The three steps.
- Document the change. What is different, since when, and what care it now requires — specific, dated, clinical. More help with bathing, a new wound, more frequent nursing needs.
- Your physician certifies it. An updated Letter of Medical Necessity states the new hours per day and days per week, tied to your accepted conditions. What an LMN is →
- The DOL reviews and adjusts. Hours go up when the evidence supports it — and can be reduced when documentation is weak.
“That’s all the hours you get” is not a final answer when your condition has changed. It is a documentation problem wearing a verdict’s clothes.
Why documentation quality decides it.
The DOL authorizes what the record supports. An agency that documents your needs visit by visit can show the change the day it happens; an agency that writes the renewal from memory cannot. At Alara, the request for more hours is drafted from recorded clinical data in our care system — the evidence is already assembled when the need appears. The full guide to how hours are set →
Common questions.
Who do I ask first?
Tell your agency and your physician what has changed, specifically and with dates. The updated certification goes to the DOL from there.
Can hours go down?
Yes — when documentation does not support the current level. That is another reason the record quality matters.
How do I get more home health hours under the White Card?
Document the change in your needs, have your treating physician certify an updated Letter of Medical Necessity with the new hours, and submit it to the Department of Labor, which reviews and adjusts the authorization.
Sources: DEEOIC Procedure Manual, Home & Residential Health Care. The Department of Labor sets and adjusts authorizations.