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Q. Where do I report if i have any concerns regarding Patient care?
A. Any concerns about patient care can be reported to JCAHO at (800) 994-6610.
Q. How do I qualify for home health care and have Medicare pay for it?
A. In order to qualify for home health and have medicare pay for it, you must be considered homebound, be under the care of a physician and require a skilled service.
Q. What does homebound mean?
A. The patient is homebound if he/she experiences a normal inability to leave home. The patient's physical condition and/or physical limitations are such that it would be a considerable and taxing effort for the patient to leave home.
Determination of homebound status depends on the illness or limitations of the patient. The need for supportive devices for assistance alone does not necessarily render the patient homebound.
Homebound status is not affected by frequent absences from the home when the reason is to receive medical treatment.
The patient is allowed brief and infrequent absences from the home for non-medical reasons, such as barber/beauty shop, to attend church, etc. However, these absences should be infrequent and of short duration.
Q. Can I go to Church on Sunday and still be considered homebound?
A. Yes. Medicare recently changed the definition of homebound to allow patients to go to Church on Sunday. However, you would still need to meet the above requirements for homebound status.
Q. Do I have to pay anything if I have Medicare?
A. If you qualify for home health through Medicare, you will not have to pay anything. Medicare pays for the care. There is no deductible or out of pocket expense.
Q. If I don't qualify for Medicare to pay for home health, can I still have it?
A. Yes. If your physician orders home health and you do not qualify under Medicare guidelines, you may pay for the services yourself. Call us for a fee schedule.
Q. How often will you come see me?
A. At the time of admission to the service, an RN will assess your condition and needs and will set up a plan of care with you. The RN will discuss the frequency of visits with you and will also discuss expectations at that time.
Q. What does Home Health Aide do?
A. The primary function of a home health aide is to perform personal care, such as bathing, dressing, grooming, caring for hair, nails and oral hygiene. The aide spends anywhere from 45 minutes to 1 hour in the home. Once the personal care pis complete, the aide may also perform other duties for the patient.
The aide may straighten the bedroom, clean the bathroom, change the bed linens, or fix a snack for the patient. The aide does not perform spring-cleaning, sweep and mop floors, vaccum etc. These duties are the duties of a provider, not an aide.
Q. MEDICARE AT A GLANCE (Coverage Highlights)
Type of Care Time limits You Pay Medicare Pays Eligibility Not Covered
Hospital Inpatient including semiprivate room,meals and regular nursing services First 60 Days Day 61-90 First 60 days: $840 Deductible Days 61 - 90 Balance Over 65:Eligible for Social Security Under 65:Certain Private Rooms, Private Nurses, Doctor's Visit Services
Lifetime Reserve Lifetime limit of 60 days $420 co-payment per day Balance Same as for Hospital Inpatient Care Same as for Hospital Inpatient Care
Skilled Nursing Care Facilities: certified by Medicare such as THI Health and rehabilitation Centers. Frist 60 Days Days 21 - 100 First 20 Days: Nothing Days 21-100 $105 per day First 20 Days: 100% Days 21-100 Balance Must be an extension of at least 3 days of hospital inpatient care and authorized by a physician Same as for Hospital Inpatient Care including personal convenience items
Home Health Care performed by nurses, therapists and home health aides Intermittent care recertified every 60 days by physician No co-payment 100% Homebound authorized by your physician Full-time, Long term nursing care at home, drugs, meals and homemaker services
Inpatient Psychiatric Hospital Care Lifetime limit of 190 Days Days 21 - 100 Same as for Hospital Inpatient Care Balance Same as for Hospital Inpatient Care Same as for Hospital Inpatient Care
Hospice Care performed by nurses, therapists and home health aides Unlimited 5% Copay (upto $5) each prescription related to terminal illness. Respite Care: 5% of Respite Care Balance Certified by physician as terminally ill. Treatments other than pain relief and symptom management of terminal illness
Accredited By JCAHO
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