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What is home health care? |
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Imagine being
disabled, too ill to care for yourself or having a condition
that requires regular medical attention. Most people assume
that a hospital or nursing home is the only option for
care. However, with assistance from a home health care
agency, you can receive care in the comfort of home. Home
health care is an excellent, cost-effective alternative
to hospital or other institutional care. Service is based
on the individual's need. |
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What
are the advantages of home health care? |
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In many cases,
home health care permits a person to be discharged earlier
from a hospital, reduces hospital admissions, assists
with a more rapid recovery and fosters patient/physician
relationships. Most importantly, the patient is often
happier at home and receives more care and attention from
family, friends and home health care professionals. |
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Who
uses home health care services? |
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People
of all ages use home health care services—from senior
citizens to young children. Some examples include: |
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Those
who are able to be discharged from a hospital or
nursing home but need |
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additional
care; |
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Those
who are terminally ill and want to live their final
days with dignity surrounded |
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by their loved ones in the comfort of their own
home; |
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Those
who have short-term health needs; and |
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Those
who need assistance, due to age or disability, to
remain at home. |
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Who
provides home health care? |
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In Michigan,
there are two main types of home health care agencies—
certified agencies and private duty agencies. |
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Certified
Agencies |
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Certified
home health care agencies comply with Medicare and Medicaid
regulations. An individual's Medicare benefit defines
the conditions that qualify for service. The need for
service typically arises after hospitalization or a significant
change in medical condition. Care is prescribed by a physician
and is generally restricted to skilled services that may
include nursing; physical, occupational or speech/language
therapy; medical social work; and/or home health aides
to assist with personal care needs. While a physician
must prescribe care, the patient has the right to select
the provider of his/her choice. |
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Private |
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Private duty
agencies offer a wide variety of services including medical
and non-medical care. For example, private duty services,
in addition to nursing, could include assistance with
shopping, laundry, meals and companionship. The patient/family
generally incur the cost of care, although some insurance
plans may also cover all or a portion of it. |
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What
types of professionals comprise the home health care team? |
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The home
health care team consists of physicians, nurses, home
health aides, medical social workers and therapists who
coordinate care based on an individual's needs. |
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Physicians |
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Physicians
may recommend home health care services. They also authorize
a coordinated treatment plan and periodically review services.
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Nurses |
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Nurses provide
skilled services for the patient, supervise other caregivers
and coordinate patient care with the physician. They may
also train family members and friends to assist the professional
caregivers and to help care for the patient. |
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Home Health
Aides |
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Home health
aides assist with a patient's personal care needs and
are supervised by a nurse from the home health care agency.
Typical assistance may include bathing, dressing, grooming,
companionship, meal preparation and light housekeeping. |
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Medical
Social Workers |
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Medical social
workers assist the patient and family in a variety of
ways by providing counseling services and directing them
to other resources relevant to their situation. For example,
medical social workers may help the patient obtain financial
assistance or help him/ her meet certain emotional needs.
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Therapists |
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Physical,
occupational, speech/language and respiratory therapists
provide essential services based on the individual patient's
needs. The therapist also may train other caregivers to
assist the patient with exercises and routine care. |
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Other
Home Health Care Services |
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Dietary services,
transportation, chore services, homemaker services, home-delivered
meals, companionship, home medical equipment and intravenous
therapy products are also available in a home setting.
Your home health care agency can provide information and
may be able to make the necessary arrangements for you.
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Hospice |
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If a patient
is terminally ill, hospice care may be available in an
institutional setting or in a patient's home. Services
focus on keeping an individual as comfortable and pain
free as possible. Hospice services also assist the patient
and family members with respite care, bereavement care.
Most home health care agencies can either provide hospice
service or refer you to a hospice in your area. |
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Who
pays for home health care? |
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Medicare,
Medicaid or other health insurances may cover the cost
of home health care services. Some insurance policies
will not cover all home health care services unless certain
conditions are met. You can still obtain care without
insurance coverage through a private duty agency on a
private pay basis. Additionally, some agencies may have
funding to help people who cannot afford the private pay
option. The home health care agency will be able to assist
in determining if the services you need are covered or
if you need to make other arrangements.
Please review the differences between private duty and
certified agencies as defined on pages 1 and 2 of this
guide. Your insurance policy may specify what type of
agency will be covered. |
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How
is service initiated? |
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A physician,
patient or family member can initiate service. However,
Medicare, Medicaid and most insurances require physician
involvement. Once the physician prescribes home health
care, he/she authorizes a coordinated treatment plan,
commonly called a "plan of care," and periodically
reviews services and the patient's progress. If a physician
does not prescribe home health care, but the individual
still desires services, a private duty agency can suggest
a plan of care to meet a wide variety of needs and budgets. |
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How
do I choose the right agency? |
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Information
regarding home health care services can be obtained from
many sources. The Michigan Home Health Association is
an excellent reference and can be contacted at (517) 349-8090.
Other resources include: hospital discharge departments,
your physician, public health departments, telephone directory
yellow pages under "home care," "home health
care" or "nursing" or through Web site
search engines using similar headings.
Below are some questions to ask a home health care
agency. Also, a convenient check list of other considerations
appears on page 6 of this guide. Take your time to find
the agency that best meets your needs. |
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Does a nurse or therapist conduct
an evaluation of the individual's needs in the home?
What is included? Are family members, patient's
physician and other health professionals included? |
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Is
there a written plan of care for services? Does
it include duties to be performed, by whom, at what intervals
and for how long? Will it be explained to the family?
Can you review it? |
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Does
the agency provide written statements describing its services,
eligibility requirements, fees and funding sources?
Do the admission documents outline client services, fees
and admission guidelines? Does the marketing brochure
or annual report offer helpful guidance on the agency? |
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Is
the agency Medicare certified? Medicare certification
is a measure of quality because that agency has met federal
requirements. You can review the agency's Medicare Survey
Report at your local Social Security Office. However,
non-participation in Medicare does not indicate that an
agency provides poor care. For example, Medicare certification
is not applicable for private duty agencies. |
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Is
the agency accredited? Accreditation, a voluntary
process conducted by nonprofit organizations, means that
the agency has met basic standards, including personnel
requirements, supervision and accountability. Agencies
that provide skilled nursing services may be accredited
by the Community Health Accreditation Program (CHAP, ACHC) and/or
the Joint Commission on Accreditation of Healthcare Organizations
(JCAHO). |
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Does
the agency send supervisors to visit the home and evaluate
the quality of care periodically? |
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How
does the agency choose and train its employees? |
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What
arrangements are made for emergencies? |
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What
arrangements will be made if your financial resources
are exhausted? |
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Patient
rights and responsibilities |
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Patients
with a certified home health care agency have specific
rights and responsibilities regarding their care. The
Statement of Patient Rights is available through home
health care agencies and in several languages through
the Michigan Home Health Association. Many non-certified
home health care agencies have similar documents outlining
their patients' rights and responsibilities. |
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What
are some other sources of information? |
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Michigan
Home Health Association (517)349-8090 |
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Established
in 1981, the Michigan Home Health Association (MHHA) is
the state trade association for home health care providers.
MHHA provides a unified voice for all components of home
health care and promotes high standards of patient care
in the delivery of home health care services. It is an
advocate of home health care services within the total
health care system. |
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addition MHHA: |
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sponsors
and promotes education programs, cost-savings projects
and research in |
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home
health care; |
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promotes
understanding, cooperation and communication among
home health care |
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providers;
and |
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serves
as a liaison with other organizations at local,
state and national levels |
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National
Association of Homecare |
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www.nahc.org
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Patients
with a certified home health care agency have specific
rights and responsibilities regarding their care. The
Statement of Patient Rights is available through home
health care agencies and in several languages through
the Michigan Home Health Association. Many non-certified
home health care agencies have similar documents outlining
their patients' rights and responsibilities. |
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National
Hospice and Palliative Care Organization |
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www.nho.org |
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Patients
with a certified home health care agency have specific
rights and responsibilities regarding their care. The
Statement of Patient Rights is available through home
health care agencies and in several languages through
the Michigan Home Health Association. Many non-certified
home health care agencies have similar documents outlining
their patients' rights and responsibilities. |
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| What
is Homebound Status? |
| Homebound status
is required for us to provide care. Following examples
may help you determine the homebound status. |
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Chairbound/Bedbound
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Severe
shortness of breath |
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Pain
restricting movement |
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Needs
assistance to move |
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Server
functional limitations |
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Requires
maximum assistance for all activities |
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Severe
immune supression |
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Impaired
mental status |
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Confusion
level precedes safe leaving of home without supervision
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Severe
weakness, unsteady gait, holds onto funiture or
walls for support Angina |
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with
activitiy |
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Lower
extremity edema that impairs ambulation |
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Cannot
safely leave the home without assistive device |
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Medically
restricted due to risk of infection, post-op |
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Weakness
due to chemotherapy or radiation treatments |
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