Chapter 7. Home Health Care

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Chapter 7. Home Health Care

• Long-Term Care Managing Across the Continuum
• (Second Edition)

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Learning Objectives

1. Define and describe home health care
2. Identify and define the components of home health
   care
3. Identify and describe regulations affecting home
   health care providers
4. Understand the financial, ethical, and managerial
   issues affecting home health care
5. Identify trends affecting home health care and
   the impact of those trends

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Definitions

• Home Care Supportive services
• Home Health Care Skilled nursing and other
  health-related services
• Community-Based Any service provided outside of
  a facility, including home care and home health
  care

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How Home Health Care Developed

• Public health department visiting nurses
• Freestanding visiting nurse associations
• Growth based on better reimbursement

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Philosophy of Care

• Takes services to the consumers homes
• Eligibility requirements (based on Medicare
  regs)
• Physician-ordered
• Intermittent
• Homebound

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Types of Home Health Care

• Home health agencies
• Hospice agencies
• Homemaker and home care aide agencies
• Staffing and private duty agencies

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Ownership of Home Health Care Agencies

• Mix of nonprofit, for-profit, and
  government-owned
• Growing number are affiliated with other health
  care organizations
• Hospitals
• SNFs
• Rehabilitation facilities

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Services Provided

• Nursing Therapies
• Dental care Laboratory
• Nutrition Care Mgt.
• Personal care Homemaking
• Transportation Education

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Consumers ofHome Health Care

• Largely elderly
• Some need on-going care
• Others need only temporary care following a
  hospital stay

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Market Forces

• Consumer choice
• Cost-effectiveness

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Regulations

• Medicare Conditions of Participation
• State licensure

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Accreditation

• JCAHO
• CHAP
• ACHC

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Financing Home Health Care

• Medicare
• - PPS
• Medicaid
• Other government programs
• Managed care
• Private insurance
• Self-pay and other sources

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Staffing

• Combination of professional and non-professional
  staff
• Nurses
• Home Health Aides
• Therapists
• Social Workers
• Other specialists

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Legal Ethical Issues

• Patient noncompliance
• Patient Safety
• Fraud and reimbursement abuse
• Patients rights

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Management Qualifications

• Not regularly licensed
• Medicare Conditions of Participation
• Certifications

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Management Challenges Opportunities

• Supervision of staff
• Staffing shortages
• Prospective payment

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Significant Trends

• Technology
• Managed care
• Wellness programs

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In Summary

• Home health care has a long history, but has
  become increasingly attractive in recent years,
  and should continue to grow.