Maryland Home Health: Common Terms, How to pay for Home Health, Licensing and Questions to ask

One of the main appeals for many who call Maryland home is the easy access to so many major metropolitan cities in the region. Maryland is known for the beautiful Chesapeake Bay and the luminescent blue crabs. Baltimore is a city woven with great history, and the easily accessible outdoors allows for year-round adventuring. The economy is robust and continues to grow stronger. Maryland has a strong and loyal population, and a growing number of adults aged 65 and older. As a result of aging, it is common some people may require care at some point. Home health services are unique in comparison with other forms of care. These services are generally provided so the patient may be in their home while receiving care, as opposed to a long-term facility like a nursing home. People typically think of a nursing home when they envision senior care. Nursing homes are not the only option. Home health designs each individual’s treatment plan (as assigned by the doctor), which 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.

Maryland has several cities where aging adults may receive high quality healthcare and senior living solutions: Baltimore, Annapolis, Frederick, Ocean City, Bethesda, Salisbury, among many others.

*Take note that home health services are different from other types of care. Generally, when people think of senior care they immediately imagine a nursing home. This is definitely not the case. Nursing homes are far from your only option when providing care for a loved one.

Definitions of types of care

Home Care: Caregiver assistance related to activities of daily living, including: mobility, eating, toileting, bathing and personal hygiene, dressing and grooming or cognition support. These services are typically not covered by medical insurance and do not require a physician’s order.

Home Health: includes skilled nursing services, physical therapy, occupational therapy, speech language therapy and medical social services. A home health care agency may choose to be Medicare certified to be reimbursed for their services. Home health agencies may also teach you how to care for yourself. Services ordered by a physician, covered by Medical Insurance and typically provided following a hospital or skilled rehab stay.

Rehabilitation & Therapy: treatment for an injury, illness, or pain with the goal of restoring function, including nursing and therapy services. Rehab is ordered by
a physician and services are provided by nurses and physical, occupational, and speech therapists. Examples include working with a physical therapist to help you walk and with an occupational therapist to help you get dressed.

Respite Care: short term relief for family caregivers to take a break from the caregiving responsibilities and allows for a healthier and better quality of life for both the caregiver and care receiver. Respite services include: companionship, personal care, recreational activities and security. Respite care can be provided as short stay or for a longer period that allows the family caregiver to go on vacation or a business trip. Longer duration respite care is generally found at select senior housing communities although some Companion services may provide this service in the home.

Hospice Care (Palliative Care): emphasizes comfort measures and counseling to provide social, spiritual and physical support to the dying patient and his or her family. The goals of hospice are to keep the patient as comfortable as possible by relieving pain and other symptoms. Hospice care, is typically offered in the last six months of life and covered under Medicare Part A .

Short-term or long-term care?

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.

Service plans

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.

What to look for in a Maryland Home Health Agency

Most commonly, your loved one’s doctor will prescribe a home healthcare agency. Being serviced by the agency your physician has chosen is not set in stone and you may choose to use a different home health agency if you choose. If you know someone, a friend or family member who has received home health care and they were satisfied with their trained professional team, you can inquire into that agency.

The home health team consists of:

Physicians
Nurses
Home health aides
Certified nursing assistants
Physical therapists
Occupational therapists

What does the certified team of Home Health aides do?

Physical Therapists

Physical therapists work to help individuals regain strength and mobility after an injury. They may help with range of motion and muscle movement, relieve pain and improve general strength. The physical therapist will implement specialized exercises and teach how to do them with detailed instructions. Along with teaching rehabilitative exercises, they will be willing to answer any questions or concerns.

Registered Nurses (RNs)

RNs perform certain medical assistance, like changing dressings, managing catheters, injections, managing medications for patients. These nurses will make evaluations of the individual when visiting.

Certified Nursing Aides

These aides are certified to visit the home and provide medical care. They may help with ADLs as well. They are trained and certified to assist with mobility devices, administer medications, help with braces, massage and help with simple dressing of wounds.

With specific training, some certified nursing aides may operate medical equipment such as oxygen ventilators. Training and certifications will vary by state.

Home Health Aides

Home Health Aides come to the home and perform medical care. They may assist with activities of daily living (ADLs): preparing meals or bathing, getting dressed and even some light housekeeping as needed. These are trained professionals who can generally administer medications and may assist with mobility devices and other tasks.

Laws and regulations for Maryland home health

Licensing

The Maryland Health Care Commission licenses home health agencies in the state.

Medicaid

Medicaid may cover community-based services, which vary by program and may include, but are not limited to, personal assistance, nursing, nurse monitoring, medical day care.

How much does Home Health in Maryland cost?

The average cost for home health services in Maryland can be upward of $5,400 per month. However, it is common that people receiving home health services will not require 40 hours per week of care and rehabilitation. Some simple services may cost between $18 to $25 per hour.

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?

Resources and Links – Maryland

Elder Abuse Prevention Coalition A coalition of the Baltimore County Departments of Aging, Social Services and Health to educate the public on what is elder abuse and how to prevent elder abuse.

Maryland Department of Aging In Maryland’s twenty-three counties and Baltimore City, each local governing body designates an Area Agency on Aging or AAA. The agency may be a unit of local government or a private, nonprofit corporation. In some counties, it is the office on aging. In others, it may be named differently. In Baltimore City, it is called the Division on Aging and Care Services.

Senior Health Insurance Assistance Program (SHIP) Trained volunteers offer free assistance to help people understand basic Medicare information, eligibility and enrollment- evaluate Medigap Insurance policies and Long Term Care Policies- and assist with insurance forms and systems.

Maryland Legal Aid– To provide high-quality, free legal services to Marylanders living in poverty through representation and advocacy and to bring meaningful change to the systems that impact them.

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.

Maryland Department of Health works to support and improve the health and safety of all Marylanders through disease prevention, access to care, quality management, and community engagement.

Senior Living

Care & Support

Maryland Home Health