Home Health or Home Care for Your Aging Parents or Elderly Clients?
In the past week there has been quite a bit of news published about home care agencies being involved in fraudulent activities and abuse of the elderly. Yes, this actually happens, but there are steps you can take to find reputable and appropriate care for your aging parents.
Let me first define the differences between “Home Care Services” and “Home Health.” There are important distinctions between the two that apply to who will pay the bill, what kind of services are provided, qualifying criteria, and how to navigate through the process.
The state of Washington defines “Home Care Services” as non-medical services and assistance provided to ill, disabled, or vulnerable clients that enables them to remain in their residences. Home care services include, but are not limited to: personal care such as assistance with dressing, feeding and personal hygiene to facilitate self-care; homemaker assistance with household tasks, such as housekeeping, shopping, meal planning, meal preparation, and transportation; respite care assistance and support provided to the family; or other non-medical tasks, as defined in this section or delegated tasks of nursing under RCW 18.79.260 (3) (e) and rules adopted thereunder.
The above definition puts it in simple terms, and outlines the basics of “Home Care Services.” Please note that each state has their own wording to define services within that state, but basically the allowable tasks encompassing home care are the same. Payment for such services also may vary across each state, but usually these type of services are paid for by Medicaid (for those who qualify), private pay by the client or family, or community programs.
Get referrals from friends, hospital discharge planners, senior centers, medical providers, or community leaders. Most agencies that receive Medicaid payment for these services are required to do background checks and may do drug and alcohol testing on prospective employees. If you hire your best friend’s second cousin to provide personal care services or homemaking tasks you may have to perform the background check yourself. You may feel you are saving money by going with someone not associated with an agency, but remember, agencies will usually provide back-up personnel in case of illness and they take care of employment taxes and training.
Tasks provided under “Home Care Services” that are paid for by Medicaid and certain other programs are for the benefit of the client only. This means that areas will be cleaned that the client utilizes, but bedrooms of other family members are not included. Meals will be prepared for the client, but the provider is not a short order cook for the entire family. Feel free to verify all tasks and restrictions with the agency during the initial interview.
“Home Health Care Services” fall under care that is provided in the home to a patient who has had a recent acute medical episode or a significant change in health status within a certain time frame. The care must be ordered by a doctor with precise orders for the treatments or care to be provided. If Medicare is paying for the services there is no additional charge to the patient, but the patient must meet homebound status and it is understood that services are provided for a “short duration.”
The goal of “Home Health Care Services” is to return the patient to a medically stable condition or to attain a satisfactory level of rehabilitation. The patient must require frequent monitoring by a licensed nurse, therapist, dietician, or social worker to assess health status and progress. There are specific goals and objectives written into the plan of care so the patient, family, and caregivers are all aware of the anticipated outcomes.
Home Health Care agencies who accept Medicare clients go through a stringent review process before becoming licensed and are subject to surveys every two years by an accrediting organization or state surveyors in order to maintain their status as a licensed agency. All employees must pass background checks before being hired. Drug testing is often randomly performed and is required if there are complaints or suspicion about the use of illicit drugs.
Private insurance and private payment by families are also acceptable methods of payment for home health care services. You can track the record of a home health care agency by going to www.Medicare.gov. Once again, referrals from hospital discharge planners, your medical provider, friends, and service agencies that serve the elderly are a way to find the best agency for your needs.
Do you have additional questions about the difference between “Home care Services” and Home Health Services?” Please leave questions, stories, or ideas in the comments section.
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