Home Health Care

Medicare Certified Home Health Care Agencies

Do Home Health Agencies care for minors?

Yes, most will. Some Home Health Agencies specialize in pediatrics. Some Home Health Agencies will not because they may not have anyone on staff that has had previous experience with pediatrics.

Do Home Health Agencies provide hospice care (terminally ill)?

Yes, some agencies are specialized in this care.

Do Home Health Agencies provide RNs or LPNs on an hourly basis for skilled care, such as, patients on ventilators or with wounds that need care?

Yes, most agencies do provide this care, however, be sure to ask questions as to whether the healthcare professional has experience in this area. Some agencies are only licensed to provide companions and homemakers only.

Can a Home Health Agency provide a daily shower/bath visit only?

Yes, some agencies provide this care on a 1 hour basis for a flat fee each time the caregiver goes out to the home. However, each agency is different so check with your local home health agencies. Most agencies require a minimum of 4 hours per day.

What kinds of services are provided by a Home Health Agency?

Companions, homemakers, escorts, home health aides, physical therapist, occupational therapist, speech therapist and social workers. Some agencies may provide more or less of what is listed; however, this is standard in the home health industry

Will I have the same nurse come to my home for every visit?

Yes, for the most part in order to provide the best in continuity of care, home care agencies like for the same nurse to follow patients in their home.

Is prior hospitalization required for Medicare home care visits?

Prior hospitalization is not a requirement to receive Medicare home
health. What is required is a patient is 65 years of age or older or receiving Medicare disability, homebound according to Medicare guidelines, and a physician writes a home care order for skilled nursing and/or physical therapy in a home environment.

Can a resident in an Assisted Living Facility receive home health care through Medicare?

A patient can receive Medicare home health care services at an Assisted Living Facility. Keep in mind, there is no duplication of services as an Assisted Living Facility is still a home and does not bill insurance.

What type of patients may benefit from receiving home health care?

Medicare home health is designed for short term, intermittent, skilled care. Medicare home care does not provide custodial care such as cooking and cleaning for a patient. A licensed Registered Nurse (RN) will conduct the initial evaluation to determine how frequent a nurse whether the same RN or a Licensed Practical Nurse (LPN) will come and/or therapist following the doctor’s home care order. During the initial assessment, patients and their family have a great opportunity to be educated on proper care, medications required and frequency and duration of the home care visits.

Will the same nurse or therapist come to my home during each home health visit?

It is a rule of thumb in order to maintain continuity of care; most home care agencies try their best to keep the same clinician for each visit. From time to time a nurse or therapist may leave on vacation or be sick but should resume care upon their return to work.

Does a patient have the right to change home care agencies or nurse if he/she does not like them?

According to Federal law, home health care patients have the right to choose which institution, agency or person will provide their home care services. Under Section 1802 of the Social Security Act the law clearly states “Any individual entitled to insurance benefits under this title (such as Medicare) may obtain health services from any institution, agency, or person qualified to participate under this title if such institution, agency, or person undertakes to provide him/her such services”.

What can physical therapy do for a patient at home?

For patients that need strengthening and are considered homebound, physical therapy at home is great for patients recuperating from a fracture or needing to learn to use equipment for ambulation and gait training. Physical therapists also make recommendations about removal of throw rugs in the home that can be considered obstructive and increase risk for falls.

Why would a doctor order home health care for a patient?

A physician will order home health care services if he/she feels a patient would benefit from increased monitoring at home. Home health care can help reduce emergency care and hospital readmission for patients living with chronic illnesses and can educate patients on disease management process. Home health is a great way to increase patient’s compliance and can help reinforce proper diet, the importance of medications and other interventions in order to promote health aging.

What are some signs/symptoms why a patient may need physical therapy?

Physical therapy may be warranted in an aging adult if:
1. Taxing effort getting in an out of a chair or bed
2. Difficulty standing for a period of time
3. New onset of pain or complaints of pain
4. Increased difficulty retrieving objects
5. Change in balance or poor balance
6. New diagnosis that results in general weakness such as a mini stroke or pneumonia

What type of strengthen exercises are done at home with a physical therapist?

Physical therapy at home may be used for training purposes such as:
1. Stair climbing
2. joint mobility
3. transferring assistance and proper movement
4. Increase in stamina and activity tolerance
5. use of assistive devices

What types of nursing skills may warrant Medicare home health visits?

A few situations that may require home health services are:
1. Teaching a patient about Disease Management Process
2. Instruction in Medication Management
3. Post Operative Care (wound care and monitoring)
4. Catheter Care and Instructions
5. Observing and assessing exasperated health conditions that are unstable
6. Cardiac Assessment

What type of clinician can come to a patient’s home for home health under Medicare?

A clinician able to come to a patient’s home for home health can be:
1. Registered Nurse (RN) /Licensed Practical Nurse (LPN)
2. Physical Therapist (PT) /Physical Therapy Assistant (PTA)
3. Speech Therapist (ST) – Assess and monitor language disorders and dysphasia.
4. Occupational Therapist (OT) – Can assist and train a patient with upper body mobility and daily activities of living.
5. Medical Social Worker (MSW) – Must be accompanied by a skill at home. The MSW can assess for social and emotional factors related to a patient’s illness and can recommend local outreach programs for the patient to benefit from.
6. Home Health Aide (HHA) – Limited assistance such as assisting a patient with bathing up to three times a week.

What can a patient expect from a home health nurse regarding frequency and duration of visits?

Because home health care services is insurance based designed for short term intermittent care, clinicians generally give a patient a 2-3 hour timeframe of when a patient can expect the clinician to come by for a home visit. Family members and patients…don’t be shy and be sure to ask for the clinician’s cell phone number.

Can I go to Outpatient Physical Therapy and receive Home Health Care simultaneously?

Under Medicare guidelines, Outpatient Physical Therapy Services can not be utilized simultaneously as home health care. If a patient’s health requires skilled nursing care to monitor a recent health setback it may be best to start with home health care services at home with both nursing and physical therapy. Once the patient is feeling better and doctor approved, then Outpatient Physical Therapy may be appropriate.

What do I need in order to receive home health care services at home?

Contact either your primary care physician or specialist regarding your general health condition. There needs to be a new diagnosis or exacerbation of a current illness in order to receive care by Medicare and the patient must be considered homebound. The term “homebound” is subject to interpretation and more information can be found on www.medicare.gov. A good rule of thumb is if leaving one’s home environment requires physically a taxing effort, then you may be perhaps considered homebound.

What type of new diagnoses or exacerbation of diseases may be appropriate for home health care services:

Here are just a few of the many diagnoses/diseases that may be appropriate for a patient to receive home health care:
1. Congestive Heart Failure
2. Unstable Angina
3. Unstable blood pressure
4. Osteoarthritis
5. Osteoporosis
6. Rheumatoid Arthritis
7. Pneumonia
8. Anemia
9. Chronic Obstructive Pulmonary Disease (COPD)
10. Stroke
11. Bowel Disorders
12. Diverticulitis
13. Fractures
14. Post Operative Surgery
15. Parkinson’s Disease
16. Multiple Sclerosis
17. Urinary Retention
18. Uncontrollable blood sugar – Diabetes

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Non Medical Personal Home Care

What is the difference between a companion/homemaker and a home health aide?

A companion/homemaker can provide home duties such as light housekeeping, meal preparation, laundry and errands. Companionship is just that companionship with NO HANDS ON CARE. A home health aide can provide all the services mentioned in addition to HANDS ON CARE such as dressing, bathing, feeding etc…
p(question). Will a Home Health Agency take patients on regular outings such as, the hairdresser, shopping, church or community events?

Yes, this is one reason why home health is so important. Your lifestyle, family, friends are important and necessary for the quality of life that you deserve.

Is a home health aide licensed or certified?

Each state is different on their requirements. Most home health aides go through at least a 40 hour training period with follow up education throughout the year. For example, CPR, first aid, elder abuse etc. are part of these trainings. Check with your local area on the requirements in your state.

What is the difference of going through a Home Health Agency and hiring my own caregiver?

Liability! Home Health Agencies are covered for malpractice, liability, workers compensation etc… They have access to entities to check for any past criminal behavior and to be sure that they are who they say they are. They also are skills tested to be sure that they do indeed know how to care for the patient. Just remember…we all know a criminal that we liked at some time in our lives.

Do Home Health Agencies provide escort services to functions or travel from state to state?

Some home care agencies do provide escort services while others will not because of liability issues. Check with your local home health agencies on this request. This service can be costly through some agencies, so do your homework.

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Safeguards

How are background screenings done on employees that do home care?

Each state’s requirements differ. Most home care agencies do a background check for their state and some also require FBI fingerprinting. There are additional screenings that can be done at the discretion of an agency such as OIG screening, Social Security number screening, county level screening etc… All Home Health Agencies do require a license or certification screening if that level of care is needed.

Is the same caregiver sent to my home?

Most of the time yes, if hours allow it or the caregiver isn’t sick. Continuity of care is important to any Home Health Agency, so that the client/family can establish a relationship with their caregiver.

Do Home Health Agencies care for minors?

Yes, most will. Some Home Health Agencies specialize in pediatrics. Some Home Health Agencies will not because they may not have anyone on staff that has had previous experience with pediatrics.

Do Home Health Agencies provide ongoing training for their healthcare workers?

No, not always. Some agencies require ongoing training for their employees, however, they are sent to a training facility. Most agencies do offer ongoing training as part of their benefit package to insure that their employees are up to date with the latest education. Some states require a certain amount of training each year, just check with your local state entity, such as, the Area on Aging.

Can I change caregivers if I am having personality issues?

Yes, absolutely. All home health agencies want you to be happy with not only their service, but also the caregiver that is sent to your home.

How do you match your caregiver to the client?

Many things are taken into consideration, such as, the personality of the client, the needs of the client, the interests and hobbies of the client. This enables a home health agency to provide a caregiver with common interests and needs.

Do Home Health Agencies have overnight service?

Yes, service can be provided from 2 hours to 24 hours and some agencies even provide live-in care.

Can you check on a Home Health Agency’s license to see if they have had any complaints?

Yes, most of this information can be found on the website. You can check your local state agency that oversees those agencies and also check with you local Better Business Bureau. Some states have a “Watch List” which will allow you to find out whether they have been in trouble with the state.

Do Home Health Agencies provide service in an Assisted Living Facility or Nursing Home?

Yes, quite often the care that is provided in these facilities is minimal. Having a caregiver that will advocate for you on your behalf can ensure the best possible care that the facility can provide. So many patients can not speak their needs for themselves and this is a way to provide reassurance of quality care

Do Home Health Agencies communicate with the family on issues with their loved ones?

Yes, family members are always encouraged to be a part of the care planning for their loved one, unless it is requested by the patient to specifically NOT communicate with certain parties.

Do Home Health Agencies do random checks of their employees while at the client’s home?

Yes, most agencies will, to ensure that the care requested is being done. This is called a “Supervisory Visit”. Some agencies charge a fee for this on a monthly basis, and some don’t. During a supervisory visit the plan of care can be changed as well, as the patient’s needs may change.

Is my information kept confidential?

Yes, most definitely. Each state has laws in place to protect you from your information getting in the hands of people that shouldn’t have it.

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Payment Options

Does private insurance cover the cost of home health?

Yes, although most long term care policies cover home health services at home with no “in” or “out” of network providers. This gives consumers the option to select the home health agency that they desire; however, depending on the policy and the coverage, it may not. Check with your local agent for any questions about your policy. Some agencies will find this information for you by providing them with your policy number.

Does Home Health cost a lot?

Each individual’s financial situation is different. Most home health agencies will work with a family to provide services within their means. Home health agencies can also provide you with resources for funding for home health. Check with several agencies and ask many questions to assist you in finding the help you need. Also, take time to compare the costs of home health vs. assisted living facilities in your area; you may be quite surprised what you find. It is also important to remember that you get what you pay for, as with anything.

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