Scope of Services Home Care

Disclaimer: The Scope of services for Thumbay Physical Therapy and Rehabilitation Hospital (TPT&RH) will be reviewed and renewed as and when there will be any change in provided services that may be due to addition of new services or withdrawal of current services or will review at least annually. Please note that laws, regulations, and standards are subject to change.

A.   Physician Consultation Areas in northern Emirates

B.   Rehabilitation and Therapy Focus Areas

• Orthopaedic Rehabilitation
• Neurological Rehabilitation
• Pre & Post Natal Rehabilitation
• Paediatric Rehabilitation
• Pain Management
• Speech and Language Management
• Post-Operative Rehabilitation
• Post Covid Rehabilitation
• Cardiopulmonary Rehabilitation
• Lymphedema Rehabilitation

C.   B. Nursing Focus Areas

• Comprehensive Clinical Care
• Chronic Disease & Post‑Hospital Transition Management
• Health Education & Preventive Care
• Palliative and End‑of‑Life Support

D.   C. Care Assistance Focus Areas

• Activities of Daily Living (ADL) Support
• Environmental & Safety Support
• Home safety checks, adaptive equipment setup, and bed sore prevention.
• Companionship & Psychosocial Support
• Caregiver Collaboration

1.   Goal

1.1.   The purpose of home care rehabilitation and medical services is to maintain, restore, or optimize the physical, cognitive, communicative, and emotional capabilities of persons served within the comfort and safety of their own homes.

1.2. To provide specialized and person centred services and assistance due to illness, injury, impairment, disability or a specific age or development need.

1.3. To promote medical stability, comfort, and independence through coordinated nursing, physician, therapy, and care assistance interventions addressing each person’s individual health conditions and functional goals.

1.4. To enhance quality of life by fostering self‑management skills, resilience, engagement in meaningful daily activities, and improved participation in family and community life.

1.5. To support early recovery and safe reintegration into normal routines—including work, school, or caregiving roles—by minimizing functional decline, hospital readmissions, and long‑term dependence.

1.6.  To help each child, adult, or older person achieve the highest possible level of independence in mobility, communication, and self‑care through a person‑centered, home‑based approach.

2.   Home Care Team

• Doctor (Physician)
• Physiotherapists
• Speech Therapist
• Registered Nurses
• Care Assistant
• Home Care co-ordinator
• Driver

3.   Services Offered

3.1 Orthopedic Rehabilitation

The Orthopedic Rehabilitation team consists of highly trained physical therapists. TPT&RH goal with orthopedic rehabilitation is to return each patient to his or her maximum level of function utilizing a team approach to recovery.

Orthopedic Rehabilitation available at TPT&RH includes treatment for but not limited to:

• Back and neck pain therapy
• Shoulder/arm, hip, knee and ankle therapy
• Sport injury rehabilitation
• Pre- and post-surgical care
• Pain management
• Arthritis/Fibromyalgia
• Post-surgery total joint replacements (hip, knee , ankle , elbow, shoulder )
• Post-surgery diagnoses related to musculoskeletal issues
• Joint sprains/strains
• Muscular strain

3.2 Neurological Rehabilitation

Neurological rehabilitation is provided by a team of highly trained professionals whose goal is to maximize the independence and quality of life for every patient.  This requires a high level of collaboration and cooperation among the team, physician, patient, and family to achieve these goals.  TPT&RH provides Neurological rehabilitation services but not limited to:

• Stroke
• Traumatic Brain injury/concussion
• Brain surgeries (e.g., aneurysm repair, Arteriovenous Malformations (AVM) etc.
• Neuro-degenerative diseases (e.g., Parkinson’s, Multiple Sclerosis, Transverse myelitis, Amyotrophic Lateral Sclerosis (ALS), etc.)
• Spinal cord injury
• Balance and Coordination
• Post Covid Rehabilitation
• Vestibular assessments
• Gait assessment

3.4 Cardiopulmonary Rehabilitation

Cardiorespiratory physiotherapy is an area of physiotherapy that specialises in the prevention, rehabilitation, and compensation of person served with diseases and injuries in the heart and lungs. These conditions may manifest themselves as shortness of breath, persistent cough, increased work of breathing or the reduced ability to exercise. Common cardiorespiratory conditions include but not limited to:

• COPD, asthma, and chronic bronchitis
• Congestive cardiac failure and ischemic heart disease
• Post operative thoracic and cardiac surgery
• Post COVID respiratory dysfunction and fatigue
• Pulmonary infections (pneumonia)

3.5 Paediatric Rehabilitation

The Paediatric Rehabilitation Physiotherapy  and speech therapy Departments provides complete paediatric  rehabilitation services to children with movement problem and gross motor function delay such as Cerebral palsy, Down syndrome, Congenital muscular problem, and other neurological disorders. Paediatric rehabilitation is used for children with:

• Cerebral palsy
• Down syndrome
• Autism spectrum disorder
• Developmental delay
• Genetic syndromes
• Pediatric Orthopedics deformities

3.6 Nursing and Care Assistance Services

Complementing the core rehabilitation areas, nursing and care assistant services ensure medical stability and holistic daily living support.

Nursing Services:

• Medication administration and IV therapy
• Wound, catheter, and tracheostomy care
• Chronic disease management (diabetes, hypertension)
• Health education and preventive care monitoring

Care Assistant Services:

• Assistance with personal and daily activities (mobility, hygiene, feeding)
• Bed sore prevention, positioning, and light housekeeping
• Emotional support and ongoing communication with the care team

4. Activity Limitations

Comprehensive outpatient rehabilitation services are provided to all ages who have experienced an injury or illness that had resulted in the loss of function (abilities) in activities of daily living (ADLs), Instrumental Activities of Daily Living (IADLs), mobility, cognition and/or communication.

5. Cultural Needs

TPT &RH shall respect all cultural needs of the patient and family and accordingly abide by UAE Law. Shall respect the female privacy and provide the selection of genders for the treatment. Observance of religious and cultural practices, including prayer times, fasting periods, and family customs that may influence the care plan.

6. Impairments

TPT&RH shall include physical impairment patients, speech and language impairment and swallowing, cognitive and behavioral impairment and activities of daily living (ADL) patients. TPT&RH shall accept patients with comorbidities; however patients must be hemodynamically stable.

7. Intended discharge/ Transition Environments

Discharge Criteria: Patients receiving outpatient rehabilitation services will be discharged from services when certain criteria are met. The discharge criteria include, but are not limited to, the following:

1. The person served has met or substantially achieved goals established in the current individualized plan of care.

2. The individual has achieved maximum functional potential and the continued provision of skilled services is no longer required or reasonable.
3. Progress has plateaued or temporarily ceased despite modifications in the plan of care.
4. Medical, psychological, or social factors now limit safe participation or require a higher level of care.
5. The individual has transitioned to self‑management, with trained family or caregiver competence verified by the team.
6. The patient’s plan includes a scheduled transfer to outpatient, community, or long‑term care services for ongoing support.
7.  A physician or referring provider requests discontinuation of home care services.
8. A significant interruption of care has occurred (greater than  days) outside the defined plan of care.
9. The person repeatedly exhibits unsafe or aggressive behaviors that compromise staff safety or the therapeutic environment.
10. The person served or legal representative declines further participation or elects to discontinue care.
11. The person’s care is transferred to another provider or facility for specialized management (e.g., inpatient, hospice, or community rehabilitation).
12. The person served has achieved the goals that were established or updated in the most recent plan of care.

8. Medical Acuity

TPT&RH Home Care admits only persons who are medically suitable for safe home‑based management. The organization ensures that every individual is hemodynamically stable and free from acute medical conditions that would require hospital‑level monitoring. Medical oversight, physician clearance, and ongoing risk review are integral to maintaining safety and program appropriateness. Based on the condition of the person served:

• Initial physician assessment is required prior to starting rehabilitation or nursing intervention to confirm suitability for home‑based management.
• Ongoing clearance is obtained from the attending physician when clinical status changes, such as new medical diagnoses, complications, or significant alterations in vital signs.
• The nurse or therapist documents any medical risk indicators and reports these immediately to the supervising physician for review.
• If at any point medical instability, acute infection, or behavioral risk is identified, the service shall be paused or discontinued, and the person referred for medical stabilization or emergency evaluation as per TPT&RH’s risk and emergency response policies.

9. Medical Stability

TPT&RH Home Care provides services only to individuals whose medical condition permits safe delivery of care in the home environment. Continuous monitoring, early recognition of deterioration, and timely physician referral help maintain medical safety, prevent complications, and ensure continuity of care.

• TPT&RH Home Care accepts persons served who are medically stable and suitable for community‑based rehabilitation and nursing intervention.
• The service team can effectively manage minor (Stage 1 or superficial) wounds and other low‑risk clinical conditions using evidence‑based wound‑care protocols.
• Nurses and physiotherapists collaborate to monitor skin integrity and pressure areas throughout the course of care.
• All applied treatments, dressing changes, and pressure‑injury prevention strategies are documented in the person’s home‑care record.

10. Types and ages of patients served

TPT&RH Home Care provides services to individuals of all ages and conditions appropriate for home‑based, medically stable for care.

11. Setting

All interventions are delivered in the person’s residence or community living environment, including private homes, apartments, or senior‑care residences.

12. Hours of service

13. Fees and Payer source

TPT&RH Home Care accepts payment through multiple sources:

• Major insurance providers with whom contractual arrangements exist.
• Cash or card payment at time of service.
• Charitable or third‑party sponsorships as approved by management.
• Detailed fee schedules are available to persons served and families upon admission, in compliance with UAE, MOH and payer transparency requirements.

14. Types of Insurances

All Major insurances shall be covered include but not limited to:

1. Al Buhaira National insurance
2. Almadallah Insurance Govt. & Dubai police

15. Frequency of service

The frequency and duration of visits depend on individual medical and rehabilitative needs, interdisciplinary recommendations, and payer authorization.

• Average Schedule:  2 – 5 home visits per week (approximately 8 – 20 sessions per month).
• Frequency may vary based on clinical progress, therapist or nurse evaluation, and physician instructions.
• 24‑hour nursing or caregiver shifts may be provided for complex cases or palliative coverage.

16. Referral Source

TPT&RH Home Care admits persons served through:

• Internal referrals from Thumbay Group facilities, including hospitals, outpatient departments, and specialty clinics.
• External physician or hospital referrals supported by medical documentation and stability confirmation.
• Community or insurance case‑management referrals, provided they meet admission and safety criteria.

17. Recognized standards or guidelines for practice used

(Professional standards, clinical paths, multidisciplinary care plans, national guidelines)

• www.csp.org.uk
• www.apta.org
• www.CARF.org
• Ministry of Health and Prevention (MOHAP) Home Care Regulations

18. Review of Scope of services:

Scope of Service shall be reviewed at least on an annual basis.