- Home health referrals connect patients with skilled in-home care through hospitals, physicians, discharge planners, payers, care managers, and community partners.
- A complete referral should include patient information, diagnosis, requested services, payer details, clinical documentation, and physician or practitioner information when required.
- Agencies can improve referral growth by making the intake process easier, communicating quickly, and showing measurable care quality.
- Quality ratings, hospital readmissions, emergency department use, and patient outcomes can influence referral partner confidence.
- Referral volume matters, but referral quality, admission rate, documentation completeness, and start-of-care timelines are better indicators of sustainable growth.
What are home health referrals?
A home health referral starts when a provider, care partner, payer, patient, or caregiver identifies a need for skilled care in the home. The agency then reviews the referral to determine whether the patient’s needs, documentation, payer requirements, service location, and staffing needs align with the agency’s capabilities.
How the home health referral process works:
- A patient need is identified by a hospital, physician, discharge planner, payer, family caregiver, or care partner.
- The referral source sends the agency patient information, clinical history, requested services, and payer details.
- The agency reviews the referral for eligibility, documentation completeness, service area, staffing capacity, and clinical fit.
- The agency follows up with the referral source, patient, caregiver, or ordering provider to clarify missing information.
- If the referral is accepted, the agency schedules the start of care and begins coordinating services.
- The agency communicates updates to the appropriate provider or referral partner as care begins.
When each step is handled consistently, agencies are better positioned to accept appropriate referrals and avoid delays caused by missing information. A reliable process also helps referral partners understand what to expect, which can make them more likely to continue sending patients to your agency.
What information should a home health referral include?
Complete referral information helps the agency make timely decisions. When key details are missing, intake teams may need to follow up with the referral source, patient, caregiver, or ordering provider before care can begin. This can delay admission and create frustration for referral partners.
- Patient name, date of birth, address, and contact information.
- Primary diagnosis and relevant clinical history.
- Reason for referral and requested services.
- Recent hospitalization, surgery, or post-acute care details.
- Medication list and known safety concerns.
- Insurance or payer information.
- Ordering physician or practitioner information, when required.
- Documentation supporting skilled need and homebound status, when applicable.
- Caregiver availability and home environment considerations.
Agencies can make this easier by giving referral partners a simple checklist or referral form. Clear expectations reduce back-and-forth communication and help ensure the agency has enough information to evaluate the patient, confirm eligibility, and coordinate care.
Common home health referral sources
Not all referral sources serve the same role. Some partners may send a high volume of referrals, while others may send fewer but more appropriate referrals. Agencies should understand which sources align best with their clinical strengths, payer relationships, staffing capacity, and service area.
- Hospitals and discharge planners
- Primary care physicians
- Specialists
- Skilled nursing facilities
- Rehabilitation centers
- Case managers and social workers
- Managed care organizations and payer partners
- Assisted living and senior living communities
- Community-based organizations
- Families and caregivers
The strongest referral networks are built through consistency. Referral partners are more likely to return when an agency communicates clearly, accepts appropriate patients, provides reliable care, and follows up when questions or concerns arise.
Home health referrals vs. home care referrals
Home health referrals usually involve skilled clinical services provided in the home, such as nursing, therapy, or medical social work. Home care referrals often involve nonmedical support, such as help with bathing, meals, transportation, companionship, or daily activities.
| Category | Home health referrals | Home care referrals |
| Type of care | Skilled medical care | Nonmedical personal support |
| Common services | Nursing, therapy, medical social work | Bathing, meals, companionship, transportation |
| Common referral sources | Hospitals, physicians, discharge planners, payers | Families, senior living communities, care coordinators |
| Documentation needs | Clinical information, payer details, and provider information when required | Care needs, schedule, safety concerns, and support preferences |
How quality ratings influence home health referrals
Quality ratings can influence how referral partners evaluate a home health agency. Hospital discharge planners, physicians, health systems, skilled nursing facilities, payers, and care managers need confidence that patients will receive safe, timely, and effective care after a referral is made.
For Medicare-certified home health agencies, quality ratings are publicly available through CMS Care Compare. These ratings help referral partners evaluate patient care outcomes, patient experience, and other performance indicators before recommending an agency to patients or their families.
To strengthen your position with referral sources, focus on improving the quality measures that reflect both clinical performance and patient safety. This includes supporting mobility, medication management, timely care, patient education, and reduced avoidable hospital use. Consistent performance in these areas can strengthen your agency’s reputation with referral sources.
Agencies can strengthen care transitions by applying strategies that improve home health outcomes and support safer, more consistent care after referral.
How risk reduction supports stronger relationships
Referral partners want confidence that patients will be safe, supported, and less likely to return to acute care unnecessarily after they transition to home health. When hospital discharge planners, physicians, care managers, and other referral sources evaluate an agency, they are not only looking at whether the agency can accept the referral. They are also considering whether the agency can help reduce preventable complications, support recovery at home, and communicate effectively when patient needs change.
Key risk factors referral partners may consider include:
- Unplanned hospital readmissions.
- Emergency department utilization.
- Medication management concerns.
- Patient safety risks in the home.
- Caregiver readiness and education.
- Timely communication with physicians and referral partners.
Reducing these risks requires consistent staff training, accurate documentation, clear patient and caregiver education, strong care coordination, and a reliable approach to healthcare compliance training.
Training, compliance, and consistent care processes can help home health agencies strengthen the quality signals that referral partners often consider. The following resource explains how compliance-focused solutions can support safer, more consistent care delivery.
How to market your agency
To attract more home health referrals, agencies need to show referral partners that they can accept appropriate patients, start care quickly, coordinate effectively, and support positive outcomes in the home.
Make it easy for referral sources to understand who your agency serves and what information you need to process a referral. A referral partner one-sheet can include your service area, accepted payers, clinical specialties, intake contact information, hours of operation, and documentation requirements.
Your marketing should also highlight quality indicators that matter to referral partners, such as CMS quality ratings, patient satisfaction scores, readmission reduction efforts, emergency department utilization trends, staff training, and care coordination processes.
Strong referral marketing is also relationship management. Agencies should respond quickly to referral inquiries, communicate clearly when information is missing, and follow up with referral partners after care begins. These touchpoints show that your agency is reliable, organized, and focused on patient needs.
To strengthen your referral outreach, consider focusing on:
- Create a referral partner one-sheet with service area, accepted payers, specialties, and intake contacts.
- Share relevant quality ratings, patient outcomes, and risk reduction efforts.
- Educate referral partners on the patients your agency is best equipped to support.
- Simplify referrals with clear documentation requirements and fast intake follow-up.
- Track referral source performance to focus outreach on partners who send appropriate, complete referrals.
- Follow up consistently to support communication, trust, and continuity of care.
Effective referral marketing positions your agency as a dependable care partner. When referral sources understand your capabilities, see evidence of quality care, and experience smooth communication, they are more likely to continue sending appropriate home health referrals to your team.
Medicare documentation considerations
For Medicare-covered home health services, referral documentation should support why the patient needs skilled care in the home. Documentation may need to show the patient’s clinical condition, the skilled services needed, relevant physician or practitioner information, and homebound status when applicable.
Agencies should also confirm whether required face-to-face encounter documentation is complete and related to the reason the patient needs home health services. Because payer and regulatory requirements can vary, agencies should verify current Medicare, Medicaid, payer, and state requirements before accepting or processing referrals.
Common home health referral mistakes to avoid
Even strong agencies can lose referral opportunities when the process is unclear or inconsistent. Small issues such as slow follow-up, missing documentation, or unclear communication can affect how referral partners view the agency. Addressing these mistakes can improve both referral volume and referral quality.
- Missing documentation: Confirm that the referral includes enough clinical information to evaluate the patient’s needs.
- Slow response times: Follow up quickly so referral partners know whether the agency can accept the patient.
- Focusing only on referral volume: Track admitted referrals, referral quality, and start-of-care timelines.
- Using the same message for every referral source: Tailor outreach to hospitals, physicians, payers, and community partners.
- Failing to communicate outcomes: Share appropriate quality, risk reduction, and patient experience data with referral partners.
Metrics to track for home health referrals
- Total referrals by source.
- Accepted referrals by source.
- Rejected or incomplete referrals.
- Conversion rate from referral to admission.
- Average time from referral to start of care.
- Hospital readmissions, emergency department use, and patient outcomes.
Tracking these metrics helps agencies understand which referral sources create the best outcomes. A high referral count does not always mean a strong referral strategy. Agencies should look at which sources send complete referrals, which referrals convert to admissions, and which patients can be served safely and effectively.
Strengthen your strategy with better staff training
Strong home health referrals depend on more than outreach. Agencies also need trained, confident teams that can support patient safety, document accurately, communicate with referral partners, and deliver consistent care in the home.
Relias helps home health and home care agencies support staff training, compliance, onboarding, continuing education, and care quality through online learning solutions built for home-based care teams.
Explore Relias home health training and solutions to strengthen staff readiness, compliance, onboarding, and care quality across your home-based care team.
FAQs about home health referrals
What are home health referrals?
Home health referrals are recommendations or orders that connect patients with skilled healthcare services delivered in the home. They may come from hospitals, physicians, discharge planners, payers, care managers, families, or community partners.
Who can send a home health referral?
Home health referrals may come from physicians, hospitals, discharge planners, skilled nursing facilities, rehabilitation centers, payers, social workers, case managers, families, and other care partners.
What information is needed for a home health referral?
A home health referral should include patient information, diagnosis, reason for referral, requested services, payer details, clinical documentation, and ordering provider information when required.
How can a home health agency get more referrals?
A home health agency can get more referrals by building strong referral partner relationships, simplifying intake, communicating quickly, improving quality outcomes, and sharing relevant performance data with referral sources.
Why are home health referrals rejected?
Home health referrals may be rejected because of incomplete documentation, payer limitations, service area restrictions, staffing capacity, clinical inappropriateness, or missing information needed to confirm eligibility.
What is the difference between home health referrals and home care referrals?
Home health referrals usually involve skilled care delivered in the home, such as nursing, therapy, or medical social work. Home care referrals often involve nonmedical support, such as help with meals, bathing, transportation, or daily activities.
What metrics should agencies track for home health referrals?
Agencies should track total referrals, accepted referrals, incomplete referrals, conversion rate from referral to admission, average time to start care, readmissions, emergency department use, and repeat referral activity by source.
5 Keys to Growing Your Home Health Business
The healthcare market is constantly shifting, and home health agencies are uniquely poised to meet new opportunities. To satisfy increased demand, you must keep your team prepared to meet the needs of today’s home health patients. Find out how with the growth strategies shared in our e-book.
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