Home health in the state of Utah
A physician orders home health, and the services are typically provided after a hospital stay or a skilled rehab stay. These services are unique in comparison with other forms of care. The patient may resume normal function around the house after they’ve recovered. Utah is a great place to live and receive care because of the low housing costs and low costs of living -not to mention one of the most beautiful landscapes in all of the United states. Not all health services require around the clock care. Sometimes a loved one may only need help a few days a week.
Aside from the home health team, there are other types and levels of care to fit the requirements of all seniors.
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 .
This is not Home Care
What are the differences between these two types of care?
Home care professionals assist with activities of daily living (ADLs). This is non-medical care. However, caregivers may work with patients to craft a plan to fit their needs. These in-home aides may assist with personal care and health monitoring, similar to the care an individual would receive in a long-term facility or community, in the comfort of their own home.
Home health differs from these other services in its approach to care
This level of care is designed for individuals who are ill with a chronic condition and assists in recovery after surgery and other acute health conditions. Home health allows a patient to discharge from the hospital earlier and reduce future hospital admissions. Home health is there to assist in faster recovery.
The home health team consists of:
- Physicians
- Nurses
- Home health aides
- Certified nursing assistants
- Physical therapists
- Occupational therapists
Trained home health professionals offer a litany of health services
- Injections
- IV transfusion
- Diabetes management
- Catheter care
- Tracheotomy care
- Post-op rehabilitation
Typically, visits scheduled a few times a week with different disciplines of the home health team.
Licensing and Regulations in Utah
The Department of Health and Human Services licenses and regulates home health operations in the state of Utah. They license and monitor several agency types as well as health professionals. You can contact the Utah Department of Health for more information.
Additional information about federal licensing: Licensing and certifications for Home health agencies must be in compliance with state and local standards. Medicare Part B and the Hospital Insurance Act cover home health services. In order to receive Medicaid and Medicare, agencies must meet certain standards set out by the Centers for Medicare and Medicaid Services (CMS). A physician and qualified nurses oversee the skilled nurses and the other home health professionals.
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.
Knowing what to look for in care
It’s not uncommon to have questions as you gather information about senior healthcare and services. Looking into specific services and comparing to other types of care can seem overwhelming. But we’re here to guide you on your journey:
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?
Additional Resources
This link is the source for all things related to Medicare & Medicaid.
The Utah Department of Health & Human Services
A great source to learn more about Medicare and Medicaid coverage.
This video link explains all you need to know about Medicare coverage of home health services.
Retirement Connection is a great place to learn the differences between Home Health and other services.
