The types of care offered by home providers fall into one of five main categories, according to Hank Charpentier, MBA, MA, Certified Senior Adviser® and Co-founder of Partners in Healthcare:

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• Household Care: cooking, light housekeeping, laundry, transportation

• Personal Care: bathing, feeding, dressing, incontinence assistance

• Medical Care: medication reminders, medical advocacy, RN house calls

• Social Support: companionship, community activities, conversation

• Occupational Support: hobbies, home exercise programs

 

Home Health Agencies specialize in providing physical, occupational, speech, behavioral, and social work services in the home or facility during a rehabilitation period.  These therapies are usually covered by insurance and/or Medicare.  This type of company will sometimes offer other services, such as companion and personal care, but these additional services would most likely not be covered by standard insurance and/or Medicare and would be paid privately by you or your family.

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Home Health Agencies will also have a staff Registered Nurse who will come to the home and meet with you or your loved one to determine a plan of care in conjunction with the doctor.  The company may also send a series of different nurses depending on the complexity of the medical situation.

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Nurse Registries specialize in providing skilled, hands-on care.  If your loved one needs 24-hour attention, it is usually because the body or mind is not able to function on some level due to injury or illness. These agencies handle the basic companion care such as transportation, companionship, laundry and cooking, and are licensed to feed, bathe, lift, diaper and administer medications under the direction of the patient’s doctor and in conjunction with the agency staff Registered Nurse.

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The agency staff Registered Nurse will also create a care plan following the doctor’s orders. These agencies often accept long-term care insurance and private pay.  The caregivers are typically CNAs (certified nursing assistants) who have passed a state exam and have extensive training. However, you will still need to verify that they have caregiver experience in the home.  Since these agencies offer hands-on care, if the level of health declines from companion care to hands-on care, you won’t have to change agencies  creating a more stable environment for the patient and family.

In addition to nursing care, many patients can receive physical therapy, occupational therapy and speech therapy in the comfort of their own home.

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Trained staff should always let you know what services are covered under Medicare, and what services will require any additional out of pocket expenses. You should always sign consents for treatments and anticipated expenses.

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All services, for patients meeting the criteria, are fully covered by Medicare. The care must be intermittent and skilled. Each episode of Medicare home health is for a 60 day period requiring the doctor to reauthorize service as needed under strict Medicare criteria.  Supplemental care can be provided in addition to the services provided by Medicare. All services can only be provided under the direct supervision of a licensed physician in the state of Florida.

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The goal is to help improve your loved one’s condition or to maintain his or her condition and prevent it from getting worse. This includes, but is not limited to:

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• Comprehensive medical assessments and teaching of disease management such as hypertension, diabetes, wound care, COPD, CHF, and other chronic or acute conditions.

• Protocol for preventing admission and/or re-admission to hospitals.

 

When selecting a home care agency, you should always verify:

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• Are they a licensed home care agency?

• Are they accredited by the Joint Commission, CHAPS, or the state?

• Do they have a nurse on call 24/7?

• What languages are spoken at the agency?

• What is the coverage area?

• How quickly can they start care? They have to start care within 24-48 hours.

• Can they provide additional private pay services if needed?

• Are there any hidden charges?

• What will be covered by insurance, and what services will be private pay?

• Are they contracted with the Veterans Administration (VA)?

• What other managed care contracts do they have?

• Does the provider have appropriate insurances to protect against theft or malpractice and are they bonded?

• Does the provider offer flexible hours and are there any minimum hours per shift?

• Does the provider offer a free home assessment and a medical evaluation, and are there regular consultation follow-up and service evaluation meetings?

• Is the caregiver permitted to give hands-on care if the client’s health declines?

• Are the employees independent contractors or W-2 employees of the agency?