What is home health care?

Visions Home Health Before modern medicine, caring for someone in the home was quite common, and hospitalization was rare. Increasing numbers of patients need continuing professional medical services when they return home. Professional home health care services include a broad range of care and support services for those who are recovering from a hospital stays. Patients, who are chronically ill, injured, disabled, or need medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living.

Home care services are typically provided by home care organizations. There are a variety of home care organizations, Health care providers may be utilized to deliver specialized services and products such as medical equipment and supplies, pharmaceuticals, and drug infusion therapy. The range of home health care services a patient can receive at home is limitless, from nursing to therapy to social support. The most common form of home health care is nursing. In consultation with your physician, a plan of care will be designed to ensure your medical needs are met.

Home health care may include:

  • Skilled nursing
  • Physical therapy
  • Speech therapy
  • Occupational therapy
  • Nutritional services
  • Social services
  • Resource management`
  • Vaccination
  • Home medical equipment
  • Educational advice
  • Wound care
  • Pain management
  • Home safety instructions
  • Infusion therapy

FAQs for selecting a Home Health Care Provider

There are many important factors to consider in choosing the best agency to meet your needs, most important of which is to assess what types of services you or your loved one will need. When selecting an agency, it is important to ask the appropriate questions during your initial meeting. Below is a list of sample questions:
  • How many years has the agency been serving your community?
  • Is the agency an approved Medicare provider?
  • Does the agency provide patients with a "Bill of Rights" that outlines the rights and responsibilities of the agency, patient, and caregiver alike?
  • Is there a written plan of care for the patient's treatment that the patient, physician and family participate in developing?
  • Does the agency staff educate the family members on the care being administered to the patient and ways they can assist?
  • Are supervisors assigned to oversee care to ensure that the patient receive continuity of care that  will help provide quality treatment?
  • Are agency caregivers available seven days a week?
  • Does the agency have a nursing supervisor on call and available 24 hours a day?
  • Who can you call with questions or complaints regarding patient care, caretaker issues or general questions?
  • Will the agency provide a list of references?

Home Health / Home Care Checklist

Visions Home Health and Visions Home Care, LLC. meets all the questions below.
  1. Medicare-certified?
  2. Medicaid-certified (if you have both Medicare and Medicaid)?
  3. Offers the specific health care services I need (like skilled nursing services or physical therapy)
  4. Meets my special needs (like language or cultural preferences)
  5. Offers the personal care services I need (like help bathing, dressing, and using the bathroom)?
  6. Offers the support services I need, or can help me arrange for additional services, such as Meals on Wheels, that I may need?
  7. Has staff that can provide the type and hours of care my doctor ordered and start when I need them
  8. Offers a continuity of care so you know who is helping you at home or in a extended care facility?
  9. Is held in high regard by your hospital discharge planner, doctor, or social worker?
  10. Has staff available at night and on weekends for emergencies?
  11. Explained what my insurance will cover and what I must pay out-of-pocket?
  12. Does background checks on all staff?
  13. Has letters from satisfied patients, family members, and doctors that testify to the home health agency providing good care?

More about home health

Skilled care

Conducted under the direction of your doctor, skilled care consists of services provided by health care professionals such as nurses, medical social workers and physical therapists. There are several types of professional home care providers:

  • Physicians diagnose and treat illnesses and work with your home care providers to determine which services you need and when you need them. They also recommend specialists when necessary.
  • Registered nurses (R.N.s) and licensed practical nurses (L.P.N.s) provide professional-level medical services such as injections and intravenous (IV) therapy, wound care, health education, and medical assessments. R.N.s may also provide case management services.
  • Social workers help you and your family find community resources and provide counseling. Social workers also serve as case managers and can help coordinate a variety of services to make sure you have the medical treatment and support you need.
  • Physical therapists help restore strength and mobility after surgery or an injury or if you are disabled. They use specialized equipment to relieve pain and treat injured joints and muscles. Physical therapists can also teach you or your caregivers techniques for walking and helping you move from one position to another.
  • Speech therapists help you regain your ability to speak and communicate, and may also help you with breathing, swallowing and muscle control. In most cases, these services are needed after surgery or stroke.
  • Occupational therapists (O.T.s) use rehabilitation techniques to help you learn how to manage everyday tasks such as eating, bathing, dressing and minor household chores.
  • Dietitians evaluate your dietary needs and advise you on how to make sure you are getting appropriate nutrition.

Other services

Home care services can also include:

  • Lab tests and X-rays
  • Medication delivery and pharmacy services
  • Respiratory therapy or treatment from other health professionals
  • Clergy visits
  • Transportation
  • Meal delivery
  • Emergency monitoring systems

Paying for home health care

Home health services can be costly. You may need to pay for home care services directly, or costs may be covered through insurance or other public or private sources.

  • Medicare. Medicare may pay for medical home health care services through a certified home health care agency, if a physician orders these services. Services covered by Medicare include skilled nursing assistance, or physical, speech or occupational therapy. If your home health services are covered under Medicare, your doctor, care manager or discharge planner will probably make arrangements for a home health care agency.
  • Medicaid. Depending on your income and assets, if you are over 65 you may be eligible for Medicaid coverage.
  • Older Americans Act. This federal program funds state and local programs that provide services to frail and disabled individuals who are 60 years old or older.
  • Veterans Affairs. If you are a veteran and at least 50 percent disabled due to a service-related injury or illness, you may be eligible for medical services through Veterans Affairs hospital-based home care services.
  • Community organizations. Depending on your situation and finances, certain community organizations cover home care costs.
Insurance. Many insurance programs cover some home health care services for short-term medical needs. However, long-term coverage varies. Long term care policies are available through private insurance companies and the federal government.

Types of home health care that Medicare will pay for

Section IV.g. Home Health Care Benefit (Part A and B)
If you qualify for the home health benefit, Medicare covers the following types of care:

  • Medicare pays in full for skilled nursing care, which includes services and care that can only be performed safely and effectively by a licensed nurse. Injections (and teaching patients to self-inject), tube feedings, catheter changes, observation and assessment of a patient's condition, management and evaluation of a patient's care plan, and wound care are examples of skilled nursing care that Medicare may cover.
  • Medicare pays in full for a home health aide if you require skilled services. A home health aide provides personal care services including help with bathing, using the toilet, and dressing. If you ONLY require personal care, you do NOT qualify for the Medicare home care benefit.
  • Skilled therapy services. Physical, speech and occupational therapy services that can only be performed safely by or under the supervision of a licensed therapist, and that are reasonable and necessary for treating your illness or injury. Physical therapy includes gait training and supervision of and training for exercises to regain movement and strength to a body area. Speech-language pathology services include exercises to regain and strengthen speech and language skills. Occupational therapy* helps you regain the ability to do usual daily activities by yourself, such as eating and putting on clothes. Medicare should pay for therapy services to maintain your condition and prevent you from getting worse as long as these services require the skill or supervision of a licensed therapist, regardless of your potential to improve.
  • Medical social services. Medicare pays in full for services ordered by your doctor to help you with social and emotional concerns you have related to your illness. This might include counseling or help finding resources in your community.
  • Medical supplies. Medicare pays in full for certain medical supplies provided by the Medicare-certified home health agency, such as wound dressings and catheters needed for your care.

Types of home health care Medicare will not pay for

Section IV.g. Home Health Care Benefit (Part A and B)
Medicare's home health care benefit is limited. Medicare does not cover many home care services. Medicare home health care does not cover:

  • 24-hour a day care at home
  • Prescription drugs
    • To get Medicare drug coverage, you need to enroll in a Medicare Part D plan. You can choose a stand-alone Medicare private drug plan (PDP), or a Medicare Advantage plan with Part D coverage (MA-DP).
  • Meals delivered to your home
  • Homemaker or custodial care services (i.e. cooking, shopping, laundry)
    • Unless custodial care is part of the skilled nursing and/or skilled therapy services you receive from a home health aide or other personal care attendant.
The Medicare hospice benefit may pay for some of these items and services for people at the end of life.

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