Home health care is medical or therapeutic/rehabilitation care provided at home. Services are provided at home because it is difficult for the older adult to transfer or move easily. Services are ordered by a physician. Most home health care is covered by Medicare, other medical insurance, and sometimes Medi-Cal. In order for Medicare to cover the cost, the home health care agency must be a Medicare Certified Home Health Agency. Home health care is usually authorized after an older adult is discharged from a hospital or skilled nursing facility.
Medicare authorizes payments for 60 days (considered 1 “episode of care”). This can be renewed. Medicare covers home health services, which include medical supplies, paid on a reasonable cost basis. Medical supplies do not usually include durable medical equipment.
Home health services can include:
1. Skilled nursing services – (e.g. clinical observation, assessment and analysis of health conditions and response to treatment; various types of tube feeding, care of decubitus ulcers (bed sores), training of caregiver);
2. Home health aide services – (e.g. assistance with medications, changing a dressing on a small wound, personal care which can include feeding, assistance with elimination (including some enemas, routine catheter and colostomy care). It should be noted some of these services are not allowed to be performed by care staff of home care agencies;
3. Physical therapy – (e.g. range of motion exercises, gait evaluation and training);
4. Speech-language services – (e.g. help with communication, voice disorder, feeding/swallowing difficulties due to health condition);
5. Occupational therapy services – (e.g. therapeutic activity to restore physical and/or sensory function, increase self-help abilities, learn to use devices/orthotics); and,
6. Medical social services – (e.g. usually provided by a social worker- includes referrals to community resources).
Sometimes older adults and family members are reluctant to let strangers in their home for follow-up medical care. Home health care may be rejected for fear of privacy intrusion, the belief that caregivers or the older adult can handle it on their own, or just a general reluctance to learn different ways of managing health conditions. Researchers have found that older adults who are discharged from a hospital and use home health care have lower rates of hospital readmission. Home health care increases independence and confidence in managing health conditions.
Medicare prints a handbook on the home health services they cover. You can access the document here.