Health In Your Home - Medicare Comparison Grid

HOME HEALTH DEFINITIONS

This guide contains information about health care services provided in the home. Such services may be needed during recovery after a hospital stay or to help a disabled or elderly person live independently in their own home. Home Health Care Services • Health care services o ered in the home may include: • Nursing care • Physical, occupational, respiratory or speech therapy • Home health aide services • Medical social services • Nutritional counseling • Medical equipment and supplies • Homemaker/companion services

HOMEMAKER/COMPANION SERVICES: Services provided by homemakers and companions include housekeeping, meals, shopping, and trips outside the home. These services can also be o ered by a home health agency, nurse registry, or hospice.

HOME HEALTH AGENCIES Home health agencies provide nursing care; physical, speech, occupational, respiratory and IV therapy; home health aide and homemaker/ companion services; home medical equipment; nutritional guidance; and medical social services in the patient’s home or place of residence. These agencies are required to carry liability and workers compensation insurance on all employees. These employees are supervised and working under the direction of a licensed practitioner. These services can be paid for by Medicare, Medicaid, Long Term Care Insurance and private pay.

NURSE REGISTRIES: An agency that o ers health care related contracts for nurses, home health aides, certifi ed nursing assistants, homemakers, and companions in a patient’s home and as temporary sta to health care facilities.

HOME MEDICAL EQUIPMENT PROVIDERS: Home medical equipment providers sell or rent home medical equipment and services for use in a patient’s home or place of residence. Equipment includes, though is not limited to, oxygen, respiratory equipment and customized wheelchairs. Services include delivery, set up, instruction and maintenance of equipment. A home health agency or hospice can also provide this service.

MEDICARE HOME HEALTH AGENCY: If you have Medicare, you can use your home health benefi ts if you meet all the following conditions: You must be under the care of a doctor and you must be getting services under a plan of care established and reviewed regularly by a doctor. You must need, and a doctor must certify that you need, one

or more of the following: Intermittent skilled nursing care, physical therapy, speech-language, pathology services, continued occupational therapy. The home health agency caring for you must be approved by Medicare (Medicare-certified). You must be homebound, and a doctor must certify that you’re homebound. A person may leave home for medical treatment or short, infrequent absences for non-medical reasons, such as attending religious services. You can still get home health care if you attend adult day care, but you would get the home care services in your home. Eligibility is also based on the amount of services you need. If you meet the conditions above, Medicare pays for your covered home health services for as long as you’re eligible and your doctor certifies you need them.

HOME HEALTH AIDES/ASSISTANCE ADL’S: Refers to persons specifically trained to help individuals with their personal care needs and activities of daily living (ADL’s). Activities of Daily Living are activities that reflect the client’s ability to perform tasks that are essential for self-care such as bathing, feeding oneself, dressing, toileting, transferring from a bed to a chair, etc. Other tasks may be assigned to aides per individual agency and family negotiations/contract. Home Health Aides are available for just a few hours per week up to 24-hour care on a temporary or long term basis. PHYSICAL THERAPY (PT): Refers to assessing and treating large motor function, utilizing rehabilitative techniques of exercise, gait training, prosthetics, and heat to restore the client to his/ her highest functional level of strength, range of motion and mobility.

OCCUPATIONAL THERAPY (OT): Assesses and treats small motor function. Utilizes rehabilitative techniques of exercise, splinting and assistive devices to increase the client’s ability to carry out normal daily activity such as feeding, dressing, grooming, and performing household tasks. Guides client through specialized regimes and encourages sensory and muscle return. Exercises and activities are used to increase upper body extremity function.

SPEECH THERAPY (ST): Assesses and treats speech and swallowing disorders. Provides individually designed treatment programs to maximize communicative e ectiveness for the client, such as stroke, head injury, laryngectomy, voice disorders, as well as cognitive deficits.

SOCIAL WORKER: A clinical social worker whose purpose in health care is to enhance, promote, maintain, and restore the best possible social abilities of the patient or family. Services provided may be preventative, developmental, or remedial in nature.