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What is home health care?

It is care provided in the comfort of your own home by a certified home health agency to treat an illness or injury. Home health care is less expensive, less intrusive, more convenient, and just as effective as the care received in a hospital or skilled nursing facility. Services provided may include skilled nursing, speech therapy, occupational therapy, physical therapy, behavioral health care, and monitoring patient’s adherence to prescriptions.

What type of home care agencies are there?

Certified Agencies: Primarily engage in providing skilled nursing services and therapeutic services. Certified agencies comply with Medicare and Medicaid regulations and has approval as meeting the standards established for licensing by the State or locality.

Private Duty Agencies: Offer a wide variety of medical and nonmedical services. Services may include, but are not limited to: nursing, assistance with shopping, laundry, meals, and companionship. The patient/family generally incur the cost of care, although some insurance plans may cover all or part of the costs.

What are the advantages of home health care?

Home health care services permit a person to be discharged earlier from a hospital. It reduces patients’ hospital admission and re-admission rate. Most importantly, it allows individuals to receive professional care in a familiar setting which results in a more rapid recovery.

Who is eligible for home health care?

If you are utilizing Medicare benefits, you must meet the following criteria:

  • You must be under the care of a doctor, and must be receiving services under a plan of care established and regularly reviewed by a doctor.
  • The home health agency caring for you must be approved by Medicare (Medicare-certified).
  • You must be certified as homebound by a doctor
  • A doctor must certify that you need, one or more of the following.
    1. Intermittent skilled nursing care
    2. Physical therapy
    3. Speech-language pathology services
    4. Occupational therapy

Does my doctor have to order homecare?

Medicare, Medicaid, and most insurance policies require physician oversight.

How are services initiated?

Home care services may initiate once your physician prescribes home health care and authorizes a coordinated treatment plan.

How soon will the services start?

A registered nurse will perform an assessment within 48 hours of a referral for home health or within 48 hours from the time the patient is discharged from the hospital.

How often will you come to my home?

The frequency of visit is determined based on the health assessment performed by one of our registered nurses well as your physician’s prescription.

Will my insurance cover home health care?

Medicare, Medicaid, or other health insurances may cover the cost of home health care services.
Original Medicare will pay for any covered services you receive from a Medicare-certified home health agency during a 60-day episode.

If included in your plan, some private insurances may also pay for home health care but may not cover all services unless certain conditions are met. The home health care agency will be able to assist you in determining if the services you need are covered or if you need to make other arrangements.
Note that you may still obtain home health care without insurance coverage on a private pay basis. In some cases, certain agencies may be able to provide financial assistance for individuals who are not able to afford the private pay option.

What are my rights as a patient?

  • Right to choose your own home health agency
  • Right to have your property treated with respect
  • Right to be given a copy of your plan of care, and participate in decisions about your care
  • Right to have your family or guardian act for you if you are unable to
  • Right to make complaints to the agency or the State Survey Agency about your treatment

cases, certain agencies may be able to provide financial assistance for individuals who are not able to afford the private pay option.

How do I effect a switch if I am not satisfied with my current agency?

If you are dissatisfied with the services being provided, you may call the agency and ask for a discharge. This is your right as a patient.

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