Medicare Certified Health Care at Home Is One Solution.
My father’s release from the hospital was the miracle we had been praying for, but I had no idea how we would manage. (Jump to Lessons Learned)
Two years after dad was admitted to the hospital, I find myself comfortable with a language I never knew existed: “Event”; “Compliance”; “Case Manager”; the list goes on. My father’s hospital stay was the “event” that kicked off a host of services to ensure he had the care needed for a smooth transition to home. Our smooth transition meant vists from a Medicare certified home health agency which provides physician-prescribed medical services.
Prior to his release, the hospital Discharge Planning team worked out all the insurance requirements so dad could receive at home skilled nursing from a home health agency. In our case, we choose a local Visiting Nurse Association (VNA). The hospital social worker contacted the agency for us and handed off case details. It was not long before the home health agency called to set up the first visit. (For more information on non-profit home health agencies, click here: Visiting Nurse Association – a Home Health Agency)
Every visit our agency case manager (a registered nurse), would go over dad’s medication, measure his legs for signs of water retention, ask a host of questions and answer any of ours. Because CHF (Congestive Heart Failure) can quickly escalate, she made sure a Telehealth monitor was installed in the house. Hooked up to the phone line, it recorded his blood pressure, heart rate, blood oxygen and weight every day. This information was remotely monitored by a nurse at VNA headquarters. Any concerns were immediately relayed to us and dad’s doctor. She made it very clear that a two-pound weight gain in one day required an immediate visit to his cardiologist.
A nutritionist helped us to understand just how much salt is hidden in baked goods and breads. I found myself standing in food stores reading ingredients on every product before making a purchase. I am amazed at the number of consumer goods marked low sodium which are still too high for a CHF patient. And the pepper we were adding to flavor food? One of the worst things to aggravate dad’s GERD (Gastroesophageal Reflux Disease).
Our Home Health care team was rounded out by a physical therapist and social worker. Physical Therapy consisted of a series of exercises dad could easily do at home to help re-gain his strength. The social worker made us aware of community resources like the local Office on Aging. For more on these resources click here: (Help in Caring for Your Parents Using Community Resources).
- If your loved one is admitted to the hospital, be sure to speak with the case manager, social worker and discharge planner to understand services available upon release. If there is a move from one floor to another (e.g. ICU to regular), your case manager may change. Be sure to make contact with this new resource.
- Because we used a Medicare certified home health agency, Medicare paid for the visits. But there is a limit to the number of visits from the nurse, physical therapist and nutritionist. Once those limits are hit, only another event (e.g. surgery, hospital or rehab stay) could re-start the clock for Medicare funded services. )
- Click here to access the pamphlet: Medicare and Home Health Care
- Dad was sent home, not to a Rehabilitation or Skilled Nursing Facility (SNF). If your mom or dad moves from the hospital to another facility, Medicare will pay for the services under certain conditions. (Source: agingcare.com Medicare coverage of skilled nursing facility).
- After a hospital stay of 3 consecutive days or more.
- When the skilled services are for a medical condition treated during a qualifying three-day hospital stay. You must be admitted to the hospital for it to be considered a qualifying stay
- Your doctor must order the services you need for rehabilitation or SNF care.
- My father did not need help in Activities of Daily Living (ADLs) like bathing, dressing, and eating. However, help was needed with the laundry and housekeeping tasks my father could no longer manage. In the healthcare industry, these activities are known as Instrumental Activities of Daily Living (IADLs). Medicare does not pay for these non-medical Companion Care/Homemaker home health aide services. The family paid for an agency to come in twice a week to take over laundry and housekeeping. (Source: thevisitingnurse.blogspot Things you need to know about).
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.