As a caregiver, making the decision to hire a home health care worker or agency comes with not only a sense of relief but also with a sense of worry.
The relief comes in the fact that there will someone with your aging parents from time-to-time to assist them in the daily tasks that they need to as they get older.
The worry…are they doing the right things by your parents?
So I am going to talk about hiring a home health care worker from a few different perspectives…
First, how to make sure you are hiring the right person or agency. Secondly, how do you go about paying for these services…including whether or not the government through Medicare will pay for these services. And finally, I will wrap up with a look at some of the local resources that may be available to you.
Hiring A Home Health Care Worker/Agency
There are a few options that you have in order to find a home health care worker. The first is to seek out a list of reputable organizations that are approved by Medicare…
What you would do is go to the Medicare home health comparison tool and you will see…
Just plug in your zip code and hit the submit button and you will receive a list of all of the Medicare home health care agencies in your area.
For the purposes of this example, I typed in my zip code and when I submitted the search I saw this…
The image above shows the listing of the first three home health care facilities as well as the check-marks indicating the types of services that each home health care agency offers. Those services are…
- Nursing care-Care given or supervised by Registered Nurses. Nurses provide direct care; manage, observe, and evaluate a patient’s care; and teach the patient and his or her family caregiver.
- Physical therapy-Treatment of injury and disease by mechanical means, such as heat, light, exercise, and massage.
- Occupational therapy-Services given to help you return to usual activities (such as bathing, preparing meals, and housekeeping) after illness either on an inpatient or outpatient basis.
- Speech therapy-This is the study of communication problems. Speech therapists assist with problems involving speech, language, and swallowing. Communication problems can be present at birth or develop after an injury or illness, such as a stroke.
- Medical social services-Services to help you with social and emotional concerns related to your illness. This might include counseling or help in finding resources in your community.
- Home Health Aide-Services to help you with daily living activities (such as getting up, bathing, getting dressed, and making a meal).
From here, you also have the ability to compare individual agencies. You can select up to three at a time to compare, which will tell you whether an individual agency is owned privately, state-operated or a religious affiliation and when the agency was certified by Medicare.
But the really important information is in other two tabs, which I have highlighted with the orange rectangle. These two tabs show you…
1) The quality of patient care-charts and graphs are there for you to see how this particular agency compares to state averages in 22 separate indices such as…
- How often patients got better at walking or moving around.
- How often the home health team treated their patients’ pain.
- How often the home health team checked patients for the risk of developing pressure sores (bed sores).
2) The results of patient surveys, so you can see how their clients felt about their services.
Therefore, the Medicare comparison tool outlined above is a great way to hire a home health care aid.
Are there others? Yes, especially if you are looking for limited services a few days a week, such as helping with housekeeping or the occasional bath or meal preparation. The one that I think people use the most is to find a registered nurse and pay them off the books.
This type of arrangement works well, especially if you know the nurse. For example, this was something my brother and I utilized for a time. The way we found the nurse was that she was someone who worked in the hospital treating my mother.
Mom and the nurse hit it off and had a great rapport, so it was natural for us advantage of this.
This was before Mom’s heart attack so at the time her needs were not extensive. As a result, paying a part-time home care aide to come in 1-2 days a week for a an hour or two each time isn’t a big deal.
However, it was a solution that would be out of the question now if Mom was to ever come home after the nursing home stay as her needs would be FAR more extensive, and we would need a more established agency.
Medicare Home Health Care
Of course these services and the load they can take off of your mind are great, but the question becomes…how do you pay for all of this? And that really leads to, “Does Medicare pay for a home health care aid?”
Medicare does list its eligibility requirements for home health care and what services it will provide 1. I am going to summarize it below. If you have Medicare currently they will pay for home health care if…
—Your doctor certifies, through a certificate of medical necessity, that you need at least one of the following services…
- Intermittent skilled nursing care (Medicare will not pay for home health care if you more than “Intermittent” or part-time care)
- Physical therapy
- Speech-language pathology services
- Occupational therapy
—The home health care agency is certified by Medicare (using the Medicare home health care comparison tool outlined above will take care of this).
—The person receiving the aid must be certified by a doctor to be home bound. And this means…
- Leaving home is not recommended because of your condition
- You require special assistance from a walker, wheelchair, special transportation or another to be able to leave your home
What Does Medicare Cover
Medicare home health care coverage is for the six services that were laid out above…
- Nursing care
- Physical therapy
- Occupational therapy
- Speech therapy
- Medical social services
- Home Health Aide
But there are certain services that are not paid for by Medicare…
- 24 hour a day care (Remember, Medicare covers intermittent home health care only)
- Meal deliveries to your home (but I will discuss this in the section below)
- Typical house cleaning services, like laundry, cooking, cleaning and food shopping if these are the only types of services you need. Also, personal care like washing, toileting and showering are not covered when these services are the only services you need
What Does Medicare Pay For And What Do You Have To Pay For
This is THE question you must ask before making the final decision to hire a home health care agency.
However, Medicare will typically for 80% of the costs of Medicare-covered services and any “durable medical equipment” such as a walker or oxygen tanks that are required for your care.
As for the remaining 20% of the bill, you will need to either pay that out-of-pocket or through a Medicare Supplemental Insurance Plan if you own one, which will pay the remaining 20% of the costs.
Finally, I want to wrap things up by taking to you about some local charities and government agencies that may be able to help you with some of the things that a Medicare home health care agency won’t be able to, like meal delivery and things like that.
The nationally-based charity will provide delivery of a hot meal to those who need. So, if you fit into the category of those who need help with meal preparation but this is the only service they require, meaning that Medicare won’t cover it, then Meals-on-Wheels is one place to look for help.
All you have to do is visit their website input your zip code and you will be directed to the nearest office to call and set up deliveries.
Peapod is an online grocery website for those who don’t want to go food shopping. You submit your order online and then your groceries are delivered to you.
There is a small service fee, from $7-$10 typically, depending upon where you live but for those who cannot get out Peapod is a terrific resource to allow them to receive their groceries without going out.
Office of the Aging
The services will vary depending upon where you live, but I have found that contacting your local Office of the Aging to inquire what type of services they have available could be a life saver. They offer everything from senior day care centers, volunteers who offer respite care to caregivers, free transportation to doctors visits, etc…
You won’t know the help you can get until you make the call.
To find your local Office of the Aging, you can either do a quick internet search ( a Google search for “_________ County Office of the Aging” will find it) or you can check the blue pages of your telephone book.