Home Health Section – APTA
PO Box 4553 • Missoula, MT 59806-4553
www.homehealthsection.org • 866.230.2980
Home Health Physical Therapy Case Report
The purpose is to provide a detailed description of the physical therapy management for patients receiving
home health treatment. Selection of the individual patient can provide relevant information to home
health practitioners by describing unusual cases, highlighting a clinical experience that has not yet been
described in the literature, or defining success/failure of a given treatment approach.
Directions: This form has been standardized for the Section’s use in publication. You cannot alter the text
on this page or change the field formats, but you are welcome to provide us with supplemental
information or special instructions related to your case report in a separate document(s). Hints and
instructions are available in blue italics below each field. The fields will expand as you enter text. You can
move from field to field by using the Tab button or simply clicking in the field.
Please note that you are required to submit a completed “Informed Consent Form” with the case report. If
your company also requires the completion of an informed consent form, please submit a copy of your
completed company form along with the Home Health Section form. (You are welcome to black out any
confidential information in the form.)
Title
Be specific: refer to the condition and/or intervention that make this case of interest to home health therapy practice.
The title should clearly state what the case report is about. For example: “Home Health Management of the Bilateral
Total Knee Replacement Patient: Functional training considerations and effective approaches to developing the
patient’s tolerance for exercise progression.”
Background/Purpose
State the focus of the case as related to diagnosis/clinical condition and home health physical therapy treatment. The
author should feel free to state opinion and share anecdotal experience as motivation for writing case report. If
available, a brief review of the literature related to the topic should be included. If relevant, include information about
other disciplines involved in the care and any unusual or challenging issues. The statement of purpose is most often
appropriate at the conclusion of this section.
Patient Profile
This section should help the reader understand and appreciate the exact nature of the patient’s condition and
justification for home health physical therapy services. The following may be included:

Demographic characteristics

Primary reason for home health physical therapy treatment

Home health primary diagnosis and co-morbidities

Patient's concerns/complaints

Other relevant medical history

Prior or current services related to the current episode

Patient/family goals for physical therapy
Physical Therapy Assessment
Describe the patient’s baseline status: functional limitations, key impairments, and relevant pathology. The use of
standardized outcome measures (e.g.- Timed-Up-And-Go, BERG Balance Scale) is encouraged. Describe clinical tests
performed and patient response.
Physical Therapy Intervention
Provide parameters such as intensity, frequency, duration, and progression. State changes in treatment over time,
along with the rationale for such changes. Sufficient detail should be included so that reader can readily replicate the
treatment approach (tables and flow sheets are acceptable).
Outcome
Describe the treatment outcomes with time points and compare discharge outcomes to baseline. The patient’s
improvement with standardized outcome measures can be presented here.
Discussion
Summarize how the case demonstrated the intended purpose. Relate this case to potential implications for home
health clinical practice (e.g.- “lessons learned)”. The author may note the need for further research in an attempt to
encourage higher-level investigation.
References
Provide literature citations following AMA style (if applicable).