Medicare Home Care
Certified home health care is provided for an acute and temporary need defined as "skilled care," and is often only provided for several weeks. Certified home care may include a nurse, physical therapist, occupational therapist and other professionals, such as a speech therapist, medical social worker and Home health aide. The client however, must be homebound and there are other restrictions as well.
Examples: Medicare home care typically runs in 60 day episodes. Meaning a Registered Nurse, Physical Therapist, Occupational Therapist, Speech Therapist, medical social worker and a home health aide could be assigned and the need for services is reevaluated typically after 60 days. If after 60 days sufficient improvement is shown, with no further opportunity for progression, or no improvement is shown, the patient is discharged. If progression is shown and the home care team feels additional progression can be accomplished, the patient will be what’s referred to as re-certified where the patient is typically allotted another period of between 30 and 60 days. The disciplines provided through the Medicare benefit are designated a certain duration and length of time. Registered Nurses are allotted 1 hour per week, Physical and Occupational Therapists typically 2 to 3 times per week depending on need in 45 minute increments. Home Health Aides are provided in one hour increments for assistance once to twice a week to assist with bathing and hygienic needs.
Private Duty Home Care
Private duty home care provides hourly care, which often includes assistance with bathing, dressing, meal prep, housekeeping, transportation and other services. Sometimes the services of a Registered Nurse are required as well. With private duty home care, there are no requirements for being homebound, and no limited certification period as with skilled home health care. Private duty home care is often long term, and helps to maintain a client’s independence so they may remain at home. Private duty homecare is specifically beneficial when a client is looking for assistance with activities of daily living, which is provided by a home health aide. This can range from 1 hr to 24 hrs daily or a choice of an allotted amount of hours daily, weekly or monthly. Upon initial start of service a Registered Nurse is provided to do a full assessment and evaluation to implement a care plan. Thereafter a registered nurse is utilized 1 per month for supervisory purposes over all care as well as on a PRN basis for medication management, wound care or other nursing needs. Companion care is also another great aspect of private duty home care. Sometimes activities of daily living and companionship can be utilized in conjunction with each other if the client desires both services. Companionship is offered as a sole service for those looking for the contact of another person to assist them in comfort and prevent loneliness. Good examples of clients that utilize companionship care are those suffering from loneliness or forms of depression and widowed spouses.
Payment Options
Payment options for Medicare are clearly paid for through the Medicare benefit home care allotted amount. Private duty is paid for out of pocket or through certain Long Term Care insurance policies (please check with your insurance company for eligibility requirements and benefit coverage). Private duty is beneficial when you are seeking assistance from a home health aide outside of 2 hours a week, a companion, or a Registered Nurse more than 1 a week. Also the Medicare benefit is not able to be utilized unless the patient is homebound. Homebound is defined as: your condition keeps you from leaving home without help (such as using a wheelchair or walker, needing special transportation, or getting help from another person); leaving home takes a considerable and taxing effort; a person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as attending religious services. You can still get home health care if you attend adult day care, but you would get the home care services in your home.