Home health care is the cost effective alternative to extended hospital stays or institutional care. Being at home helps clients feel better about themselves and gives them a sense of security and well-being, without imposing a burden on family and friends. In addition, home care can cost a fraction as much as hospitalization or a long term care facility.

The scope of home care is broad. Clients cross the spectrum of care; from newborn infants to the elderly and infirmed. Services include non-medical personal care, such as assistance with personal hygiene, meal preparation, mobility, and light housekeeping to skilled nursing care and specialized therapeutic care.

Staying at home means being near family and friends - people who can offer loving care and support. A trained home care provider can teach caregivers the skills needed to help with specialized types of care.

back to Q & A

Who Needs Home Care?

• If you are unable to meet your own needs due to health, age or social problems.
• If you are stressed with taking care of a family member who can no longer care for themselves.
• If you are missing work or ignoring your immediate family to care for a loved one.
• If you are homebound and lonely, frightened, or depressed.
• If you need assistance getting groceries, going to appointments, or around the house.
• If you have an infant or sick child and need help with care or housework.
• If you were recently hospitalized for surgery or illness.
• If you are a new mother, or soon to be mom with special needs.

back to Q & A

How Do I Choose An Agency?

You should select home health care services as carefully as you select a physician, a lawyer or any other professional. Home health care should help relieve you of emotional and financial burdens, not  add to your worries with unexpected costs or unsatisfactory performance. Here are some areas to investigate before you make up your mind.

Credentials of the home health care agency

• Does the agency have a client's bill of rights available?
• What is the professional reputation of the agency?
• Are employees bonded and insured? Bonding of employees entering your home is an important protection against theft. Professional personnel - such as RNs - should also carry malpractice insurance
• Does the agency carry liability insurance?
• Does the agency run department of motor vehicle checks?
• Does the agency screen the employees for illegal drugs?
• Does the agency perform criminal background checks on their staff.

Billing Procedures

1. Medicare is a federal health care program for older and certain disabled Americans. 

2. Medicare covers the home health services of nurses, therapists, social workers and home health aides. A physician must provide written orders for care to the providing agency. Check with your local Social Security office or home health agency for details.

3. Medicaid programs are health programs for the needy; jointly supervised and financed by the federal and state governments.

4. Medicaid and other government programs cover many home health care services; some states include physical and occupational therapy and speech pathology in their covered services.

5. In general, about 80 percent of the nation's Blue Cross plans provide some home care benefits. More than a third of these require some prior hospitalization. Some home health care services - such as homemaking - are usually not covered by Blue Cross plans. Private insurers are now starting to provide home care benefits.

back to Q & A

What Services Are Available?

1. Rehabilitative home care is provided to people who are convalescing from an illness or are in a rehabilitation program. Many of these patients have been recently discharged from a hospital. The rehabilitative health care team may include a physician, nurse, nutritionist, homemaker, home health aide as well as various types of therapists.

    

   • Skilled Nursing is the most common rehabilitative home care service. Nurses change dressings, administer drugs and monitor patients for complications or serious changes in health. They also teach patients and their families how to perform skilled nursing procedures so they can eventually perform them themselves.

     Nurses are divided into two groups: registered nurses (RNs) and licensed practical nurses (LPNs). RNs, are trained to make independent judgments about a patient's condition and care, and can perform basic patient examinations. LPNs focus on mastering routine nursing tasks, while working with and under the supervision of the RN.

      

   • Therapists make up another part of the spectrum of home health care providers. Their role: To restore, maintain or enhance the abilities of those under their care. There are several different types of therapy. Physical therapy focuses on enhancing physical movement. Speech therapy works on communication problems. Occupational therapy helps people overcome problems of daily living at home or at work.

   
   

2. Basic home care refers to the kinds of services provided to patients who otherwise might be unable to remain at home because of a disabling health condition. Continued health supervision with an emphasis on health promotion enables these patients to maintain both a stable state of health and relative independence. Homemaker and home health aide services are the least expensive home care service. Many of the recipients of such care have a chronic illness or disability.

    

   • Home Health Aides perform three general types of services: personal care, basic nursing and incidental homemaking. Aides cannot provide skilled nursing care. For example, although they can take and record your temperature, pulse and respiration rate, and make sure you follow simple medical recommendations such as getting more exercise, they generally cannot administer drug injections or medications.

   back to Q & A

Is Home Care Is Right For You?

If home care is deemed appropriate, your home care agency will conduct an assessment. This is a detailed evaluation of your situation that confirms the need for services ordered and identifies any other beneficial services. The assessment is usually made by an RN at your home. The agency then tailors a home care plan to your needs and reviews it with you. Before finalizing the plan, the agency advises your doctor of its assessment and presents the plan for your doctor's approval. The plan outlines key details, including treatment goals, the specific services and level of care that will be provided, and any medical equipment and supplies that may be needed.

back to Q & A

How Do I Pay For Home Care?

Some agencies are certified by Medicare/Medicaid to provide for their patients.  To find out whether you or someone you know qualifies for home health services under Medicare/Medicaid, talk to the hospital discharge planner or your doctor, or call the agency directly.  For those patients who are not covered by Medicare/Medicaid, most health agencies accept reimbursement from private insurance companies or from the patient directly.

To be eligible for Medicare/Medicaid paid visits, a patient must first qualify for skilled care, such as that provided by an RN.  Medicare does not cover basic home health care services limited to assistance with bathing, dressing and or feeding.  If a Medicare patient qualifies for service under the agency's guidelines, Medicare is billed directly; a bill is usually not sent to the patient. 

back to Q & A

Do I qualify for Medicare-paid services?

The answer is YES ...

1. If you are "homebound" That is, if it is fairly difficult for you to leave your home without assistance in order to visit your doctor. (Note that you do not have to be bed-bound).
2. If you are experiencing a new health problem that may require the help of a nurse, a physical therapist or a speech pathologist.
3. If your doctor would allow us to make a home call and follow up with your care under his/her direction and supervision.

How Long Can I Receive Visits?

Each home visit lasts as long as it takes to provide necessary care, usually anywhere from one-half hour to two hours..  Visits are routinely scheduled between 8 a.m. and 6 p.m. 365 days a year.  After 9 p.m. urgent visits to existing patients can be made as needed. 

back to Q & A