Education
Inform Yourself
Top 10 Reasons for Home Care
Links to Important Agencies and Organizations
Type of Home Care Agencies
Frequently Asked Questions
Additional Resources
With all of the choices available for healthcare today, it is important for people to know what options are available to you and how to get started receiving care in a timely manner. HomeHealthNYC.com is happy to provide you with various links to important organizations that can help you find and pay for care, as well as articles regarding home health care.
Top 10 Reasons for Home Care - back to top
1. Home care serves to keep the elderly in independence. None of us wants to be totally dependent and helpless. With some assistance, seniors can continue to function as viable members of society.
2. Home care prevents or postpones institutionalization. None of us wants to be placed in a nursing home unless this is the only place where we can obtain the 24-hour care that we may need.
3. Home care promotes healing. There is scientific evidence that patients heal more quickly at home.
4. Home care is safer. For all of its lifesaving potential, statistics show that a hospital is a dangerous place. The risk of infection, for example, is high. It is not uncommon for patients to develop new health problems as a result of being hospitalized. These risks are eliminated when care is given at home.
5. Home care allows a maximum amount of freedom for the individual. A hospital, of necessity, is a regimented, regulated environment. The same is true of a nursing home. Upon admission to either, an individual is required to surrender a significant portion of his/her rights in the name of the common good. Such sacrifices are not required at home.
6. Home care is a personalized care. Home care is tailored to the needs of each individual. It is delivered on a one-to-one basis.
7. Home care is the most effective form of health care. There is very high consumer satisfaction associated with care delivered in the home.
8. Home care improves the quality of life. Home care helps not only add years of life, but life to years. People receiving home care get along better. It is a proven fact.
9. Home care is less expensive than other forms of care. The evidence is overwhelming that home care costs less than other forms of care. Home care is considerably less expensive than hospitalization or nursing home placement to deal with comparable health problems.
10. Home care extends life. The U. S. General Accounting Office has established beyond doubt that those people receiving home care lived longer and enjoyed living.
Links to Important Agencies and Organizations - back to top
To learn more about general Medicare and Medicaid coverage, go to www.medicare.gov.
To find out more information regarding home care and hospice programs in New York City visit http://homecare.nyhealth.gov/index.php.
For information on services and opportunities available for seniors in New York City please visit New York City’s Department for the Aging web site here
http://www.nyc.gov/html/dfta/html/about/about.shtm.
AARP offers a good article concerning choosing a home care provider. It can be found here: http://www.aarp.org/families/caregiving/caring_help/a2004-11-30-agency.html.
The Home Care Directory has put together a collection of articles covering a vast array of topics that would be of interest to people looking for home care. The articles can be found on their web site here: http://www.thehomecaredirectory.com/home_health_care/related_articles/
Types of Home Care Agencies - back to top
The New York State Department of health provides a web site regarding home care in New York. Below is a brief description (courtesy of the Department of Health) of the various types of providers.
Certified Home Health Agencies (CHHAs)
Certified Home Health Agencies provide part-time, intermittent health care and support services to individuals who need intermediate and skilled health care.
CHHAs can also provide long-term nursing and home health aide services, can help patients determine the level of services they need, and can either provide or arrange for other services including physical, occupational, and speech therapy, medical supplies and equipment, and social worker and nutrition services.
Services provided by CHHAs may be reimbursed by Medicare, Medicaid, private payment, and some health insurers.
The NYS Department of Health is responsible for monitoring the care provided by certified home health agencies. Complaints, questions or concerns about certified home health agencies should be directed to the Home Health Hotline (800-628-5972).
Special Needs CHHAs
Special Needs CHHAs fall into two categories based upon the populations they are approved to serve:
- Populations eligible for services from the Office of Mental Health (OMH) or Office of Mental Retardation and Developmental Disabilities (OMRDD): The special needs certified home health agency provides services to a population of patients in their homes who would otherwise require care in a facility or program licensed by either OMH or OMRDD.
- Pilot Program Home Health Agencies: Ten such agencies are permitted under regulations to provide services to a particular population group and that group's identified special needs. During the application process, these agencies demonstrated that they were better able than other home health agencies to meet the special needs of the defined population group in the areas of improved continuity of care, access to services, cost effectiveness and efficiency.
Serving Both Long and Short-Term Patients
Serving both long and short-term patients means a home health agency that is also providing services to patients enrolled in the Long Term Home Health Program. These are patients who would otherwise be treated in a nursing home or institution. Patients cannot independently choose to join these programs but must be enrolled in these programs, usually by the local Department of Social Services. Because these patients are different from traditional home care patients, the quality measures reported for these agencies may not be directly comparable to other agencies and may not reflect the actual quality of care and services.
Long Term Home Health Care Program
The Long Term Home Health Care Program is a coordinated plan of medical, nursing, and rehabilitative care provided at home to persons with disabilities who are medically eligible for placement in a nursing home. This program offers patients an alternative to institutionalization.
This program is available to individuals who are medically eligible for placement in a nursing home and choose to receive services at home. An assessment to determine nursing home eligibility is performed by a registered nurse who uses an approved assessment form which identifies the individual's medical diagnoses and their level of independence in performing the activities of daily living such as bathing, eating, walking, and toileting. These individuals must have care costs which are less than the nursing home cost in the county.
Individuals can access this program through a hospital discharge planner, the local Department of Social Services (LDSS), or a Long Term Home Health Care Provider. The county determines eligibility for the program, and the LDSS authorizes all services that are provided.
All regular Medicaid Services are provided and the following may be eligible:
- Case Management by RNs
- Home delivered or congregate meals
- Housing improvements and moving assistance
- Respiratory Therapy
- Medical social service, nutrition and dietary services
- Respite care, social day care, and social transportation
The LDSS is responsible for participating in the periodic reassessment of the services provided. The providers are responsible for obtaining physician orders and administering the assessment tools. The NYS Department of Health periodically surveys the providers to determine the quality and scope of the medical, nursing and rehabilitative care they deliver.
The NYS Department of Health is responsible for monitoring the care provided by long term home health care programs. Complaints, questions or concerns about the long term home health care program should be directed to the Home Health Hotline (800-628-5972).
Serving Both Long and Short-Term Patients
Serving both long and short-term patients means a Long Term Home Health Program that is providing services to patients who would otherwise be treated in a nursing home or institution as well as traditional home care patients. Because traditional home care patients are different than those enrolled in the Long Term Home Health Care Program, the quality measures reported for programs serving both long and short-term patients may not be directly comparable to other agencies and/or programs and may not reflect the actual quality of care and services.
Hospice Care
Hospice is a program that provides care to terminally ill individuals that focuses on easing symptoms rather than treating disease. The emphasis of the program is to help individuals remain at home for as long as possible. The hospice program provides physical, psychological, social, and spiritual support and care for the patient and their family.
Hospice also offers hospice residences. Each home is operated by a certified hospice agency and is residential in character and physical structure. The intent of the hospice residence program is to provide hospice access to individuals who lack a suitable home or available family, which are elements ordinarily necessary for hospice care in the patient's home.
Services offered through hospice include nursing and physician services, medical social services, counseling (including nutrition and bereavement counseling), and physical and occupational therapy. In addition, hospice can provide home health aide and homemaker services, medical supplies and appliances, speech therapy, and short-term inpatient care.
Hospice is available through Medicaid, Medicare, private payment and some health insurance carriers. Referrals to hospice may come from any source, but must have physician certification that the patient has a terminal illness with a life expectancy of fewer than six months.
The NYS Department of Health is responsible for monitoring the care provided by hospice. Complaints, questions or concerns about the hospice program should be directed to the Home Health Hotline (800-628-5972).
Licensed Home Care Services Agencies
Licensed Home Care Services Agencies (LHCSAs) offer home care services to clients who pay privately or have private insurance coverage. These agencies may also contract to provide services to Medicare/Medicaid beneficiaries whose cases are managed by another provider or entity, such as providing home health aide services to a certified home health agency patient or providing a licensed practical nurse for a Medicaid prior-approved private duty nursing shift.
The Department of Health conducts periodic surveys and investigates complaints at these agencies. If there are findings that a violation of rules and regulations exist during such activities, a written report, a Statement of Deficiencies, is issued and the agency must submit a plan of correction to the Department within 10 days. This plan must specifically indicate how the agency will return to and maintain compliance with each rule or regulation it violated.
Quality measurement data are not currently available for this provider type. Inspection data for licensed home care agencies do exist, but are not currently available in the electronic format necessary to post the information on the Web site. Efforts by the department to make this information available electronically are on-going. In the meantime, interested parties may contact the freedom of information officer at the department to obtain this information:
Robert LoCicero
Records Access Office
New York State Department of Health
Corning Tower Room 2348
Albany, New York 12237-0044
Fax: (518) 486-9144
E-mail: foil@health.state.ny.us
Web: www.nyhealth.gov/nysdoh/phforum/foil/howto.htm
Limited Licensed Home Care Services Agencies
Limited LHCSAs are operated by the certified operator of an adult care facility (an adult home or an enriched housing program) to directly provide:
- personal care services and related nursing supervision which are not the responsibility of the adult care facility; and/or
- application of sterile dressings by a registered professional nurse;
- intramuscular and subcutaneous injections by a registered professional nurse; and
- all other related nursing tasks associated with the administration of intramuscular and subcutaneous injections or application of sterile dressings.
These services must be pre-approved for each patient by the local Department of Social Services or the New York City Human Resources Administration (HRA).
The NYS Department of Health is responsible for monitoring the care provided by home care agencies. Complaints, questions or concerns about the home care program should be directed to the Home Health Hotline (800-628-5972).
Home Care FAQ - back to top
Below are some frequently asked questions provided by the American Geriatrics Society.
http://www.americangeriatrics.org
Home Care FAQ
by Catherine M. Eberle, MD, University of Nebraska Medical Center
Q. What is home care?
A. Formal home care is the provision of services and equipment to a patient in his or her home for the purpose of restoring and maintaining the best possible comfort, function, and health.
Q. What services may be provided as a part of home care?
A. Services may include any of the following:
- Professional service - care provided by a doctor, nurse, dentist, foot doctor, therapist (such as physical, occupational or speech therapists), psychologist, pharmacist, or social worker.
- Ancillary service - care provided by a home health aide who often helps with bathing and personal hygiene; or help provided by homemakers, chore aides, volunteers, or home-delivered meals.
- Diagnostic testing - such as drawing blood, taking x-rays, and performing heart tests.
- Medical equipment - such as intravenous supplies and drugs, medical alert services, blood sugar tests, home safety (such as ramps and rails to assist in moving around), hospital beds, canes, walkers, and other items deemed medically necessary by your physician.
Q. Do I qualify for home care?
A. For Medicare to cover help at home, a person must be homebound or frail. A "homebound" person is someone unable to leave his or her home except for doctor appointments or to go to church. A "frail" person has many illnesses and goes to the hospital or emergency room for his or her care.
Q. How can I receive home care services?
A. Most often your doctor will refer you to a home care agency or equipment provider when you become ill and need more care and services at home. This may happen while you are in the hospital, but you do not have to be in the hospital to get home care services. You should tell your doctor if you are having problems at home and think you could benefit from help.
Q. How long will I be able to receive home care services?
A. How long you receive home care assistance depends on how long you need that help, if there is someone to provide the care, as well as how you pay for it.
Q. Who pays for home care?
A. The following programs often pay for home care services:
- Medicare
- Medicaid
- Other health and disability insurance
- Social Security, Title XX
- Older Americans Act, Title III
- Veterans Administration
- Various charities
You may also pay for services out-of-pocket. Some agencies provide services according to a person's ability to pay.
Q. How much does it cost?
A. The cost depends on the service, the equipment and your insurance. If you were in the hospital recently, Medicare or your insurance company may cover services and needed equipment. The agencies on the list below can identify groups that will pay for services.
Resources to help you learn more about home care in your area: - back to top
National Association for Home Care
228 Seventh Street, SE
Washington, DC 20003
Phone: (202) 547-7424
Fax: (202) 547-3540
Website: www.nahc.org
Health Care Financing Administration (HCFA)
7500 Security Boulevard
Baltimore, Maryland 21244
Phone: (410) 786-3000
Website: www.hcfa.gov
You may find answers to your questions about Medicaid and Medicare and home care services at www.hcfa.gov/faqs/default.asp.
Other groups that can help are:
- Area offices on aging
- Your insurance company
- Medicare
- Medicaid
- Home health agencies
- Case managers