---
kind: "section"
citation: "42 C.F.R. § 405.2416"
title: "42"
number: "405.2416"
heading: "Visiting nurse services."
url: "https://uscodex.org/cfr/42/405.2416"
---

# §405.2416. Visiting nurse services.

- (a) **Visiting nurse services are covered if the services meet all of the following—**
  - (1) The RHC or FQHC is located in an area in which the Secretary has determined that there is a shortage of home health agencies.
  - (2) **The services are rendered to a homebound individual.**
  - (3) The services are furnished by a registered professional nurse or licensed practical nurse that is employed by, or receives compensation for the services from the RHC or FQHC.
  - (4) **The services are furnished under a written plan of treatment that is both of the following—**
    - (i)
      - (A) Established and reviewed at least every 60 days by a supervising physician of the RHC or FQHC; or
      - (B) (1) Established by a nurse practitioner, physician assistant or certified nurse midwife; and

        (2) Reviewed at least every 60 days by a supervising physician.

    - (ii) Signed by the supervising physician, nurse practitioner, physician assistant or certified nurse midwife of the RHC or FQHC.
  - (5) During a PHE, as defined in [§ 400.200](/cfr/42/400.200.md) of this chapter, an area typically served by the RHC, and an area that is included in the FQHC's service area plan, is determined to have a shortage of home health agencies, and no request for this determination is required.
- (b) **The nursing care covered by this section includes the following—**
  - (1) Services that must be performed by a registered professional nurse or licensed practical nurse if the safety of the patient is to be assured and the medically desired results achieved.
  - (2) **Personal care services, to the extent covered under Medicare as home health services.** These services include helping the patient to bathe, to get in and out of bed, to exercise and to take medications.
- (c) This benefit does not cover household and housekeeping services or other services that would constitute custodial care.
- (d) For purposes of this section, homebound means an individual who is permanently or temporarily confined to his or her place of residence because of a medical or health condition. The individual may be considered homebound if he or she leaves the place of residence infrequently. For this purpose, “place of residence” does not include a hospital or long term care facility.

## Notes

### Amendments

[43 FR 8261, Mar. 1, 1978, as amended at 79 FR 25475, May 2, 2014; 85 FR 19285, Apr. 6, 2020]

### Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

### Source

Source: 43 FR 8261, Mar. 1, 1978, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 263a, 405(a), 1302, 1320b-12, 1395x, 1395y(a), 1395ff, 1395hh, 1395kk, 1395rr, and 1395ww(k).

### Amendments

[43 FR 8261, Mar. 1, 1978, as amended at 79 FR 25475, May 2, 2014; 85 FR 19285, Apr. 6, 2020]