Most home health agencies offer these basic services:
Home Health Nursing Services are initiated by a registered nurse who develops the plan of care with you, your doctor, and your family. Skilled nursing care can include physical exam assessment, wound care and dressing changes, catheter care, IV therapy, colostomy care, and patient and family teaching. The nurse coordinates your care at home and keeps the doctor informed of your progress.
Home Health Aid Services supplement the care provided by the registered nurse by helping with daily needs. Services include assistance with personal care: bathing shampooing, and changing linens. The aide also can help with meals, simple prescribed exercises and limited household tasks.
Physical Therapy Services are provided to relieve pain, prevent further disability and restore function for maximum independence through a home exercise program designed by a physical therapist.
Occupational Therapy Services teach you how to adapt daily routines and surroundings for more independent living. Occupational therapy includes instruction in self-care and homemaking tasks.
Speech Therapy Services help with problems with pronunciation, swallowing or hearing and can help with the development of language skills.
Medical Social Services help with personal, family, and financial problems that may develop as a result of your illness or disability.
Medical Supplies such as dressings, tape, and catheters are available from the home health agency. Incontinent supplies--diapers and chux--also can be obtained.
Equipment such as a wheelchair, walker or hospital bed, if needed, can be obtained with
assistance from the home health agency.
Home health care brings quality health services to individuals in the privacy of their home and helps them to remain in familiar surroundings. Services including skilled nursing care, speech, physical or occupational therapy, and personal care services can be provided to individuals of all ages. The professionals at the home health agency will work with the patient and his/her family and the physician to improve health in the quickest and safest way.
In order to offer home health or hospice services in Kentucky, home health agencies and hospices are required to obtain a certificate of need and be licensed to serve a given geographic area. Only licensed agencies may be certified to receive Medicaid or Medicare reimbursement for providing home health services or hospice services.
There may be several agencies approved to provide services in a given area. Each individual has the right to choose the home health agency which best suits his/her care needs.
A good home health agency will always provide:
1. Evaluation of the patient's health needs by a registered nurse or therapist;
2. Development of a plan of care by the nurse or therapist;
3. An opportunity for the patient to ask questions, to be kept informed and to understand the
services given, including information about charges for services
and financial arrangements for payment;
4. Assurance that all care is coordinated with the physician and other health care
providers and is provided by qualified health care personnel;
5. Instruction on how to care for one's health needs;
6. Assurance that care is treated confidentially.
WHEN MAKING A REFERRAL, basic information is needed to facilitate the referral process. Those making referrals should be prepared to provide the following information:
Identifying Data:
Name, age/birth date,
Address or directions to the home,
Telephone number,
Name and telephone number of relative or neighbor,
Admission and discharge dates when hospitalized.
Data Regarding Plan of Treatment and Therapies:
Patient's diagnosis(es),
Medication and recommended care and therapies,
Physician's name,
Dates of clinic and/or doctor's appointment,
Supplies and equipment needed.
Would you rather stay at home than go to the hospital or a nursing home when
you are sick? Perhaps you or a family member need some type of "special care"
which neither you nor your relatives can handle alone? Home health care could
be the answer!
Home health care brings health services to you in the privacy of your home and
helps you remain in familiar surroundings. Services which include skilled nursing
care, therapy, and personal care services can be provided to individuals of any age.
For example:
a cancer patient requiring chemotherapy
a teenager recovering from a fracture
a child with diabetes
a grandparent recovering from surgery or an acute illness
a businessman recuperating from a heart attack
a pregnant woman with high blood pressure or diabetes
a wife and mother with terminal illness
a baby with breathing problems
a stroke victim who requires physical, speech or occupational therapy
Highly trained, skilled professionals can care for you in your home when you are
ill or disabled as an alternative to a longer hospital or nursing home placement.
Charges for home health services vary among agencies, and government health plans are subject to change. Potential home health clients should inquire about charges and coverage before accepting services. The fact that a patient's physician may order home health care does not guarantee that reimbursement sources will cover the care.
Medicare, Medicaid and private insurance may cover all or a portion of the cost of home health care. In Kentucky, only licensed home health agencies or hospices may be certified to receive Medicare and Medicaid reimbursement for providing home health or hospice care. Some providers of related home care services or supplies may be reimbursed by these payors but not for providing hands-on home health care.
To be eligible to receive home health services under Medicare or Medicaid programs, individuals must be eligible for these programs and must have health care needs which can be met by care provided on an intermittent basis (less than full time). There must be a need for skilled care services, and the individual must be essentially home bound. There is no requirement for a prior hospital stay in order to receive home health benefits. A home health agency can be of assistance in determining if the patient's health care needs meet the criteria for Medicare of Medicaid reimbursement.
Some agencies have a sliding fee schedule for those individuals without insurance coverage. Also some home health providers participate as a "Kentucky Fair Share Provider" as part of a voluntary network through which they provide limited services to individuals who are without financial resources, have no insurance, are not eligible for Medicaid or Medicare and have non-emergency health care needs. A physician participating in the Kentucky Physician Care Program may refer someone to home health through this network. The hotline number for accessing the "Kentucky Fair Share" Program is 800-633-8100.
All private insurance carriers in Kentucky must offer home health benefits; however, full home health care coverage may be an optional benefit. Coverage varies widely. Insurance plans may cover expanded services beyond specific identified benefits if such services are cost effective and medically appropriate alternatives to institutional care. Each potential patient should check with his/her insurance company or with a home health agency to determine how much home health coverage may be available.
A special Medicaid program called Home and Community Based Waiver Program provides supportive care in the home for those Medicaid recipients who are eligible for care in a nursing facility. The services are ordinarily not covered under Medicaid's traditional home health care. Special income and eligibility requirements must be met. Any home health care agency providing these services can explain requirements and assess whether the patient's needs qualify them for these services.
Through its Home Care Program, the Commonwealth of Kentucky provides limited funds for services to elderly individuals who do not need skilled care, but whose ability to remain at home unaided is limited. In many areas of the state, a home health agency may be the agency authorized to provide these special government funded services.
Workers Compensation may cover home health services needed as a result of a job related injury. Determination and eligibility information can be obtained from employer or workers' compensation representatives.
In some instances Veterans Benefits may include home health services for eligible veterans. Individual determinations are made by the Veterans Administration. The Champus program covers dependents of active military personnel, military retirees and their dependents and survivors.
Private pay patients always have the option to pay for home health services with personal funds. The charges should be agreed upon before services are accepted.
Home health services are available in all Kentucky counties. Remember if you need home health services, you have a right to choose from among the agencies licensed to serve your community. To find out about home health for you or your family member, ask your doctor, talk with the hospital discharge planner or social worker, or look in the telephone book under home health or nursing.
When selecting a home health agency:
1) make sure the agency is licensed in Kentucky;
2) make sure it provides the services you need;
3) find out how the agency handles payment and billing before accepting services.
For a list of home health agencies and services available to you, contact:
Kentucky Home Health Association
154 Patchen Drive, Suite 90
Lexington, KY 40517
Phone: (859) 268-2574
It is anticipated that observance of these rights and responsibilities will contribute to more effective patient care and greater satisfaction for the patient as well as the Agency. The rights will be respected by all Agency personnel and integrated into all Home Care Agency programs. A copy of these rights will be prominently displayed within the agency and made available to patients upon request.
