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Seeking Input: Decisional Capacity Assessment Practices in Home Health Agencies

  • 1.  Seeking Input: Decisional Capacity Assessment Practices in Home Health Agencies

    Posted 08-15-2025 10:17 AM

    Hi everyone,


    I'm reaching out with a question submitted by one of our members, and I'd love your input!

    In most states, patient decisional capacity is typically determined by a medical physician.  In home health agencies, however, provider involvement in patient care is typically nurses, therapists, social workers and other skilled caregivers who are not MDs.   

    As a matter of community practice, when it is needed, how do home health agencies make determinations about decisional capacity for a patient/client? Do they always use a physician?  What process is followed?  Do they rely on previous written determinations made by a referring physician?  Does their medical director get involved?  At a granular level, how is this handled? 

    I appreciate any information or perspective you can provide-thank you in advance! 



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    Carla Smith
    National Alliance for Care at Home
    Manager, Member Engagement
    csmith@allianceforcareathome.org
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