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What is home health care and why do I need it?  

Tuesday, October 2, 2012


Home Health Care is skilled nursing care and certain other health care services that you receive in your home for the treatment of an illness or injury. This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).

This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).  




II. How to get Medicare Home Health Care: 
• Your doctor must determine you need medical care in your home.
 • You will need at least one of the following services: skilled nursing care, physical or speech therapy. 
• You must be homebound. Homebound means that leaving your home is a considerable and taxing effort
III. What qualifies as Skilled Home Care Services?
• Wound Care for pressure ulcers or surgical wounds 
• Physical Therapy (fall prevention, recent fractures, recent stroke, TIA's, endurance issues, or transfer training) 
• Occupational Therapy (recent strokes, ADL training-such as dressing, grooming, and bathing)
• Speech Therapy (swallowing issues, aspiration, recent stroke, pneumonia)
 • Patient and Caregiver education
• IV Therapy
• Injections (diabetes, B-12)
• Medication Management
IV. Home Health vs. Hospitalization:
• In many cases home health care services may be appropriate to prevent an individual from being hospitalized.
• Most patients and their families prefer to stay at home rather than be placed in the hospital or skilled nursing facility when their condition allows them to remain at home.

• Home health care is usually less expensive and in some cases just as effective as care in a hospital or skilled nursing facility. 
Home health care assists a person in their recovery from an illness, accident, surgery, or change in their medical condition. Professional health care and rehabilitation services are delivered in a person's home environment under the direction of their personal physician.        
Services offered include:     
Skilled Nursing 
24/7 Availability     
Physical Therapy 
Wound/Ostomy Care   
Occupational Therapy  
Infusion Therapy   
Speech Therapy 
PT/TNR results in home  
Home Care Aides 
Pain Management    
Medical Social Workers 
Rehabilitation 
Who pays for home health care?
If you are Medicare eligible and qualified for care, there is no out of pocket cost to you. Home care can also be paid for by many private insurances or a variety of public programs.
To qualify for Medicare home health services, there are five basic requirements:
1. Your physician must determine that you need home health care services
2. Your own physician must write the orders for home health services, and oversee your care
3. You must need skilled services that are provided by a nurse or therapist
4. Your physician must determine that you are homebound, requiring considerable effort and help to leave home
Because benefits and requirements can vary, we can help you check with payors about your specific benefits, even before beginning services, so you can have this information at the start of care. 
-Medicare pays 100% of the cost for home health care for individuals 65 years of age or over or permanently disabled.
-Private insurance will pay for home health care. Benefits vary per policy and verification of benefits is required.
-Medicaid pays 100%. Pre-authorization is required.
-Workers Compensation Insurance.-Private Pay.
We can HELP you in a number of ways.      
   ·     Patient specific health data with observations by a professional nurse are reported to the physician. 
  •  Helping patients and their families to understand and follow physician's orders regarding nutrition, special diets, medications, and general nursing care:
 ·       Assisting with home management of catheters and feeding tubes.
 ·     Giving injections ordered by the physician and teaching patients and family the proper techniques for doing so. 
  ·       Helping patients restore strength and independence through physical therapy exercises, 
  • Educating diabetic patients on how to manage diet, insulin, and other health related measures. 
  • Enabling the patient with ostomy how to resume a full, active life.
 ·        Assisting patients with bathing and personal grooming (ADLS).

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