Choosing a Home Care Provider?
What is Home Care?
"Home care" describes services delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living. Home care services generally are available 24 hours a day, seven days a week. Depending on the patient's needs, these services may be provided by an individual or a team of specialists on a part-time, intermittent, hourly, or shift basis.
What Services Are Provided by Home Care Agencies?
Home care providers deliver a wide variety of health care and supportive services, ranging from professional nursing and home care aides to physical, occupational, respiratory, and speech therapies. They also may provide social work and nutritional care and laboratory, dental, optical, pharmacy, podiatry, x-ray, and medical equipment and supply services. Supportive services are also available that help individuals with routine daily tasks.
Who Provides Home Care?
Home care services are usually provided by home care organizations but may also be obtained from registries and independent providers. Home care organizations include home health agencies; hospices; homemaker and home care aide agencies; staffing and private-duty agencies; and companies specializing in medical equipment and supplies, pharmaceuticals, and drug infusion therapy. Following are descriptions of the various types of home care providers.
Home Health Agencies: The term home health agency often indicates that a home care provider is Medicare certified. A Medicare-certified agency has met federal minimum requirements for patient care and management and therefore can provide Medicare and Medicaid home health services. Due to regulatory requirements, services provided by these agencies are highly supervised and controlled.
Professionals who deliver health care at home include:
- Registered nurses (RNs) and licensed practical nurses (LPNs) provide skilled services that include injections and intravenous therapy, wound care, education on disease treatment and prevention, and patient assessments.
- Physical therapists (PTs) work to restore the mobility and strength of patients who are limited or disabled by physical injuries through the use of exercise, massage, and other methods.
- Social workers evaluate the social and emotional factors affecting ill and disabled individuals and provide counseling.
- Speech language pathologists work to develop and restore the speech of individuals with communication disorders and also help retrain patients in breathing, swallowing, and muscle control.
- Occupational therapists (OTs) help individuals who have physical, developmental, social, or emotional problems that prevent them from performing the general activities of daily living (ADLs) such as eating, bathing, dressing, and basic household routines.
- Dietitians provide counseling services to individuals who need professional dietary assessment and guidance to properly manage an illness or disability.
Para-professionals who deliver health care at home include:
- Home Health Aides assist patients with daily living activities such as getting in and out of bed, walking, bathing, toileting, and dressing.
- Homemaker and chore workers perform light household duties such as laundry, meal preparation, general housekeeping, and shopping.
- Companions provide companionship and comfort to individuals who, for medical and/or safety reasons, may not be left at home alone. Some companions may assist clients with household tasks, but most are limited to providing sitter services.
- Volunteers activities include, but are not limited to providing companionship, emotional support, and counseling and helping with personal care, paperwork, and transportation.
Questions to Ask Potential Home Care Agencies
Ask questions in the following areas to gain the knowledge and confidence to choose the agency that best fits your needs.
Scope of Services:
- What services do you provide?
- Do you specialize in any particular area of service?
- Do you provide respite care services?
- Do you provide 24-hour care?
- Do you have any minimum service requirements?
- Are there any restrictions on when services can be provided?
- Do you provide a free nursing assessment to determine what types of services are needed?
History and Accreditation:
- When was your agency established?
- Is your agency accredited? By whom?
Hiring Practices:
- What types of employees do you employ?
- What are your hiring standards and qualifications?
- How do you verify experience and credentials?
- Do you test potential employees on their clinical skills before hiring them?
- Do you bond and insure your employees?
- What kind of liability insurance do you provide to employees?
- Do you perform criminal background checks on employees?
- Do you employ any bilingual employees?
Employee Supervision and Scheduling:
- How do you assign employees to particular cases?
- How do you orient employees to cases?
- What sort of training and continuing education is provided for employees?
- How do you supervise employees?
- How do you handle scheduling problems?
- How do you handle personality conflicts?
- Who can I contact if I have problems after normal work hours?
Care Plan:
- How do you determine the care plan?
- How will you introduce the care team to us?
- How do you monitor and evaluate the care plan?
Insurance and Billing:
- What types of insurance do you accept?
- How is insurance billing handled?
- What is your hourly rate?
- Are there additional charges for services provided on weekends, nights, and holidays?
- How are taxes for field employees handled?
- What happens if an employee has an accident in my home?
- Do you provide workers compensation insurance for employees?