What Diagnosis Qualifies For A Hospital Bed

HOSPITAL BEDS

WHAT DIAGNOSIS QUALIFIES FOR A HOSPITAL BED?

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Dave D.

Health & Medical Writer
Written & Researched

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Kyle S.

Hospital Bed Expert
Editor & Commentary

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Naheed Ali, MD

Physician
Fact Checker

What Diagnosis Qualifies For A Hospital Bed? In order for their hospital bed to qualify for insurance coverage in the United States or Canada, patients must have a diagnosis from a doctor. The diagnosis can differ; the only requirement is that the doctor records the health issues that qualify for a home hospital bed. Serious illnesses make it a lot easier and a doctor may recommend it for rehab. Caregivers and relatives can use the information gathered to make sure the patient has everything they need when they come home.

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All of our articles are written by a professional medical writer and edited for accuracy by a hospital bed expert. SonderCare is a Hospital Bed company with locations across the U.S. and Canada. We distribute, install and service our certified home hospital beds across North America. Our staff is made up of several hospital bed experts that have worked in the medical equipment industry for more than 20 years. Read more about our company here.

Learn About Who Qualifies For A Hospital Bed

Conditions That Require Frequent Repositioning In A Bed

Many medical conditions, especially cardiovascular illnesses, require the patient to change their position in ways they can’t achieve in an ordinary bed. These can include chronic obstructive pulmonary disease (COPD), and patients with severe cardiac conditions who can leave the bed but must avoid physical strain can also qualify for hospital bed coverage. These patients may need to have the head of the bed elevated more than 30 degrees due to their medical issues, but this usually comes after the doctor considers pillows or wedges and rules them out. 

Hospital beds are specially designed to let users adjust their head and feet when needed, changing the pressure points and improving their body’s circulation. Qualifying for a hospital bed can depend on the severity and frequency of the symptoms that necessitate an adjustable model. If the reason for needing a hospital bed is that the patient’s condition requires frequent repositioning, the prescription and documentation must describe the medical condition.

Mobility Problems That Are Improved With A Hospital Bed

Many mobility problems can qualify people for hospital beds under their healthcare plans. These include:

  • Patients with severe arthritis;
  • Those with injuries to lower extremities, like a fractured hip;
  • Patients with spinal cord injuries, including quadriplegic and paraplegic patients;
  • Multiple limb amputees;
  • Stroke patients; and 
  • Patients who must transfer from bed to a wheelchair, with or without help.

Many of these conditions make the variable height feature of a hospital bed a medical necessity. When a patient with debilitating diseases and conditions can control the height of their bed, they can get in and out more easily and without caregiver assistance. Conditions like arthritis can require this feature to allow the patient to ease up off the mattress, enabling them to place their feet on the floor while sitting on the edge of the bed. 

Conditions That Require Caregiver Monitoring In A Hospital Bed

Doctors will often prescribe a hospital bed when a patient requires in-home care. These often include conditions that require monitoring and attention, such as cognitive impairments like dementia. An adjustable hospital bed can make it easier to feed, bathe, and entertain patients immobilized by their condition. A hospital bed will often include side rails which can be used as assistive devices for getting into or out of bed.

However, for many diagnoses, a medical bed in the home or care facility is more than just a place for rest for the patient – it’s important for their independence. Requiring caregiver monitoring does not rule out autonomy. When appropriate, a hospital bed’s rails can be adjusted to various heights, providing stable and secure locations for  patients to use to get themselves out of bed and continue their routines without professional assistance.

What Type Of Hospital Bed Will Medicare Or Government Healthcare Cover?

Government health plans such as Medicare will typically cover a portion of a very basic semi-electric hospital bed, which means that one or more functions of the bed must be operated with a hand crank. Occasionally, your supplemental insurance plan may also cover a portion.  

Regardless of where you are, we no longer live in an era with bulky, unintuitive, corroded hospital beds with uncomfortable broken spring mattresses. SonderCare provides beds that improve the way people receive their care in private residences, right down to the mattresses and sheets. A proper hospital bed system can help patients with the above-mentioned conditions when they must rest for recovery and need a good night’s sleep.

Research and Sources

The eligibility for a home hospital bed varies depending on the specific medical condition and the patient’s individual circumstances. For heart failure and community-acquired pneumonia, Santos-Eggimann (2001) found that while a significant proportion of patients were medically eligible, the acceptance of home hospital programs was low. Salazar (2009) demonstrated the effectiveness and safety of a home hospitalization unit for acutely ill patients, particularly those with chronic obstructive pulmonary disease, chronic heart failure, and pneumonia. Júnior (2010) emphasized the need for specific equipment, such as a versatile hospital bed, to support home care. Pian (2020) proposed a new model of pediatric home hospital care, suggesting that certain acute illnesses, including pneumonia, could be managed at home with appropriate support. These studies collectively suggest that a home hospital bed may be suitable for patients with specific medical conditions, particularly those with chronic illnesses or acute exacerbations, and when there is adequate support and equipment available.

  • Heart failure and community-acquired pneumonia: cases for home hospital? B. Santos-Eggimann, N. Chavaz, T. Larequi, O. Lamy, B. Yersin
    International Journal for Quality in Health Care
  • Home hospitalization unit: an alternative to standard inpatient hospitalization from the emergency department. A. Salazar, C. Estrada, R. Porta, M. Lolo, S. Tomás, M. Alvarez
    European journal of emergency medicine
  • [Hospital bed project for home care]. A. S. Silva Júnior, M. B. Posso, Laurentino Corrêa de Vasconcellos Neto
    Revista da Escola de Enfermagem da U S P
  • Acute Pediatric Home Hospital Care Julia Pian, J. Klig Pediatrics
Frequently Asked Questions About Hospital Bed Qualifications

Introduce the patient and the length of time they have been under the physician’s or facility’s supervision.  Describe how the present bed does not adequately safeguard the user, and how a fall will result in physical harm.

A home hospital bed can be paid for in a variety of ways. Out-of-pocket payment is the most convenient choice and will allow your loved one to enjoy a quality bed and sleep experience. In most cases, though, private insurance, Medicare, Medicaid, and VA health benefits will pay at least a fraction of the expense and often times you must settle for manual or semi-electric beds.

Ask your physician if they could examine you and write you a recommendation for the bed. The bed may be required and beneficial for your medical treatment. After that do a quick Google Search and look for a quality company like SonderCare and reach out to a representative.

  • Conditions That Require Frequent Repositioning In A Bed
    • Patients with cardiovascular illnesses, COPD, and severe cardiac conditions.
    • Need for elevation of the bed head more than 30 degrees.
    • Hospital beds allow adjustment of head and feet, improving circulation.
    • Adjustable beds required for frequent repositioning due to medical conditions.
  • Mobility Problems That Are Improved With A Hospital Bed
    • Severe arthritis patients.
    • Individuals with lower extremity injuries, such as fractured hips.
    • Spinal cord injury patients, including quadriplegic and paraplegic.
    • Multiple limb amputees.
    • Stroke patients.
    • Patients needing to transfer from bed to wheelchair.
    • Variable height feature aids in bed egress and ingress.
  • Conditions That Require Caregiver Monitoring In A Hospital Bed
    • Cognitive impairments like dementia.
    • Adjustable beds facilitate feeding, bathing, and entertainment.
    • Side rails assist in getting in and out of bed.
    • Adjustable rails for patient autonomy and routine maintenance.
  • What Type Of Hospital Bed Will Medicare Or Government Healthcare Cover?
    • Medicare covers basic semi-electric hospital beds with hand crank operation.
    • Supplemental insurance may cover a portion of the cost.
  • SonderCare's role in providing improved hospital bed systems for private residences.

From Our Experience...
"In my two decades of experience, choosing a hospital bed for home use comes down to several key factors: patient needs, adjustability, safety features, and ease of use. Consider the patient's medical condition and what features will provide the most comfort and support, such as head and foot adjustments or built-in massage functions. Safety features like side rails are crucial, especially for those at risk of falls. User-friendly controls allow for easy adjustments, promoting independence for the patient. It's not just about buying a bed; it's about investing in comfort and quality of life."

Dr. uses SonderCare to provide home hospital beds.
Dr dr dr SonderCare home hospital beds.

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