Saturday, January 14, 2017

What do I need to know about home health?

I have been a nurse for 25 yrs, and this June it will be 26.  I have worked many outlets; med surg, telemetry, er, all different ICUs, dobutamine clinic, long term, and home health.  I have worked for many agencies in the 8 years that I have done home health.  So what are the important aspects of home health should a family or individual look for?

In Illinois there are over 800 home health agencies in all counties.  This explains why there is a pre claim law now in effect for Illinois.  The main reason is fraud!  So I will list the link to  IDPH home health agency listing and you can start there.  This is just for Illinois, your state may have their own listing.  You can also go by referral.  Talk to someone who has had home health.  If your social worker is recommending home health, ask how much she knows about the company.  If she doesn't call and ask questions.  Here is the link to the IDPH home health agency listing
This site lists the county, phone number, license number and expiration date of their license.    When you call the agency if you start on your own, the longer they have been open, the better they are sometimes.

Stability:  How long have they been in existence?  How many nurses do they employ?  Do they have an on call NURSE?  What are their hours?  How does the patient contact someone in case of any emergency?  Have they had any complaints?  Are they Medicare certified? or Joint commission certified?  If not what other certifications do they have, and do they plan on getting them soon?  How long has the DON been with the business?  What are the experience ranges of the nurses?  With a stable company, there should be no problem in answering in any of these questions.  If their brochure says they provide home health aides, or PT, then they should be able to do so.

Experience:  How long have the owners of the company, owned it, and how much experience do they have in the area?  Are they in home health, or are they a real estate mogul?  Sometimes the owner of the agency has no idea about home health, or comes from another industry all together.  How long has the Director of Nursing been a Director of Nursing?  Has she been a Director of Nursing at other places?  Is she there at the office full time.  If not, who is?  Important.   Rules are that there has to be a nurse sitting in the office at all times.  In my opinion, if you are a director of nursing, you should be full time, and in the office FULL TIME.  Does she go on field assignments?  How does she train her nurses?  

Now you do not have to ask all these questions with your first phone call, but do ask!  Ask questions, ask questions, ask questions.  If you can't remember, write them down.

You should get a folder with the first evaluation of services.  Usually it is the home health nurse who does the first visit, but policies and agencies may vary.  In this folder is usually the business card of the director of nursing, a pamphlet, information on home safety, advance directives, flu and pneumonia vaccines, and a variety of other stuff.  If you don't get a folder ask for it.

Also, home health companies can call and ask you if you want home health if you are a medicare recipient.  This is legal.  Be aware, you can not have 2 home health companies in the same house at the same time.  This sometimes happens and is not the fault of the patient, but be aware it can happen.  The patient can have a home maker from another agency, such as DORS or senior services.  This is not the same as home health.

Your home health nurse, if she decides to do visits, must visit a minimum of once a week or  if agreed with DON, every other week.  Generally speaking, minimum is once a week.  If your nurse misses visits without notice, call the agency.  Sometimes missed visits due to illness or patient doctor visits are unavoidable, but the patient and nurse know why they are missed. 

If the patient has trouble getting the supplies from the agency, ask questions.   As of this writing, the home health company  has to provide dressing change materials to the patient.  Medicare does pay for this.  Medicare does not pay for incontinence products.

If the patient has a complaint about the nurse or agency, take it up with the DON first, if not resolved call the home health hot line.  This number should be pointed out to you in the first meeting with the nurse or PT, and is in the folder the patient receives.

This is alot of material to take in.  Hopefully our health care system will let all that need home health get home health.  Good luck, and if I can answer any questions, you can find me on instagram, facebook, here and twitter!  

Until next time~~~~~~~~~~~~~~~~~~~~


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