23 Important Referrals for Home Health Therapists

Know your interdisciplinary team! And how and when to refer your patients out.


Let’s say you’ve started treatments with Mrs. Flores, a darling octogenarian just discharged home after a stroke.

As a PT, you realize that she would be a good candidate for Botox to manage her spasticity. Or as an SLP, you suspect hearing loss. Or maybe as an OT, Mrs. Flores confides that she still can’t manage her medications consistently.

Although important, these health care concerns are not within your scope of practice to treat. What to do?

Time to make a referral!

*In the process of referring your patients out, be sure to also communicate with your supervisor if concerns of patient well-being and safety arise. And be sure to know your company’s process for making referrals and for when concerns arises.


How to Refer Patients Out to Other Providers


1) If you think your patient needs Physical Therapy, Occupational Therapy, Speech Therapy, Nursing, Home Health Aide, or Medical Social Work: It should be a straight-forward process of ordering an evaluation within your home health agency’s system. Ask your supervisor for details about how to proceed.

2. If you patient is already under the care of the specialty you want to refer to: Encourage your patient/her caregiver to call the provider directly to make an appointment. It may also be helpful if you contact the provider to let him or her know you recommended a visit and why.

If your patient does not already have a referral for the specialist: Contact the patient’s PCP and request a referral, giving the reason why you believe it would help the patient.


23 Common Referrals for Home Health Therapists


1. 911

When you suspect an urgent medical condition (i.e. chest pain, signs or symptoms of a stroke, loss of consciousness, etc).

2. Adult Protective Service

When you suspect or observe abuse or neglect 🙁

3. Audiologist

When you suspect hearing loss or an issue with hearing aides.

4. Gastroenterologists (GI doctor)

When you suspect esophageal dysphagia or other GI-related anatomical/physiological impairments (i.e. Zenker’s diverticulum, hiatal hernia, laryngopharyngeal reflux). When you have concerns about a feeding tube.

5. Home Health Aide

When the patient reports difficulty bathing or you observe that the patient has not bathed in a while.

6. Medical Social Worker

When you suspect that the patient would benefit from increased assistance at home (i.e. meal preparation, medication management). When the patient may benefit from information regarding available funding resources.

7. Neurologist

When you suspect your patient has an undiagnosed neurological impairment (i.e. dementia, Parkinson’s disease, ALS). Or a worsening neurological condition (i.e. progression of Parkinson’s disease, Parkinson’s medication no longer seems as effective, stroke symptoms are progressing atypically, etc.)

8. Neuro-Ophthalmologist

When you suspect visual neglect or visual field cuts that have been untreated.

9. Neurosurgeon

Facial pain (Trigeminal Neuralgia)
Spine referrals WITHOUT MRI/MRI report evidence of fracture, neoplasia or infection AND stable neurological function (i.e no progressive weakness or numbness or bladder/bowel dysfunction that is NOT pain related) and Physical Therapy hasn’t helped.
Arm pain (brachalgia) or Leg pain (sciatica) which is of a radicular nature and Physical Therapy hasn’t helped.
(Adapted from Santa Clara Valley Medical Center, link here)

10. Nutritionist/Dietician

When you suspect malnutrition that is not dysphagia related.

11. Occupational Therapist

When you suspect or observe difficulties performing ADL’s (i.e. dressing, feeding, preparing meals) or fine motor tasks (i.e. picking up small items, writing).

12. Optometrist

When you suspect general visual acuity issues. Or a patient needs a new vision prescription.

13. Orthopedist

When a patient with chronic pain (i.e. hip, knee, or shoulder arthritis) isn’t responding to therapy and may need a consult for surgery (i.e. hip or knee replacement). And to clarify your patient’s protocol or precautions after a surgical procedure.
(Santa Clara Valley Medical Center Referral Guide Here)

(This referral may be to an Orthopedic Surgeon. Or it may be to a Physician’s Assistant or Nurse Practitioner specializing in Orthopedics.)

14. Otolaryngologist

Also known as an ENT or Ear-Nose-Throat Doctor.

When you suspect anatomical impairments of the vocal cords and/or nasal, oral, pharyngeal, laryngeal cavities.

15. Outpatient SLP/PT/OT

When your patient is no longer homebound but would likely benefit from continued therapy. This may include a Hand Therapist (can be OT or PT)if your patient experiences significant finger, hand, wrist, arm, shoulder, or neck pain, including from arthritis, carpal tunnel syndrome, etc.

16. Physical Therapist

When you suspect the patient is a fall risk due to poor balance, has difficulty transferring, or may benefit from assistive devices.

17. Physical Medicine & Rehabilitation (PM&R) or Podiatrist

When you’d like a referral for Botox injections or to get approval for a wheelchair.

18. Primary Care Physician (PCP)

When you want a referral to a specialist or when you suspect serious medical issues (i.e. suspected stroke, injury from a fall). Or to request relevant tests (such as X-rays) or a medication review (i.e. if the patient is still taking medications that are no longer on the current medication list).

19. Psychologist/Counselor/Marriage and Family Therapist

When you suspect unmanaged or exacerbated psychological issues that affect participation in therapy or daily life.

20. Registered Nurse

When you suspect or observe a non-urgent medical issues (i.e. swelling, bruising, possible wound) or that the patient would benefit from assistance with medication management.

21. Respiratory Therapist

When you suspect issues with tracheostomies.

22. Speech-Language Pathologist

When you suspect issues with cognition (i.e. significant forgetfulness, difficulty sequencing complex exercises). Or when you suspect issues with communication, swallowing, or nutrition.

23. Urologist

When your patient would like his/her catheter removed. Or when your patient experiences the urgent need to urinate, creating an increased fall risk.



This list of referrals is by no means comprehensive, so please use your best judgement and problem solve with a supervisor when deciding the best course of action for your patients!

It may also be helpful to mention that being respectful and open-minded when requesting referrals can take you a long way. No one health care provider knows everything, but if we work together, we can certainly provide better care for our patients 🙂

Best wishes!



Summary of 23 Important Referrals for Home Health Therapists:

1. 911
2. Adult Protective Services
3. Audiologist
4. Gastroenterologist
5. Home Health Aide
6. Medical Social Worker
7. Neurologist
8. Neuro-Ophthalmologist
9. Neurosurgeon
10. Nutritionist or Dietician
11. Occupational Therapist
12. Optometrist
13. Orthopedic Specialist
14. Otolaryngologist
15. Outpatient SLP/PT/OT
16. Physical Therapist
17. PM&R or Podiatrist
18. PCP
19. Psychologist/Counselor/MFT
20. Registered Nurse
21. Respiratory Therapist
22. Speech-Language Pathologist
23. Urologist

The Home Health SLP Handbook: Everything you need to provide speech therapy to adults in the home health setting.