What the LMN is.
The Letter of Medical Necessity is your treating physician’s certification that you need care at home — naming the type of caregiver, the hours per day, and the days per week, tied to your accepted conditions. The Department of Labor reviews it and authorizes the services. Under the White Card, the first one runs through Form EE-17A (the request) and Form EE-17B (sent by the DOL to your physician).
No LMN, no care. Weak LMN, fewer hours. It is that central.
Strong LMN, weak LMN.
The Department of Labor authorizes what the documentation supports. Vague notes get vague authorizations. Specific, dated, clinical evidence gets hours that match real needs.
- A weak LMN is assembled from memory the week the renewal is due — general statements, round numbers, nothing dated.
- A strong LMN reads like a record: what care was required, when, how often, measured and documented at the time it happened.
How Alara builds them.
Your clinical record captures what your care actually requires visit by visit — assessments, wound measurements, medication changes, mobility and daily-living needs. From the in-home nursing assessment, the draft LMN is generated with the hours grid already mapped to your accepted conditions — functional findings, care types, hours per day and days per week — ready for your physician to review, edit, and sign in minutes instead of building it from a blank page. AlaraOS, the system wrapped around that record, then runs the paperwork’s whole life: signature, authorization, and every renewal assembled before the period ends. Your physician signs evidence, not recollection — and care does not stop over paperwork.
The full guide: how your hours are set, and how they can grow →
For physicians’ offices: a patient has asked you for home health and the EE-17B is new territory. We prepare the LMN documentation and the supporting record; your physician reviews and signs a specific, defensible document — no unpaid paperwork project for your staff. Send us the patient, fax the order to (725) 210-8285, or consult our clinical director first: (702) 814-9630.
Common questions.
Who writes the LMN — my doctor or the agency?
Your treating physician signs and certifies it; a good agency prepares the supporting documentation so what the physician signs is specific and defensible. Only an MD or DO may certify home health under these programs today.
How often is it redone?
Authorizations run in periods — commonly around six months — and each renewal needs updated documentation. If your needs change sooner, an updated LMN can support a change in hours.
Sources: U.S. Department of Labor, Forms EE-17A / EE-17B · DEEOIC Procedure Manual, Home & Residential Health Care. General information; the Department of Labor sets and adjusts authorizations.