Posts tagged 'Home Health Care'
Home health care is not a new concept. In fact, for centuries, that was pretty much how health care was administered. A person fell ill and someone in the household fetched the local doctor to come to the home, make a diagnosis, prescribe treatment and a plan and wait to see how the patient fared.
This method of health care worked pretty well for several reasons. For one, the person who was ill – especially if they were quite ill – did not have to struggle through the exertion of leaving their home, their family and their bed to go out and take the ride to the doctor’s office which could be quite a distance away. In addition, they could stay home and sleep or rest while waiting for the doctor, not exposing themselves to the elements especially during the cold times of year that brought rain, sleet, ice, hail and snow. Most of the time the doctor knew his patients and when given the description of the medical situation at hand by the individual who went to fetch the doctor, the doc knew what medicines and tools were needed and brought them to the house.
Today we live in a medical world full of incredible research, extensive hospital systems and services and doctors who specialize in everything from headaches to heartburn to hangnails to heart replacement. Medical breakthroughs happen daily and the progress being made is extraordinary.
All of this being the case, however, there are still those among us who would do better having more of their healthcare performed at home. Chronically ill patients – especially with more than one serious illness – and seniors who find it harder and harder to get around could benefit from having health care performed at home more often than having to go to a doctor’s office, a clinic or a hospital for routine care.
In recognition of the situation, two senators have sponsored a bill that would keep seniors at home and pay for doctors, nurses or other medical practitioners to visit them there. The bill would involve doctors or nurses creating a plan of care with the patient and showing that overall, the plan which would include more home care, would help the patient more and save at least 5% of what they are paying now. If doctors could do this, they could keep 80% of any savings over 5% as an incentive, which would help the doctors and save the Medicare system money.
Even with all the fancy medicine we have available to us today, it is good to know that we have come full circle on a few things that will help seniors and chronically ill patients get good care while remaining comfortable at home when possible.
What do you do in a situation when your parent is having surgery and needs some recovery time? How do you deal with the situation where your parent wants to recover at home – which creates a cost savings, no matter what sort of coverage they do or do not have – but Medicare Advantage wants them to go into an expensive nursing home? You hope that the politicians who are trying to mess with Medicare figure things out soon.
So, in Medicare’s bureaucratic wisdom, it makes more sense for them to send a person to a nursing home that costs from the high hundreds to thousands rather than allowing them to stay home and have a nurse visit when necessary at a much lower cost.
This is some of the issue that creates the lack of confidence in Medicare. It is also part of the reason that Medicare is having so many financial issues and so many people are predicting the downfall of the program within the next twenty years.
On the other hand, what could happen if the people running Medicare made financially intelligent and fiscally sound decisions – such as letting people stay at home rather than in nursing homes or hospitals wherever possible – the savings for those and other intelligent decisions would most likely be enough to save Medicare, if not extend it for years. Add to that an efficient, effective and accessible system so that Medicare recipients could get good services that save the system money while helping the people that need help, and Medicare might just work indefinitely.
Certainly some of these ideas have been thought of, but why have they not been implemented? This is a question for the ages. Hopefully there will be some good answers – and solutions – sooner, rather than later.
It may seem like New York doesn’t have many scams (just kidding), but one scam that is very real and is being addressed by New York’s Attorney General Andrew Cuomo is home health care fraud that is paid for with Medicaid dollars.
Cuomo has started “Operation Home Alone” which is a new program that is rooting out con artists that pose as home health care workers, but really are not. These scams have cost the taxpayers of New York millions of dollars.
The way it works is that a real home health care worker has to have 75 hours of training and be certified to work at home with individuals who need certain health services. The certification is very important because it means that an individual has been trained to treat wounds, feed, bathe and dress individuals and several other health procedures.
These uncertified home health care imposters are not only dishonest, and not only basically stealing millions of Medicaid dollars, but they are also dangerous. Since they are not trained, it is extremely risky for them to be helping individuals at risk with medical and other health issues. For instance, the average person does not know first aid or CPR. They do not know the correct way to lift someone to help them from a wheelchair to a bed, or vice-versa. They do not know how to take or read blood pressure or blood sugar or what to do in case of a seizure. And that’s the easy stuff!
Most individuals that need home health care receive it because they have health issues that they need help with. A home health care worker is taught how to keep track of and monitor all day-to-day symptoms, vital signs and issues that come up. They know how to track and record information that shows how a person’s health is progressing – for better or for worse. An untrained and un-certified individual usually knows few, if any, of these procedures.
So far, Andrew Cuomo has caught quite a few of these companies who are nothing more than rings of uncertified workers fleecing the system out of a lot of money and putting patients at risk. Cuomo has filed criminal and civil charges to the extent of the law and he is not backing down.
If you are a New Yorker, you can be happy and proud that your Attorney General is trying to protect your citizens – especially those most vulnerable – and protect the taxpayers’ money. If you feel that you have been the victim of this type of fraud by an uncertified healthcare worker, contact Medicaid at www.medicaid.gov or call Cuomo’s office, which is listed under State of New York, Attorney General.
Over ten years ago, a woman in New Jersey heeded home care with basic daily needs after a serious illness. Medicaid would pay for a home health worker to come into her home and help care for her; however the overtaxed New Jersey home health care system had no available workers.
The woman’s daughter did not know what else to do besides putting her in a nursing home. Before that happened, however, an alternative idea was that the Medicaid funds could be used for the woman to hire family to take care of her.
Through this first small step for Medicaid, but huge step for this individual’s family, the Cash and Counseling program began. Grants were given to New Jersey, Arkansas and Florida to pilot the program, and since that time in the late 1990’s, this program has spread to many states in the country.
It has been an excellent program for any reasons. One situation is that the individual is being taken care of at home by their family and not a stranger. They are in familiar place, where statistics show that they will have better resources, more interaction with family and friends, and less isolation and loneliness, all of which lead to faster and stronger recovery. In addition, staying at home and not in a nursing home is certainly much more cost effective and will definitely help the person’s health stay or become more stable.
The federal government has made it easier to participate in this program because it has eliminated the requirement for people to get a Medicaid waiver to participate. According to AARP, this will save a tremendous amount of money. AARP says that home health care costs about a half of what care in a nursing facility costs, and most individuals and their families prefer to stay at home to be cared for unless they are extremely ill or frail.
If you or someone in your family or circle of friends are in this situation, be sure to contact Medicaid at www.medicaid.gov to get further information. It is quite possible that health care can be continued at home with the comfort of being surrounded by family and friends.
Durable equipment, such as wheelchairs, walkers, hospital beds and other medical equipment has long been the subject of frustration because of their costs. If an individual has Medicare, often Medicare pays for some or all of these items, with little cost to the recipient.
However, the costs of much of this equipment are extremely high, and not affordable to most Medicare recipients. Even though Medicare helps with the expenses, there are still issues that are being addressed.
Medicare has determined that the costs are too high for them, as well. They have proposed a solution that would help consumers and help the Medicare program itself. To save money for recipients and the Medicare system, Medicare wants to institute a competitive bidding process for some durable medical equipment. This would mean that companies that supply these items would have to bid toward the lowest price in order to be given contracts through Medicare. In addition, these lower price savings would be passed on to Medicare Beneficiaries.
On the surface this seems like a good idea, and in many cases, it would work. The problem is that many of the companies that provide this equipment are small businesses that have a small profit margin. Some of these businesses have no room to decrease their prices and as a result, might be shut out of the process of providing durable equipment through Medicare. This could severely cripple the businesses or even put them out of business.
Another drawback is that there would probably be fewer choices for Medicare recipients along with fewer knowledgeable providers. Patients might have to switch from their current providers to a new one that they don’t know. Some beneficiaries have been affected already, as the bidding process has started. It is taking longer to get their equipment. A high percentage of providers have already had to cut back or go out of business.
In the long run, things will even out. In the short term, however, if you are a Medicare recipient, try to deal with durable equipment in advance. Put your order in early, and try to be patient as everything is sorted out. We can all be hopeful that the discounts will truly be passed on, saving beneficiaries money on essential equipment they need.
During the past decade or more, there has been a push by citizens, advocates and, yes, even congress, to allow individuals to have home health care rather than staying in a facility. As many of us know, a person that can live at home and interact in the community, while being taken care of medically, will most likely live a longer and fuller life.
One state, Connecticut, has moved into the cadre of states who are working to allow individuals to stay at home, get home health care, and live full lives. Senators there have passed a bill that will move about 5,000 individuals who are elderly or disabled out of care facilities and institutions back to their homes and their communities.
This is vitally important. Statistics have shown that individuals that have community support and independent living, live longer and are healthier than those who are confined to hospitals, institutions and long-term care facilities. This does not mean that everyone is capable of living on their own and interacting in the community without assistance. Some individuals might be better in a variety of care settings. However, it has long been known that there are many individuals in facilities, hospitals and institutions that should really be able to live in the community.
This is a win-win situation. Medicaid will save money – it is much less costly to live in a group home or apartment and have a variety of supports defraying the costs, than it is to stay in a hospital, facility or institution where rates range (depending on the area the person lives in) from nearly $200 per day to over $1,000 per day.
I have personally worked in several states with individuals who were involved in independent living programs. Some lived in group homes and others lived in their own apartment. Still others were able to live at home with their families. Many of them had gainful employment, meaning that in many cases, they either needed less benefits and actually paid taxes, helping the economy; or they had small jobs that prepared them to move forward in the community and eventually be self-sufficient.
No matter what the situation, helping individuals that are able to integrate into the community and work toward independence is a huge step forward for the individual, the community they live in, and society in general.
At this time, it looks as though the trend has caught on and is continuing. In the long run, it can save Medicaid and communities millions of dollars. In the short term and the long run, it will heal individuals, families, and the community and make all of these entities stronger and richer for the progressive change.
Most of us think about Medicare in terms of types and amounts of plans and coverage. Sometimes we only think about it when we are feeling ill or having to visit the doctor or hospital.
This is not all that Medicare does. There are many types of information that Medicare collects and Medicare provides. One important type of information that Medicare tracks is information regarding nursing homes. Medicare has just released information and created a database that lists the lowest quality nursing homes in the country.
The Nursing Home Compare website now has a searchable database that gives the names the lowest 5% of nursing homes around the nation. In addition to the database, CMS provides a monthly update showing results of nursing home inspections.
CMS is working hard to provide Medicare recipients and others more access and easier access to information regarding nursing homes. There are senators and congressmen who are pushing for bills to disclose even more information regarding nursing homes and the nursing home community. This may take time, but it is an important issue and it is being looked at carefully and pushed forward.
Whether you are actually at the point where you are looking for a nursing home, or you are a relative, friend or caretaker of an individual looking for or needing one, the information that CMS/Medicare has released is essential.
There is much more information at www.medicare.com, including frequently asked questions with answers and links to other sites and further information.
If you are approaching retirement, already retired and on Medicare or just looking for answers about Medicare or nursing homes, take the time to explore the subject in advance. It could certainly keep you from ending up in the wrong place in a bad situation later on.
Many individuals receiving Medicare benefits rely on home health care as one of the main benefits they receive. Home Health Care for these individuals – usually seniors or individuals with disabilities – is their lifeline and an essential link in their services and well-being.
The Center for Medicare and Medicaid Services (CMS) has once again recognized the Joint Commission’s deeming authority for accrediting Home Health Care.
This is important to beneficiaries because more than 2.4 elderly individuals and individuals with disabilities receive Home Health Care services. In order to be able to provide such services, agencies need to be accredited and “deemed” as meeting Medicare and Medicaid requirements and standards. When a Home Health Care agency has “deemed status” by the Joint Commission, research shows that the particular agency usually exceeds the standards set out for Home Health Care Providers by CMS, providing a higher level of service.
Because more and more individuals and patients are trying to get treatment as outpatients and stay in their homes rather than hospitals, the partnership between the public CMS and private Joint Commission has become essential in helping to set the highest standards, therefore encouraging and ensuring the highest quality services.
The Joint Commission, which started granting deeming authority in 1993, accredits over 3,800 organizations. Accreditation is voluntary, and Home Health Care Agencies can seek deemed status by the Joint Commission, but it is not a requirement. They can also seek accreditation by state surveyors on behalf of CMS.
The Joint Commission works to continuously improve the quality of services to the public. It evaluates and accredits over 15,000 health care programs in the country, including hospitals, home care organizations, assisted living, ambulatory care services and laboratories. It also accredits organizations dealing with specific health issues, such as stroke centers, and it is a non-profit organization.
