Home Health Care | Health Care System

In November 1990, the Home Health
Agency of North Penn Comprehensive
Health Services completed its 16th year
of providing quality home health services
to residents of all ages who live m Tioga
County and portions of adjacent
counties.
The Home Health Agency provides
home care services to the recovering,
disabled or chronically ill.
Older people take advantage of home
care services as their physical abilities diminish.
Younger adults who are disabled
or recovering from an acute illness are
choosing to be cared for at home. Infants
and children are able to return to loving
families and a secure home environment
thanks to advanced technology and pediatric
home care services.
Among those who benefit from home
care services are people in the following
situations:
• because of age, disability or illness
need additional assistance to live independently
at home;
• are able to be discharged from a
hospital or nursing home but need additional
care at home;
• require short-term assistance at
home following same day or outpatient
surgery,
• have a maternity-related incapacity;
or
• are terminally ill and want to die in
the comfort of their own home.
The physician is the key element in
home care. Many times the physician is
the initiator of home care services. All
patients must have an attending physician
who will authorize a coordinated
plan of treatment for home care services
and periodically reviews the delivery and
effectiveness of those services, recommending
changes as the patients’ needs
require
Services provided by the North Penn
Home Health Agency include:
Care Management This process is accomplished
by the Home Health Agency’s
primary professional nurses to assure
that clients receive appropriate
services.
Skilled Nursing. Registered Nurses
(R.N.s) and Licensed Practical Nurses
(L.P.N.s) provide direct skilled nursing
services for the patient who is being
cared for at home. The nurses also supervise
other caregivers as required, coordinate
the patient’s care with the physician
and tram family members to provide nee-
essary care to maintain the patient when
professional services are no longer necessary
Physical and Speech Therapies.
Professional therapists provide essential
services based on the needs of the individual
patient The therapist also plays a
vital role m training non-professionals
who are available to assist the patient
with exercises and routine care that can
allow the patient to function m the home
and recover more effectively
Medical Social Work. Social work m
the home setting involves making sure
the emotional needs of the patient and
family are met.
Personal Care Services (Home Health
Aide). These trained paraprofessionals
provide services associated with the personal
care of the patient. These services
are most valuable when assistance is
needed with bathing, grooming, dressing,
cooking and light cleaning. The
work of the Home Health Aide is supervised
by the nursing staff of the Agency.
Volunteers. These individuals are
trained to provide support to patients
and families - especially those who are
terminally ill. Volunteers.provide caregiver
relief, companionship and assistance
with meals and perform services
such as reading, letter writing, shopping,
doing errands and telephone reassurance.
Supportive Services is a separate program
offered by the Home Health Agency.
Through this program, Licensed practical
nurses provide specialized in-home
private duty nursing care up to 24 hours
per day. The Agency’s social workers are
available to patients and their families to
help handle the mountains of paperwork
involved with medical bills and provide
financial counseling on an as needed basis.
Supportive Services can be purchased
directly when not covered by another
source such as private insurance.

admin General

ONE OF THE most common questions being asked on my on-line
caregivers forum each week, as well as among colleagues,
is what is long-term care insurance, and who needs it?

There are no easy answers: This insurance is private
(rather than subsidized, as through an entitlement such
as federal Medi-Cal funding), and may cover a wide range
of services for those requiring long-term care
assistance - from help with bathing to 24-hour personal
care in a nursing home.

Long-term care itself means the kind of assistance you
need when you need personal care: It refers to an array of
medical, social and support services delivered over an
expended time to people at home or in an institution who
depend on others for some kind of assistance. You can need
long-term care because of a disabling accident or a
chronic illness. Services include in-home care such as
help with housekeeping, meals or grooming, or in nursing
homes or community-based organizations.

Women are more likely to need long-term care services:
They live longer, and they usually wind up with more
chronic illness. Women of color have even further
complications if their health has been poor since youth.

Although few insurance companies sold long-term care
insurance before 1986, according to the General
Accounting Office, the number of companies and policies
is growing fast. Some people buy these policies to protect
their assets against possible future long-term care
expenses, as a year’s outlay out-of-pocket for nursing
home care can top $50,000. Other people buy this insurance
because they are uncertain about the quality and
availability of long-term care provided through Medicaid
(Medi-Cal in California).

Who is likely to need long-term care insurance? Anyone may
need it, but those who are frail or very old are more apt to
need long-term care services. Family circumstances may
also be a factor: Whether a person can remain at home and
live independently, what kind of family or community
support system can be set up, and the degree of isolation
or frailty are all important considerations.

In California, three types of long-term care policies may
be sold: Nursing facility only, home care only, and
comprehensive long-term care. The cost of policies
varies according to the type of policy and coverage
provided. Policies with only nursing home coverage are
less expensive than those that cover both nursing
facility care and home / community care.

Other factors that influence cost include: the age at
which you purchase coverage (it’s more expensive the
longer you wait; some companies will not sell to people
over age 85); the length of waiting time you choose before
receiving benefits; the benefit dollar amount and policy
options; the state of your health at the time of purchase.

Long-term care insurance is not cheap; policies can cost
$3,000 a year and more.

Before considering any purchase, think about your
income, now and later; your assets (if your assets are
less than the cost of a year in a nursing home, the
insurance is probably not a good idea, nor is it if you are
close to qualifying for Medi-Cal); the state of your
health (people with serious problems are rarely accepted
for long-term care coverage, although certain chronic
conditions will be covered, but at a higher premium);
pre-existing conditions (there may be a waiting time
before benefits kick in).

The GAO says that long-term care insurers estimate that at
least half of their policyholders will stop paying
premiums and lose their insurance coverage before they
receive any covered service. The highest lapse usually
occurs within the first year. But they also note that
because of improved policy provisions and better trained
agents who can explain things more clearly, people are
holding onto their policies longer.

California is one of four states that has instituted a
Partnership for Long-term Care, wherein eight insurance
companies have agreed to certain standards and
provisions in providing long-term care insurance. They
offer a nursing-home-only policy (which also covers care
in a residential care facility), or an integrated policy
that covers nursing home, residential care and a full
range of home and community-based services (including
home health care, personal care, homemaker services,
adult day care and respite care).

Partnership policies are purchased through private
insurance companies. For information, call
1-800-434-0222.

Questions to ask

Here are some of the questions you should ask your
insurance sales agent when looking at a long-term care
policy:

* What levels of care are covered by the policy?

* Where can you receive care covered under the policy?
What are the restrictions?

* How long are benefits provided and what amounts are
covered? (What is the maximum daily benefit for each level
of care, are there limits on the number of days or visits
for which benefits will be paid?

* What is the length of benefit period you are
considering?

* Are there limits on the amounts the policy will pay
during your lifetime?

* Does the policy have inflation protection?

* Is there a waiver-of-premium provision? If so, how long
do you have to be in a nursing home before it begins?

* Does the policy have a death benefit?

* When do benefits begin?

* How does the policy determine whether you are eligible
for benefits?

* What does the policy cost? What is the monthly premium
excluding all riders? What is the annual cost of the
inflation rider? What is the cost of a nonforfeiture
benefit?

* Is there a discount if both spouses buy policies?

* Do premiums escalate each year or not because you grow
older?

* Is there a grace period for late payment?

* Can the policy be upgraded?

* Are there any diseases or injuries that are not covered?

It is important to contact several companies and agents
before you buy. Compare benefits, types of facilities
covered, limitations in coverage, the exclusions and
premiums. It is NOT necessary to buy several policies to
get enough coverage, experts advise.

Local resources

State Department of Insurance: 1-800-927-4357 (to verify
whether an agent is authorized to sell long-term care
insurance).

HICAP / Legal Assistance to the Elderly: Health Insurance
Counseling and Advocacy Program, San Mateo County, (415)
342-0822. “Taking Care of Tomorrow: A Consumer’s Guide
to Long-Term Care” (California Department of Aging
publication).

Council on Aging of Santa Clara County, 2115 The Alameda,
San Jose, CA 95126-1141. (408) 296-8290; Palo Alto
office: 463 College Ave., 94306, (415) 329-0888. HICAP
services.

National resources

AARP Fulfillment, P.O. Box 22796, Long Beach, CA
90801-5796. “Before You Buy - A Guide to Long-term Care
Insurance” ; “Medigap: Medicare Supplemental Insurance
- A Consumer’s Guide.”

American Council of Life Insurance, 1001 Pennsylvania
Ave. NW, Washington, DC 20004-2599. (202) 624-2000; fax,
(202) 624-2319; 1270 Avenue of the Americas, New York, NY
10020-1837. (212) 245-4198; (212) 624-2403. “Life
Insurance Fact Book Update.”

Health Care Financing Administration, Department of
Health and Human Services, 200 Independence Ave. SW,
Washington, DC 20201. (800) 638-6833. Oversees Medicare
and Medicaid programs. Medicare Publications, HCFA
Inquiries, 6325 Security Blvd., Baltimore, MD 21207.

“Medicare Handbook 1996,” “Guide to Health Insurance
for People With Medicare.”

Health Insurance Association of America, Consumer
Information Service, 1025 Connecticut Ave. NW, Suite
1200, Washington, D.C. 20036. (202) 824-1600. “Guide to
Long-Term Care Insurance.”

National Association of Insurance Commissioners, 120 W.
12th St., Suite 1100, Kansas City, MO 64105. (816)
842-3600. “A Shopper’s Guide to Long-term Care
Insurance” (1993). Free yearly copy of “Guide to Health
Insurance for People With Medicare.”

National Institute of Insurance Commissioners, 1025
Connecticut Ave. NW, Washington, D.C. 20036. (202)
223-7857. Information about long-term care policies
available in each state.

National Insurance Consumer Helpline, (800) 942-4242.
Information and referral, including health and life
insurance, long-term care, policy search. 8 a.m. to 8 p.m.

ET, M-F.

United Seniors Health Cooperative, 1331 H St. NW, Suite
500, Washington, D.C. 20005-4706. (202) 393-6222.
Information on nursing home and Medigap insurance,
advice on currently held policies. “Long Term Care: A
Dollar and Sense Guide,” and “Managing Your Health Care
Finances” (each $10).

Please send news releases, photographs and story ideas
for this forum to Elder Watch, Peninsula Editor, San
Francisco Examiner, 110 Fifth St., San Francisco, CA
94103. For reprints of “The Caregivers,” call (415)
777-7771. Join Beth McLeod’s caregivers forum Wednesdays
at 6 p.m. on AARP / AOL in the Meeting Place.

admin General

Victor Silvia asked:

The need for home health care in the United States is growing at an exponential amount. Even during the economic downturn, people are still getting older. The home health care sector has seen steady gains even in the midst of the bailout plan rejection. The 25 businesses that are in the IBD home health care sector are up 25% since the middle of March. During the week’s turbulence, the top stocks have all held strong. The strong hold on stocks has been due to the aging baby boomers. In 2007, more than 9000 home health care agencies provided care to more than 3 million patients.

Home health services are expected to grow each year ending at 119 billion dollars by 2017.The figure could be anywhere from 10% to 15% growth each year over the coming years. The industry is incredibly fragmented with the top four earners only making up 12 to 15% of the industry’s revenue. This means that there is plenty of room for companies to come in with reasonable barrier of entry.

Part of the growth is due to acquisitions. There is a favorable exchange rate that allows publicly traded companies to use their stock and buy off private firms.

Because the government has such a hold on the funding of home health care options, changes in legislation are a major concern for stock holders of publicly traded companies. Medicare and Medicaid account for 55% of the funding toward home health care services. Reimbursement issues are always a concern for home health companies.

Home health care companies are in a unique position as insurers are trying to hack away at healthcare costs. For tax payers, home health care is a more favorable option because it is so much cheaper than having to foot hospital bills.

Many chronic diseases such as diabetes, chronic obstructive disease, and renal disease can be treated effectively at home making it an attractive option. These companies market to occupational therapists and hospital discharge planners. It is important for these companies to gain referrals from these trusted health care sources.

This also means the non medical home health care employment will be more in the market. It will give caregivers and certified nursing assistants another opportunity to employ their skills. The truth is we as a nation are growing older. With the baby boomer generation growing older and retiring, there is a great strain on the squeeze generation ages 40-60 who need to take care of their parents as well as their children.

More and more people are moving to home health care as an alternative to nursing homes. There is also an increase in the number of people seeking their own caregivers independently. This gives people the advantage of determining their own set of responsibilities and the type of service they require right out of the gate.

Whatever the case, more and more people are turning to care for their chronic disease instead of acute care. This will shift the insurance burden from term life insurance and accident insurance to long term care insurance as more people will require long term health care.

admin General

MatthewPawlina asked:

Health care is increasingly expensive and rising costs are a concern for most people.

Funding long-term care needs planning the US Health Department Statistics indicates that almost 10 million people in the US will require Home Health Care. And costs of care are rising each year. To cover health related contingencies people need to protect themselves with insurance that pays for home health care.

1. Well before retirement plan for any contingencies that may arise in old age. Plan on being independent in every way and put in place a rock solid financial plan.

2. Consult a retirement planning expert or insurance expert and find out the advantages and disadvantages of insurance that pays for long-term home care.

3. Surf the internet and read articles and tips on home health care and how to protect yourself financially.

4. Study your existing health policy and try and get a insurance policy that covers all aspects not covered by health care. Long term or home care becomes essential with injuries, serious illnesses, and old age.

5. Before investing in an insurance policy that covers home health care find out what in actuality the policy will cover and be sure to read the fine print. Any clauses you don’t understand ask the insurance agent or company for clarifications.

6. Buy a comprehensive policy that will meet your needs. Choose a policy that covers nursing home care, home care, and has a rider that covers expenses incurred by family during the illness like costs of food or transport to and from hospitals. Choose the coverage intelligently.

7. Find out whether the policy you are purchasing is tax qualified or non-tax qualified. When an insurance policy is tax qualified you can deduct premiums as medical expense up to the set limit.

8. When purchasing a policy think about aspects like inflation find out all about inflation protection and higher daily benefit rate. Choose wisely depending on your age, gender, family health tendencies and so on.

9. Buy home health care insurance from financially sound companies. Check aspects like independent financial ratings from sources like A M Best Company or Fitch Investors Services.

10. Practice preventive health care and take good care of your health by eating balanced meals, exercising daily and getting regular health checks.

Home health care covers a whole gamut of services: nursing care, doctors visits, companionship, light housekeeping, as well as meal preparation. While government services too provide for home care the regulations are extensive and the system cannot cover many cases. Home health care can also cover occupational therapy, physical therapy, speech therapy, and skilled nursing. Home health care is concerned with the medical needs of patients. Home health care funding is covered by leading insurance companies as well as Medicare, Medicaid, the Older Americans Act, the Veteran’s Administration, and more.

admin General

herbalremedies asked:

Recovering from an illness or injury can be a stressful time for both the patient and the patient’s family. That stress is compounded when chronic illness or disability is involved. Research has consistently shown that, when at all possible, recovering at home is the best option for the patient’s physical and mental health. Unfortunately, when the patient is elderly or too injured or ill to care for themselves, recovering at home is sometimes not an option.

Finding friends or family members to assist with daily tasks is not always feasible. Even when family members are in a position to assist, the burden placed on them often puts a strain on their other family relationships, as well as their career and personal life.

Right Home Health Care Agency

Finding the right agency can be a daunting task, but not impossible, says Tilly Gambill, Manager of Marketing and Communications for the American Association for Homecare.

“People often receive home health services following a hospitalization or care in other care settings. Often the hospital discharge planner or social worker provides information on home health agencies,” Gambill says. “Ask the hospital for a list of home health care agencies in your community. In some communities, there may fewer available agencies. Physicians, friends, and family can recommend home health agencies, as well.”

The family got 2 references from the hospital and one from a family friend whose father with hypertension and diabetes receives home care services weekly.

To help them select the right provider, the National Association for Home Care suggests asking the following questions:

Questions to Ask a Home Care Provider

•    What are the qualifications and experience?

•    How long has the agency been in business?

•    Is the agency evaluated and accredited by a governing agency such as The Joint Commission’s Home Care Accreditation Program?

•    Is the agency licensed by the state?

•    Can the agency provide references? Ask for a list of doctors, hospital discharge planners and former clients who have experience with the agency.

•    How does the agency protect client confidentiality?

•    Is the agency inspected by any outside organization? May I see the results of the last inspection?

•    Does the agency perform a customer satisfaction survey? May I see the results of the last survey?

Questions About Caregivers

•    What are the credentials of the caregivers who work for the agency?

•    How does the agency select and train caregivers?

•    Do caregivers work directly for the agency? How are they supervised?

•    Are caregivers subject to criminal background checks?

•    Will the same caregiver be sent to my home for each visit?

•    Are nurses or therapists required to evaluate the patient’s home care needs?

•    If so, what does this entail?

•    Do they consult the patient’s physicians and family members?

•    Is the patient’s course of treatment documented, detailing the specific tasks to be carried out by each caregiver?

•    Will the agency schedule care at any time of the day or night that my physician says is necessary?

•    Can the agency provide me with written information about the rights and responsibilities of the providers, patients and caregivers?

•    Whom should I call with questions or complaints? How will the agency respond?

Questions About Services Provided

•    Can the agency provide me with written information about the services available?

•    Is there a written plan of care for each patient?

•    Does the agency involve the patient and caregivers in designing this plan and educate them about the care provided?

•    How does the agency respond to emergencies? How long does it take to respond to calls?

•    Will the agency help me find other community services such as Meals on Wheels or homemakers services, or help find medical equipment I may need?

Questions About Financials

•    Is the agency certified by Medicare?

•    Is the agency approved or accepted by my insurance plan or supplemental insurance?

•    How does the agency handle expenses and billing?

•    Does the agency provide detailed explanations of all the costs associated with home care?

•    What resources does the agency provide to help me get financial assistance, if needed?

There are several internet based referral companies available online. This type of service has you complete a form listing the type of services you are looking for such as home care

Finding the right person for the right job is never the easiest thing to do but hopefully these tips will help you.

admin General