Before the visit: five things to have ready
- Every medication in the house. Prescriptions, vitamins, supplements, anything over the counter. Gather the actual bottles rather than writing a list, because the bottles tell us things a list will not.
- Doctors and phone numbers. Primary care and any specialists.
- Insurance and Medicare cards.
- Hospital paperwork, if there has been a recent stay or procedure.
- Who decides. Whether anyone holds power of attorney or is the named decision maker.
Write your questions down in advance. Families forget half of them once the conversation starts, then think of them at ten that night.
What the nurse actually does
- Talks to your loved one first. A good nurse addresses the person receiving care, not just the adult child who arranged the visit. That matters for dignity and it produces better information.
- Reviews health history and medications, looking for duplicates, interactions and anything no longer needed. This alone frequently changes something.
- Checks the basics: blood pressure, pulse, breathing, temperature, weight, skin.
- Watches movement. Getting out of a chair, walking to the bathroom, managing the step down to the patio. This is assessment, not a test, even though it can feel like one.
- Looks at the home for safety: lighting, rugs, the bathroom, the path taken at night, where a fall would most likely happen.
- Asks about the real day. Eating, sleeping, bathing, mood, who visits, what has changed in the last six months.
- Asks the family what they need, because the arrangement has to be sustainable for you too.
The questions they will ask
Some feel personal. They are asked because the answers change the care plan, not out of curiosity.
| Question | Why it is asked |
|---|---|
| Have there been any falls? | The strongest predictor of the next fall is the last one, including the ones nobody mentioned |
| Any trouble getting to the bathroom in time? | Night-time bathroom trips are where a large share of serious falls happen |
| Who manages the medications? | Medication errors are a leading cause of avoidable hospital visits |
| What did you eat yesterday? | A far more honest read on nutrition than asking whether someone eats well |
| What worries you most right now? | The answer is often different from what the family expected, and it reshapes the plan |
What happens afterward
You should leave the visit with a clear picture, not a sales pitch:
- A recommendation in plain language: what level of help, how many hours, and why
- A written cost figure if care is private pay, not a vague range
- A benefits check. Whether Medicare, Nevada Medicaid, VA benefits or a long-term care policy could cover part or all of it
- A written plan of care if care proceeds, and for Medicare-covered home health, a plan sent to the physician for signature
- Sometimes: nothing yet. Being told to watch a short list of things and call if they change is a legitimate and common outcome
The worries families do not say out loud
- "Is the house tidy enough?" Nurses look at safety, not housekeeping. Please do not tidy away the medication clutter beforehand; seeing it as it really is tells us something.
- "Will they think I should have done more?" No. We see the whole spectrum, and the family who arranges an assessment is by definition paying attention.
- "Will my parent be angry with me?" Sometimes, briefly. It helps to frame the visit as a check rather than a verdict, and most parents are noticeably calmer once a professional has been kind to them for an hour. If refusal is the obstacle, read when a parent will not accept help.
- "Are we committing to something?" No contract, no deposit, no obligation.
Two different first visits
Worth separating, because the words get used interchangeably. A free in-home assessment is what we do for any family considering care, with no cost and no obligation. A Medicare start of care visit is the first visit of a physician-ordered home health episode, billed to Medicare rather than to you, and it starts a covered course of skilled nursing or therapy. Either way, nobody should hand you a bill for a first visit. See what Medicare covers.
How long does the first home health visit take?
Usually 60 to 90 minutes, longer than later visits. The first visit is an assessment as much as a care visit, so the nurse is gathering a full picture: medical history, medications, how your loved one moves around the home, what they can and cannot manage alone, and what the family needs. Later visits are typically 30 to 60 minutes and focused on specific care.
Does the first visit cost anything?
Our in-home nursing assessment is free and carries no obligation, whether or not you go on to use us. That is different from a Medicare start-of-care visit, which is the first covered visit of a physician-ordered home health episode and is billed to Medicare rather than to you. Either way you should not be handed a bill for the first visit, and if any agency asks for payment up front, treat that as a warning sign.
What should I have ready for the first visit?
Five things make the visit far more useful: every medication bottle in the house including vitamins and anything over the counter, a list of doctors with phone numbers, insurance and Medicare cards, any hospital discharge paperwork, and the name of whoever holds power of attorney or makes decisions. If you have questions, write them down beforehand, because families routinely forget half of them in the moment.
Will they judge how the house looks?
No, and this is the worry we hear most, usually from the adult child rather than the patient. Nurses have been in thousands of homes and are looking at safety, not housekeeping. Loose rugs, poor lighting, the path to the bathroom and whether the bed is reachable are what matter. Please do not clean up the medication clutter before we arrive; seeing it exactly as it is tells us something important.
Does having an assessment commit us to anything?
No. The assessment exists so you can make an informed decision, and a good outcome is often being told you need less than you feared, or nothing yet. We regularly tell families they are fine for now and give them a short list of things to watch. There is no contract at the assessment, no deposit, and no obligation to schedule care afterward.
Last reviewed September 2026. General information, not medical advice.