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FAQs

AssistedCare Home Health Care
What You Need to Know

What is home health?

Home Health is skilled medical care delivered in the comfort of your home. The Home Health services include skilled nursing services, physical therapy, occupational therapy, speech therapy, medical social worker services. These services are determined by and ordered by the hospital, rehabilitation facility, your physicians and specialists.

 

What are the criteria to get home health care?

To receive home health care services under Medicare, a patient must meet the following criteria:

  • homebound
  • be under a physician’s care- all home health services must be ordered by a physician
  • reasonable and necessary- treatment provided at home must fall within the accepted standards of medical practice and be appropriate for the patient
  • skilled services the patient must have a medical need that requires the skill of a licensed nurse, physical therapist or a speech therapist. Once the skilled need is established a secondary discipline such as medical social worker, occupational therapist or home health aide may be involved in providing patient services
  • part time and intermittent home visits are made to provide a needed service and not extended hours of care. The patient must also have a medically predictable, recurring need for skilled care. One time visits are not allowable under Medicare guidelines.

 

What is the difference between home health and personal care?

Home Health services are:

  • delivered by Registered Nurses and/or Licensed Therapists
  • rehabilitative or restorative in nature and are delivered over a relatively short period of time
  • paid for by Medicare and some private insurances. Home health services can also be paid for privately if the patient does not meet the Medicare criteria
  • designed to promote recovery following an acute medical crisis.

Personal care services are:

  • delivered by Certified Nursing Assistants
  • preventative in nature and are provided over a longer period of time
  • paid for by the NC Medicaid program or paid for privately. Medicare does not pay for personal care services
  • designed to maintain a medically stable individual.

 

Does my insurance pay for home health services?

Medicare, commercial insurance, and HMO’s typically cover certified home health services if criteria are met. AssistedCare will assist patients and their families determine the specific coverage and any copays. AssistedCare also offers private pay options as well.

 

Who would benefit from home health services?

You or a family member may benefit from home care if you are:

  • Recovering from a recent illness, surgery, or hospitalization.
  • Recently discharged from a nursing home but need additional care.
  • ln need of education regarding your health problem and how to manage your disease effectively.
  • Terminally ill and wish to receive end-of-life care in your home.
  • ln need of assistance in order to live independently at home and to enhance the quality of life at home.

 

How long would I receive home health services and how often would someone visit?

Length of services, number of visits, and frequency will be determined by your physician once home evaluations are completed.

 

What does homebound mean?

A beneficiary must be homebound to qualify for the Medicare Home Health Benefit. An individual would be considered homebound if he/she experiences:

  • a normal inability to leave home
  • a considerable and taxing effort to leave their home
  • absences from the home are infrequent, of short duration, or are to receive medical care.

 

What services can I receive in my home if home health is ordered for me?

Home Health services that are offered in the home include skilled nursing, physical therapy, occupational therapy, speech therapy, home health aide, and medical social worker services.  What services that a patient receives is determined and ordered by their physician.

 

How long has AssistedCare at Home been providing home health services to the community?

AssistedCare at Home has been delivering top quality home health services delivered by an outstanding team since 1996.

 

How do I get CAP Innovation Services for my child with intellectual and developmental disabilities?

Contact Program Director of CAP Innovations at AssistedCare at 910-763-9933, to assist you with the referral process.

 

Can I transfer my private duty nursing services over to AssistedCare?

Medicaid Beneficiaries may change providers at any time, for any reason, with no risk of losing or reducing their approved services. Our clinical supervisor will visit you at home to complete an admission assessment, then communicate with both your current provider and your physician to gain approval for services through our agency.

 

Can I split my approved private duty nursing hours between different agencies?

Yes! Beneficiaries may divide their approved hours between up to three PDN providers.