Home Health in San Diego, CA

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San Diego California Home Health: Common Terms, How to pay for Home Health, Licensing and Questions to ask

San Diego is a beautiful, historical location for those looking for hospice and palliative care service providers. Referred to as the “Birthplace of California”, San Diego is a hub for tourism, coastal enthusiasts, and retirees. San Diego has recently emerged as a center for healthcare development, and is home to many universities and higher education, including San Diego State University and University of San Diego.

About Home Health in San Diego

California is known for sunshine, beautiful coastline, Hollywood and Silicon Valley. The culture in California is relaxed and easy going. There is 800 miles of majestic coastline, beaches and cliffs permitting some of the most beautiful views of the Pacific Ocean. Lush mountains give Californians the opportunity for great outdoor adventures and fresh air. The state is the most populated in the nation, and also is home to the most diverse population of citizens. Because of the ideal climate and variety of communities, California is a hot spot for seniors and retirees. As our senior population gets older, the chances they may need rehabilitation or care after a surgery or injury increase and they may require care at some point. Most people think of a nursing home as the only option for senior care. Nursing homes are definitely not the only option. Home health in California is generally provided so the patient may be in their home while receiving care, as opposed to a long-term facility like a nursing home or assisted living community. The individual’s treatment plan (as assigned by the doctor) may include physical and occupational therapy, the monitoring of recovery, injections or wound care. Upon completion of the rehabilitation, the patient may resume normal function around the house after they’ve recovered.

Senior Home Health is a level of care designed for individuals who need care while recovering after surgery and other acute health conditions. Home health is there to assist in faster recovery, and allows a patient to discharge from the hospital earlier and reduce future hospital admissions. Home health services are generally short-term (temporary), depending on the doctor’s orders. Not all home health services require around the clock care. However, there are situations in which the caregivers continue the home health care beyond the doctor’s order. These services are approved and prescribed by the individual’s doctor. Within the home health plan is a detailed description of the type (or types) of medical care your loved one will receive. It will show you the plan for what types of care professionals will be delivering the care and the schedule they will be working. In California, home health and home care are regulated and licensed by the Home Care Services Bureau. This bureau is responsible for conducting compliance checks. 

Considerations when looking for care in San Diego

San Diego is the 2nd largest city in California, with the population tipping over 1,300,000 in 2020’s census. The mild year-round climate, beaches, and diverse culture have led San Diego to become a preferred location for senior citizens to retire and seek care.

Cities near San Diego

  • Lemon Grove – 9 miles northeast of San Diego.
  • Chula Vista – 9.7 miles south of San Diego.
  • La Mesa – 10 miles northeast of San Diego.
  • Spring Valley – 12 miles east of San Diego.

Pricing and How to Pay for Home Health

Typically, home health services are covered by Medicaid (Medi-Cal) if the person qualifies. Eligibility requirements are both financial and medical in nature. If Home health services are to be paid out of pocket, the average cost is a little over $6,000 per month in California. This is based on 40 hours of care per week. Generally, recipients of home health do not require 40 hours of care per week.

How to pay for Home Health and available coverage

Medicare:

Generally Medicare reimburses the cost of Home health services. Medicare typically covers your loved one when recovering from an illness or an accident or a surgery.

*Medicare covers the specific ailment. When treatment is completed Medicare coverage stops. 

Medicare is not a long-term care solution. 

Medicaid:

Medicaid programs are put in place on a state-by-state basis. Each state will have their own regulations regarding the coverage of care. Some individuals at a certain low-income level may qualify for Medicaid Home and Community Based Service Waivers.

Veteran Aid and Attendance:

This benefit is available to some military veterans or surviving spouses. 

  • A veteran may qualify for as much as $2,050 each month. 
  • A veteran with a sick spouse may be eligible for $1,600 per month. 
  • If a veteran has passed, their surviving spouse can qualify for $1,300 per month.

Private Insurance:

  • Most health insurance companies typically cover some services for acute medical needs. 
  • Do be aware, long-term coverage vary by plan. Not all long-term insurance will assist with home health services as the needs of the person tend to be temporary. 

Private pay:

Families which can afford to do so may pay for care with private funds. Private pay can be a combination of retirement funds, personal savings, pension payments and family members may contribute funds toward a loved one’s care as well.

Questions and Inquiries about Home Health

  • How long has the agency been serving this community? 
  • Does the agency have any printed brochures describing the services it offers and how much they cost? 
  • Is the agency an approved Medicare provider?
  • Is the agency currently licensed to practice (if required in the state where you live)? 
  • Does a national accrediting body certify the quality of care?  
  • Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for? 
  • Is there a care plan in place that outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver? 
  • How closely do supervisors oversee care to ensure quality? 
  • Will agency caregivers keep family members informed about the kind of care their loved one is getting?
  • Are agency staff members available around the clock, seven days a week, if necessary? 
  • Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day? 
  • How does the agency ensure patient confidentiality? 
  • How are agency caregivers hired and trained? 
  • What is the procedure for resolving problems when they occur?
  • How does the agency handle billing? 
  • Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services? 
  • Will the agency provide a list of references for its caregivers? 
  • Who does the agency call if the home health care worker cannot come when scheduled? 
  • What type of employee screening is done? 

Local hospital and healthcare providers

Scripps Mercy Hospital San Diego
4077 Fifth Ave
San Diego, CA 92103

Sharp Memorial Hospital
7901 Frost St
San Diego, CA 92123

Kindred Hospital San Diego
1940 El Cajon Blvd
San Diego, CA 92104

Alvarado Hospital Medical Center
6655 Alvarado Rd
San Diego, CA 92120

Area Agencies on Aging The California Department of Aging (CDA) administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the State. These services are provided locally by contracted agencies. This webpage is intended for those who provide, or seek to provide a variety of aging services.

The Home Care Services Bureau is responsible for licensing Home Care Organizations including processing applications, receiving and responding to complaints and conducting unannounced visits to ensure compliance.

California Department of Aging Under the umbrella of the California Health and Human Services Agency, the California Department of Aging (CDA) administers programs that serve older adults, adults with disabilities, family caregivers, and residents in long-term care facilities throughout the State. These programs are funded through the federal Older Americans Act, the Older Californians Act, and through the Medi-Cal program.

California Rural Indian Health Board The Pit River Tribe of California’s Rancherias in the operating area are as follows: * Montgomery Creek Rancheria * Roaring Creek Rancheria * Burney * Lookout Rancheria * XL Ranch Rancheria * Likely Rancheria * Big Bend Rancheria The main site, Burney Indian Health Clinic, in Burney, CA offers full time health care in many fields. As a service to the community the Shasta County W.I.C. Program is also located at the site in Burney. A satellite office, the XL Ranch Reservation Clinic, is located in Alturas, CA (Modoc County) providing referral and outreach services. The principal referral facility is Mercy Medical Center Hospital in Redding, CA which approximately miles from the main clinic site. This facility offers general medicine with 169 medical/surgical, 14 ICU, 14 CCU, 19 Pedriatrics, 29 Perinatal, 5 Acute/Respiratory and 6 ICCN beds

Eldercare Locator This is a great resource to search for specific care in specific counties and cities. This database is a nationwide resource that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.

Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings

Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available.

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Written by The Care Availability Team
Experts in the senior care & retirement living industries

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