- What is home health care?
Home health care is an excellent, cost-effective alternative to hospital or other institutional care. Service is based on the individual’s needs as defined by his or her doctor’s plan of care. This may include visits from skilled nurses, therapists, social workers and/or home health aides.
- What are the advantages of home health care?
In many cases, home health care allows a person to be discharged earlier from a hospital, reduces hospital admissions, and helps with a faster recovery. Most importantly, people are happier at home and receive more care and attention from family, friends and home health care professionals.
- Who uses home health care?
- People of all ages.
- People who can leave the hospital or nursing home but need additional care;
- People who have short-term health needs;
- People who need assistance, due to age or disability, to remain at home; and
- People who need education about the disease process and training on how to best care for themselves.
- What types of home care agencies are there?
There are two main types of home health care agencies: certified agencies and private duty (or non-certified) agencies.
- Certified agencies. 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 starts after hospitalization or a significant change in medical condition. Care is prescribed by a doctor 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 help with personal care needs. While a doctor must prescribe care, the patient has the right to select the provider of his choice. Mercyhealth at Home is a Medicare- and Medicaid-certified agency.
- Private duty agencies. Private duty agencies offer a wide variety of services, including medical and non-medical care. For example, in addition to nursing, private duty services could include help with shopping, laundry, meals, and companionship. The patient and/or family usually pay for the cost of care, although some insurance plans might also cover all or a portion of it.
- What types of professionals are on the home health care team?
The team includes doctors, nurses, home health aides, medical social workers, and therapists. They coordinate care based on the individual’s needs.
- Who pays for home health care services?
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 can help determine if the services you need are covered or if you need to make other arrangements.
- When does service begin?
A doctor, patient or family member can initiate service. However, Medicare, Medicaid and most insurance plans require doctor oversight. Once the doctor prescribes home health care, she authorizes a coordinated treatment plan, commonly called a “plan of care,” and periodically reviews services and the patient’s progress. If a doctor 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. While some insurance plans may pay for private duty services, they are typically an out-of-pocket expense.
- How do I choose the right agency for my loved one’s needs?
You can find information about home health care services from many sources, including hospital discharge departments, your doctor, public health departments, the Yellow Pages (look for Home Care, Home Health Care, or Nursing) or through Web site search engines using similar terms.
- What if Mercyhealth at Home can’t resolve my problem or concern?
To make a complaint about the agency without fear of discrimination or reprisal, call your state agency:
- Illinois Dept. of Public Health, Central Complaint Registry: (800) 252-4343
- Wisconsin Home Health Hotline: (800) 642-6552
Some questions you may want to ask a prospective home health care agency, along with Mercyhealth at Home’s answers to these questions, appear below:
Does the agency have information explaining its services, fees, and eligibility requirements?
Mercyhealth at Home has several brochures describing its programs and services. Call us to receive brochures on our Medicare-certified home health care, hospice, home medical equipment, or older adult services.
How does the provider select and train its employees?
Mercyhealth at Home’s visiting staff are bonded and insured. Employees are screened through background checks. In addition, they receive regular company-provided training.
Are nurses or therapists required to evaluate the patient’s home care needs? If so, what does this involve?
A patient’s first visit consists of a thorough assessment of physical, mental, emotional and social needs. From this assessment, an individualized plan of care is developed with input from the family and authorization from the patient’s doctor.
Is the patient’s course of treatment documented, detailing specific tasks to be accomplished by each professional caregiver?
Yes. A patient’s course of treatment and progress is documented at each Mercyhealth at Home home visit.
Does the patient and his family receive a copy of this plan, and is the plan updated as changes occur?
Yes. A copy of the patient’s plan of care, along with a list of patient’s rights and responsibilities, and an emergency plan, is left in the patient’s home.
Will the provider take time to teach family members about the care given to the patient?
Yes. Education is an important part of Mercyhealth at Home’s patient care plan. Family members are an integral part of the care team.
Who can the patient and his family members contact with questions or complaints?
Mercyhealth at Home patients and family members can call (815) 971-3550 in Illinois or (608) 754-2201 in Wisconsin.
How doesMercyhealth at Home follow-up on and resolve problems?
As a Medicare/Medicaid home health agency, Mercyhealth at Home is mandated to have a structured process in place to follow up and resolve problems.