The optimal discharge plan from the hospital is to return home. Often times the safest way to do this is with home health care services. If you recall the discharge planning steps from the post “Planning for Care After a Hospital Stay”. You’ll remember seeing Home Health Care at the top of the steps!
Home is ALWAYS the end goal. That is what doctors, therapists, nurses and social workers all want for their patients. We want them to be able to go home! We want patients to maintain their independence and live a high quality life.
As patients discharge from the hospital back to their home, there are things they should consider. Many people automatically think that because the are now at home they can get back to their normal routine. However, rolling back into routine is not as easy as you might think. Depending on your new needs (if you have any), your home may need to be re-arranged. Sometimes adaptive equipment is needed to aid you in your transition home.
After any hospitalization, our bodies take time to readjust to the lifestyle we had before we became ill. That’s ok! That’s normal! To help with this adjustment, medical care can come to the home to navigate any new needs. This is where Home Health Care comes in.
Home health can help you continue recovery safely and in the comfort of your own home. Services that can be provided include:
Medication Management
Wound Care
Ostomy Care and teaching
Diabetes care and education
Intravenous therapy
Enteral nutrition
Injection therapy and education
Anti-coagulation management and education
Trach care
Cardio vascular & Pulmonary assessment
Home safety evaluation
Physical Therapy
Occupational Therapy
Speech Therapy
Home Health Aide for bathing assistance
Social work
If home health care services are recommended to you, your social worker or case manager will help. Their job is to help you pick out a home health company and arrange the services for you. It’s important to note that Home health services cannot be arranged without a physician order.
I also want to point out that you do not need to have a hospital stay in order to get home health care services. As mentioned above, you need a physician order. So if you are already at home and thinking you could benefit from home health services, call your Primary Care doctor. They can evaluate you and set you up with home health if you need it.
Expectations of Home Health After Your Hospital Stay
The Home Health care company will contact you within 24 hours of your discharge from the hospital. They will set up a time to come and visit you at your house. The home visit will be a chance for them to evaluate your medical needs. Then you work together to make a plan of care that will help you get back to your independence. Typically a nurse will visit once a week depending on your medical needs. Physical Therapy and Occupational therapy will visit 2-3 times a week each for about 45 minutes to 1 hour to work with you on exercises and safety in your home.
Note, Home Health Care services DO NOT provide 24/7 care at home. They simply provide a few hours of assistance, education and therapy each week to help you get back to your baseline.
Picking a Home Health Company
There are so many home health companies out there, how do you know which one to choose?
Usually your social worker or case manager at the hospital will provide you with a list of local home health agencies. There are A LOT of home health agencies and it can be overwhelming.
When choosing a company, you need to remember that your insurance plays a vital role. Only certain home care companies have contracts with certain insurances. If you don’t want to pay anything out of pocket, you will want to pick a company that is contracted with your insurance.
Below are the links to some of the insurance company websites, you can use their search bars to find home care companies in your areas that are in network with your insurance company
Blue Cross Blue Shield of Kansas City
Blue Cross Blue Shield Federal Employee
How Much Does Insurance Pay for Home Health?
Most insurances follow the same guidelines as Medicare. So you shouldn’t have any co-pays or out of pocket expenses related to home health services. However, if therapy is recommending certain medical equipment for you to use at home, that is under Medicare part B. Medicare Part B pays for some medical equipment but typically you will have a 20% copay for certain equipment needs. You can check out Medicare.gov for more details.
How Do I Qualify For Home Health Care Services?
As we mentioned previously, a doctor’s order is required to get home health services. In addition, there are some criteria that have to be met under Medicare guidelines. Medicare and Medicare replacement plans require that you meet “homebound” criteria.
What the heck is “homebound” criteria? Does that mean you are under house arrest? You can never leave your home again?!
No. But that’s what most people freak out about. It does however, mean you are at home for the majority of the time. To be considered “homebound” you must meet the following:
- You require the assistance of a walker, wheelchair, cane, crutches or other mobility device in order to leave your home OR you need the help of a person to leave your home
- You have a condition that puts you at high risk if you were to leave your home
- Leaving your home takes a lot of effort medically and physicially
You won’t meet homebound criteria if you go out to restaurants on your own, or go run errands. You also won’t meet the homebound criteria if you regularly go on social outings on your own.
In addition to meeting homebound criteria, you also must have a medical or physical need for home health services. For example, you may need help with medication management because you have been prescribed a new and complicated medication. That medication may require close monitoring by a nurse. Or you may have a new health condition that requires some nurse oversight for a little bit until you are comfortable with your new medical routine.
And of course you need some help physically getting back to your “normal” routine. You may have some residual weakness and need to work on regaining strength. You may need help rearranging your home to meet your new medical needs.
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