What is home health?

Home health or home health care means clinical and medical supervision provided to patients in their homes by skilled medical professionals. Home health care includes a wide variety of services as needed by the patient provided by licensed health care professionals such as physicians, registered nurses, physical therapists, speech-language pathologists, occupational therapists, dieticians, medical social workers, respiratory therapists, wound care specialists and certified home health aides. All members of a home health care team have important roles to play and come together to make and follow a specialized care plan for the patient. Home health care also includes non-medical care such as help with daily living activities by skilled home health aides and medical social services. These home health services are most often provided by medical professionals through home health agencies or hospice agencies and are usually prescribed by a doctor after hospitalization or injury as a part of their health care regimen.

Types of home health services

There is a limitless range of home health services a patient can receive. These services are provided by health care professions according to the individualized care plan determined by the primary medical care provider. These home health services include:

Some other services provided by home health care agencies include wound care for surgical wounds or pressure sores, patient and caregiver education, and monitoring the health status of the patient.

How to get home health services

Home health care services are provided through licensed or certified home health agencies to a home or community-based setting and follow a written and individualized care plan formed by a licensed primary medical care provider. It is essential that home health services must be prescribed and performed by licensed medical professionals. Home health and community support service agencies must obtain licensure and certification by the Texas Health and Human Services in order to comply with the state and federal laws and regulations. Through these regulations, the HHS protects the citizens of Texas who are receiving these services. A limitation is that the provision of home health care is only for clients that are homebound and do not include nursing facilities or inpatient mental health/substance abuse facilities. It also excludes personal care and non-licensed home care providers.

The process usually begins when the primary health care provider deems home health services necessary for the patient and refers them to a home health agency. Then a preliminary assessment is conducted that decides which services are needed by the patient and the perceived barriers in the provision of services or medical care. The client will be contacted within 1-2 business days of referral and the services should begin at the time specified by the primary care provider. A comprehensive evaluation of the patient is also carried out which includes their health, psychosocial status, functional status, home environment, adherence to therapies, disease progression, symptom management, and prevention and the need for nursing services. A care plan designed by the primary medical care provider will be implemented by the home health agency which includes, current condition and needs of the patient and the types, quantity, and length of home health services needed. Care providers mostly update the plan of treatment at least every 60 days.

In Texas, Medicaid covers all home health services under its program. If the doctor deems nursing or therapy services essential for the patient’s care plan then Medicaid will cover the expenses. As the Medicaid funded home health services are related to a specific disease or condition, they are mostly offered for a short term and Medicaid reviews the patient’s need for home health care every 60 days. Individuals must meet both state and federal regulations to receive these services under Medicaid.

Who can benefit from this?

Due to the steady increase in the elderly population within the United States, many of whom cannot take care of themselves and have numerous health problems, an increasing number of people are opting for home health services. Another important reason for this is that medical care in hospitals and nursing homes is much more expensive when compared to home health services. Additionally, the patients can stay in the comfort of their homes where they are in a familiar environment and often surrounded by their families. Some family members might not be able to give the attention and care that these patients need due to several reasons such as if they work away from home or if the patient requires treatment that is beyond their expertise. In this case, the families may get relief from the physical and emotional stress that accompanies caregiving. Thus, home health care is usually a cheaper and more convenient option that is just as effective as care in a hospital or nursing facility. Home health care is useful for:

References

  1. Gray SL, Mahoney JE, Blough DK. Medication adherence in elderly patients receiving home health services following hospital discharge. Annals of Pharmacotherapy. 2001 May;35(5):539-45.
  2. Kenney G, Rajan S. Understanding dual enrollees’ use of Medicare home health services: the effects of differences in Medicaid home care programs. Medical Care. 2000 Jan 1;38(1):90-8.
  3. Welch HG, Wennberg DE, Welch WP. The use of Medicare home health care services. New England Journal of Medicine. 1996 Aug 1;335(5):324-9.
  4. Penrod JD, Kane RL, Finch MD, Kane RA. Effects of post-hospital Medicare home health and informal care on patient functional status. Health Services Research. 1998 Aug;33(3 Pt 1):513.

 

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