What Is Home Health Care?

What Is Home Health Care?

Home health care—frequently referred to simply as “home health”—is skilled care delivered directly to a patient’s home. Licensed medical professionals, including nurses, therapists, and aides, provide this care to treat or manage an illness, injury, or medical condition.

Home health care services can be delivered to the patient’s residence (a private home or adult foster home), an assisted living or long-term nursing facility, or a memory or residential care facility.

Services that may be covered include medical services such as skilled nursing, physical therapy, occupational therapy, speech therapy, and non-medical services such as social services or assistance with daily living.

Is Home Health Care the Same as Home Care?

Home health care (i.e., home health) significantly differs from home care. While the two services sound similar (both take place at a patient’s home or residence), home health is administered by licensed medical professionals. Further, the type of care encompassed by home health care covers a myriad of ailments and diseases, including physical therapy, post-operative care, and treatment of Alzheimer’s, dementia, and chronic health conditions.

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What Does “Homebound” Mean?

Home health care is available to any patient who needs it, but Medicare covers it only if deemed “homebound.”

Homebound means that the patient’s condition prevents them from safely leaving the home without assistance from others or assistive devices (e.g., canes, walkers, crutches, or wheelchairs).

In most cases, patients are still considered homebound even if they leave the home as needed for medical treatments that cannot be provided at home. Additional non-medical absences, such as attending church, the beauty shop, or special family events, may also be allowed.

What Are the Benefits of Home Health Care?

The primary benefit of home health care for the elderly is that it can be delivered directly to the patient’s residence, whether in a private home, adult foster home, assisted living or residential care facility, memory care facility, or long-term nursing home. This can avoid expensive hospital bills.

Family members are encouraged to actively participate in planning to help set and meet goals, working with home health care professionals to benefit the patient.

Additional benefits of home health care for seniors include:

• Fasterhealingn and recovery from illness or injury
• Improved independence (over time)
• Maintaining or improving the current condition or level of function
• Regaining self-sufficiency in the home
• Slowing of the decline of severe conditions
• Better symptom management

Pros of Home Health Care

• Care is delivered directly to the patient’s residence (either a home or facility)
• Skilled professionals provide medical services
• Home health care staff follow the physician-prescribed plan
• Patients regain independence and self-sufficiency at home
• Care is typically less expensive than hospitalization or a long-term nursing home
• See additional benefits of in-home doctor visits

Cons of Home Health Care

• Home care services like cooking and cleaning may not be included
• Patients must meet the “homebound” requirements to qualify for MedicareIt mayy not be adequate for patients who require 24-hour monitoring
• It can be expensive if not covered by insurance or Medicare
• The number of home healthcare providers may be limited depending on the location

How Does HHC Work?

The first step toward receiving HHC is to obtain a physician’s order and work with a home healthcare company to develop a detailed care plan. From there, you will be asked to complete an initial consultation with the patient, during which the company assesses the patient’s needs and develops a treatment plan. Family members and other caregivers are encouraged to participate in this planning process to ensure consistent and comprehensive care.

When services begin, home health care staff will implement the plan – following all physician orders – and keep the physician updated about the patient’s progress. The frequency and type of home health visits will vary depending on the patient’s needs. Some patients require daily car,e while others require only a short visit once or twice weekly.

All services are tailored to the patient’s needs.

What Does Home Health Care Do for Patients?

Home health care is designed to help the patient rest, recover, and receive treatment in the comfort of their own home or residence. Services provided by home health care are offered to help the patient regain independence and become as self-sufficient as possible while also managing their disease or condition.

Home health care can benefit both acute and chronic conditions, including but not limited to the following:

• Alzheimer’s Disease
• Chronic kidney disease
• Chronic obstructive pulmonary disease (COPD)
• Diabetes
• Heart disease
• Recovery from illness or surgery
• Chronic conditions or injuries

In addition to providing medically necessary services for treating the above conditions, home health care professionals act as a liaison between the patient, the patient’s family, and the patient’s doctor. They keep a log for each visit and provide updates on the patient’s condition to the doctor as needed, helping to ensure continuity of care.

What Services Does Home Health Care Provide?

Home health care consists of medically necessary, skilled services prescribed by a physician to treat an illness, injury, or medical condition.

Skilled services provided by home health care may include the following:

• Infusion therapy
• Medication management
• Nursing care
• Nutrition services
• Pain management
• Psychiatric services
• Social work
• Therapy (physical, occupational, speech)

Home health care professionals provide services tailored to the patient’s needs. Examples include checking vital signs, assessing pain, monitoring food intake, managing medications, helping with basic hygiene, and ensuring safety in the home.

What Services Does Home Health Care Not Provide?

Home health care only provides medically necessary services – skilled services prescribed or recommended by a medical doctor. It does not offer unskilled services or daily necessities such as cooking, cleaning, bathing, and transportation. These services are covered by personal home care assistance. Some home health care services offer personal home care assistance at an additional cost, which may or may not be covered by insurance or Medicare.

What Is a Medical House Call?

A medical house call is a medical visit performed by a physician in the patient’s residence. These visits are typically administered to homebound adults with limited or no access to regular medical care.

What Is a House Call Doctor?

A house-call doctor is a doctor who performs medical visits in the patient’s residence. House-call doctors may be employed by an agency or have their own practice.

What Are the Benefits of Physician House Calls?

The primary benefit of physician house calls is that patients receive quality care from qualified physicians in the comfort and convenience of their home or residence. Additional benefits of physician house calls include the following:

• It ensures regular medical care to patients who have few or no other options (e.g. homebound adults, and people who live in rural areas)
• It helps monitor and treat both preventable and chronic conditions to keep patients out of ERs and hospitals
• It encourages patients to keep up with regular medical visits by bringing the doctor directly to the patient’s home
• It saves the patient time and money traveling to the doctor’s office

Though there are many benefits associated with medical house calls, there are also some challenges, namely that house calls are not ideal for emergency medical problems and that physician availability and scheduling options may be limited in some areas.

How Often Do House Call Doctors Visit?

House call visits can be scheduled as often as the patient requires, but on average, patients are seen monthly. Visits are typically scheduled on weekdays, though the physician may be available by phone on weekends or after hours.

House-call patients can be seen in their home or an adult foster home, assisted living or residential care facility, memory care facility, or long-term nursing home.

What Is Home Care Nursing?

Two types of skilled professionals administer home health care: nurses and physical therapists.

Home health care nurses must be trained medical professionals licensed to practice in their state and equipped to follow a physician’s care plan. They typically work with elderly patients but may also provide services for children with mental or developmental issues and patients with disabilities.

What Does a Home Health Nurse Do?

A home health nurse provides skilled services in keeping with a physician’s care plan for a home health care patient. These services may include the following:

• Taking the patient’s vitals
• Administering pain medication
• Completing medical treatments
• Recording symptoms in a journal

In addition to these simple tasks, a home health nurse helps facilitate communication between the patient’s physician and caregivers. Continuity of care is extremely important, and a home health nurse helps keep the lines of communication open and teaches all involved parties how to properly manage the patient’s condition.

What Do Home Health Nurses Do on Their Visits?

The primary function of a home health nurse is to follow the physician’s plan of care, administering medically necessary services to treat, prevent, or manage the patient’s condition. On each visit, the home health nurse will take the patient’s vitals, track symptoms and other details of the patient’s condition, and administer any necessary medications or treatments. Home health nurses may also keep a journal for each patient, recording the details of the visit to ensure continuity of care and communication between family, caregivers, and the patient’s medical team.

What Is a Home Health Aide?

A home health aide is a professional who provides assistance to patients with support needs, including those who are disabled, chronically ill, or cognitively impaired. They may also provide services for seniors who require assistance in the home.

A home health aide may provide services such as checking vital signs, assisting with personal hygiene, administering medication, and implementing other elements of a physician-prescribed care plan.

Home Health Aide vs. Personal Care Aide

The duties of a home health aide and a personal care aide overlap at times, but the key difference is that home health aides typically work for agencies instead of being directly employed by their clients. Home health aides play an important role in the continuity of care, coordinating among caregivers and medical professionals, and tracking the condition and progress of their clients.

While home health and personal care aides provide services to the same type of patient, a personal care aide’s duties are typically limited to non-medical services, this may include dressing, bathing, cooking, cleaning, running errands, doing laundry, and providing companionship for their clients.

How to Get Home Health Care

There are several ways to apply for home health care, but the first step is to have your doctor evaluate your condition and draw up a home health care plan. Once you have a physician-prescribed plan, you can contact your health insurance company or work directly with an agency to establish a service.

Before applying for home health care, make sure you meet all eligibility requirements.

Who Qualifies for HHC?

There are rules for how to qualify for HHC, especially if you want it covered by your insurance or Medicare plan. To be eligible, you must meet these requirements:

• Be under the care of a physician who orders home health services
• Meet the definition of “homebound”
• Require skilled nursing or therapy services on an intermittent basis

Specific home health agencies may have additional requirements of their own, and you may also need to meet certain qualifications for your insurance plan. Be sure to familiarize yourself with these requirements before applying for HHC.

How to Pay for HHC

Patients and their families can save considerably by choosing HHC over long-term hospitalization or a skilled nursing facility. Still, medical care is expensive. When it comes to paying for HHC, there are several options:

• Self-pay
• Public third-party pay
• Private third-party pay

The first of these options, self-pay, is HHC paid out-of-pocket. Depending on your situation, you may be able to negotiate the cost of services or arrange for a payment plan with the agency.

Most Americans over the age of 65 are eligible to receive federal Medicare coverage, which may then be used to pay for HHC services. To receive reimbursement for services, Medicare requires that the following conditions be met:

• The patient is an eligible Medicare beneficiary
• The physician certifies the need for services and creates a plan of care
• The beneficiary meets the Medicare definition of “homebound”
• The care must be delivered to the patient’s place of residence
• The patient requires intermittent skilled nursing or therapy services
• A Medicare-certified agency provides the services

If you don’t qualify for Medicare, or choose not to use it, you might be able to get HHC covered by a private insurance plan. Many insurers offer a cost-sharing provision for professional in-home care for seniors.

Typically, home healthcare providers accept Medicare, and, in many cases, Medicare will pay for home healthcare if you are a current recipient and meet certain qualifications.

We accept Medicare and other private insurance plans and self-pay options at Keystone Health.

Is HHC Covered by Medicare?

Home healthcare services are covered by Medicare as long as certain eligibility requirements are met. To be eligible for Medicare coverage for HHC, you must meet the following requirements:

• Be considered “homebound” according to the Medicare definition
• Require part-time or intermittent skilled care to improve, maintain, prevent, or further slow the progression of an existing condition
• Be under the care of a medical doctor who prescribes HHC (you must have documentation of an in-person visit with said doctor either three months before starting home health care or within one month of when home health care begins)

Medicare typically covers skilled nursing care and rehabilitative services, including physical, occupational, and speech therapy. Additional services like social services, durable medical equipment, medical supplies, and other in-home services may also be covered depending on your needs.

If you have Original Medicare, you may be able to receive HHC at no cost (though you might pay up to 20% of the Medicare-approved cost for durable medical equipment). You may qualify for additional coverage if you have a Medicare Advantage Plan.

Medicare does not cover non-skilled personal care services such as cooking, cleaning, transportation, and other custodial care.