Frequently Asked Questions

When you are considering elder care services, there are many questions you find yourself asking. We've included some of the most common questions we receive every day.

Q: What is home care?

A: Home care is a broad term that describes a wide variety of health and health-related services provided in a home setting. The care is brought into a person's home to maintain or restore the person's health and well-being. Services include: nursing, physical therapy, occupational therapy, speech therapy, medical social work, in-home aides, companions and homemakers. They can also include medical equipment and supplies, infusion therapy, respiratory therapy and nutrition.

There are two categories of home care. Home health care typically describes skilled nursing and therapy services and home care describes non-medical services that address functional needs of everyday living such as meals and grooming. In both instances it is personalized care that reduces the anxiety and stress associated with most forms of healthcare and allows a maximum amount of freedom for the individual. Quite often home care also means significant savings in the cost of care when compared to institutional settings.

Every day, millions of Americans rely on home care to stay out of a hospital, nursing home, or some other institution. There is continued evidence that patients frequently heal more quickly at home and there is very high consumer satisfaction associated with care delivered in the home.

Q: Who provides home care?

A: There are basically two types of people who provide home care. There are informal caregivers such as family and friends. There are also paid caregivers, some of whom are licensed professionals such as nurses and therapists and others who are non-medical personnel such as aides, homemakers and companions.

Q: How can I access home care services?

A: Patients or family members may directly contact home health agencies to access services. Physician, Case Managers, Discharge Planners and Social Workers may also make recommendations about home health. For people discharged from a hospital, Federal Law guarantees a person's right to choose the home care provider that he or she wants in their home. The hospital is required to provide a list of all the home care agencies in addition to any hospital sponsored or owned home care agencies.

Q: Who pays for home care services?

A: Many home care services are reimbursed by Medicare, Medicaid, worker's compensation, private or group health insurance, HMOs, Veteran and military benefits (VA/Tricare), or through other special funds such as block grants. Also, private payment may be arranged with many agencies on an individual basis. When services are reimbursed by either public sources of funding or through insurance, it's important to understand the eligibility criteria for reimbursement.

Medicare requires that the following conditions be met before reimbursing for home health services:

• The individual to whom the services are provided is an eligible Medicare beneficiary
• A physician certifies the need for services and establishes a plan of care
• The beneficiary must meet Medicare's definition of "homebound"
• The care must be provided in the patient's place of residence
• The individual needs skilled nursing on an intermittent basis or physical therapy or speech therapy or has a continued need for occupational therapy once one of the other skilled disciplines has established a plan of care
• The services are provided by a Medicare-certified home health agency

When the above conditions are met, physicians may also order home health aide services or medical social worker services.

Q: How do I select a home health provider?

A: As in selecting any healthcare provider, patients and families should ask questions and make an informed selection, based on their specific needs. Some of these questions are:

• How long has the provider been serving the community?
• Does the provider select and train its employees and are they background checked and insured?
• Does the provider include the patient and his or her family members in developing the plan of care? Are they involved in making care plan changes?
• What procedures does this provider have in place to handle emergencies? Are its caregivers available 24 hours a day, seven days a week?
• How does this provider ensure patient confidentiality?
• Is the patient's course of treatment documented?

Q: Is there any other source of help for making my decision about a home health provider?

A: It is also critical that individuals take advantage of consumer protections that currently exist to promote high quality care. Fortunately, there are new, emerging ways to measure quality home care: consumer ratings and clinical performance measures. Consumer ratings, or "consumer satisfaction" information looks at home care form the consumer's point of view. Clinical performance measures look at how well regulated home health agencies provide care for some of their patients. The measures provide information about patients' physical health, and whether their ability to perform basic daily activities improved. Quality information can be found in the Federal Government website Home Health Compare to review what measures matter most to you and compare those measures for all the agencies.