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Home Health Care Services

Home health care services grow more important as the populace ages.

Home health care services can help the elderly maintain a sense of autonomy. [©Shutterstock, 2010]
©Shutterstock, 2010
Home health care services can help the elderly maintain a sense of autonomy.

Home Health Care Services

As the American population ages, the home health care services industry is growing dramatically. The American Academy of Family Physicians cites several reasons for the increase in home health care. First, medical advances have allowed people to live longer with once deadly diseases, such as HIV. Second, inpatient hospital costs are increasing dramatically, making hospital stays too costly for insurers and individuals; consequently, people are discharged from hospitals sooner. Finally, many people prefer to remain in their home during periods of long illness.

Types of Home Health Care Services

The types of home health care services include physician care, nursing care, physical therapy, speech therapy, occupational therapy, social services, home health aides, radiology, laboratory services, homemaker care, companion care, pharmaceutical services, transportation and meal delivery. Physicians involved in home health care may visit patients at home or help manage home health care needs. Nursing services are the most prevalent type of home health care. Nurses work with physicians to set up a plan of care.

Nursing services include pain control, dressing wounds, caring for patients after an ostomy, medication administration, intravenous therapy and overall monitoring of patient health. Speech, occupational and physical therapists work with patients on various deficits that may have come about due to illness. Portable X-ray machines offer radiological care at or near the home. When medical tests need to be completed at a hospital or doctor's office, transportation can be arranged for the patient.

A variety of nonmedical services are also available to people receiving home health care services. Homemakers often help patients maintain their home environment. The homemaker may do laundry, cook meals, grocery shop or clean. Companion service is available for people who live alone but require some supervision or additional help with household duties. Social workers often serve as case coordinators, connecting the patient with necessary services in the community. Meals on Wheels is a nonprofit organization that brings meals to the home, helping to ensure adequate nutrition.

Requirements to Receive Home Health Care Services

Patients who receive home health care services must first qualify for those services. Currently, home health agencies follow Medicare's standard for care. These regulations require that patients receiving health care services be under the care of a physician and be homebound. In addition, there must be documentation stating that the patient needs skilled nursing care or occupational, physical or speech therapy. Finally, regulations also state that care must be part-time, consisting of no more than 28 hours, and must occur at least every 60 days.

Finding the Right Home Health Care Provider

While there are many high-quality service providers, consumers should do their research to avoid questionable providers. The National Association for Home Care and Hospice is a trade organization that represents the interests of home health care and hospice agencies. This organization maintains a database of more than 20,000 home health care and hospice agencies. The U.S. Department of Health and Human Services provides another good search engine for home health care agencies.

After selecting several potential agencies, it is important to narrow down the choices by evaluating the quality according to the following four considerations:

• The percentage of patients who are getting out of bed, are better at walking and have less pain when moving
• The agency's record with respect to assisting the patient in daily activities, such as improvements in bladder control, bathing, taking medicine and breathing
• The percentage of patients who continue to stay at home following termination of home health care services as well as the percentage of patients who showed evidence of healing wounds after surgery
• The percentage of home health care patients who were admitted to the hospital or needed urgent, unplanned medical care

In addition to evaluating the quality of care, patients should select home health care providers that participate in their insurance plans. Furthermore, if services are covered by the insurance company, Medicare or Medicaid, then the home health care agency should agree to bill the insurer directly. If insurance is not available to cover the cost of home health care, the agency may receive federal funding for services that are not covered.

The Rights of a Patient Receiving Home Health Care

Federal law stipulates that home health care patients must be informed of their rights as a patient. The home health care agency is obligated to carry out the task of informing patients of their rights and responsibilities. Patients have the right to choose providers and receive appropriate and professional care that is in accordance with physician recommendations. Agencies not capable of meeting the needs of the patients should not admit the patient for services and should instead give a referral of another agency.

Service from the agency should be prompt and continuous. Patients should be given any necessary information before the agency performs procedures in order to meet the requirements of informed consent. The patient has the right to refuse a particular procedure as long as it is legal and the patient is properly informed of the consequences of refusal. The patient should receive information about advance directives, and agency employees should carry out those directives in accordance with the law.

If there is going to be a change in services or termination of services, the agency should provide the patient with advance warning of such changes in a timely manner. Costs should be discussed up front. If the patient's insurance does not cover costs through the particular agency, then the patient should be referred elsewhere. Patients should be made to feel comfortable enough that they can express grievances or request changes in service or staff without fear of repercussions. Finally, patients should be informed of numbers to call and procedures to take in the event of an emergency.

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