Physicians And Discharge Planners - Referrals For Skilled Services
Too often, home health care is misunderstood as being just for older people. While The Homemakers does provide services to older and disabled persons, we also provide visiting nurse, physicial and occupational services to adults of all ages - adults recovering from accident, surgery or joint replacements as well as persons those with chronic illesses.
For more than 41 years, The Homemakers Health Services has been providing services in the community to bridge the gap between release from the hospital to recovery at home.
Our professional health care team provides state-of-the art nursing, IV therapy, wound care, physical and occupational therapy, home health aide and medical social work services.
The Agency's commitment to providing the best possible care is evidenced by the fact that The Homemakers has once again earned the distinction of being named to the 2015 HomeCare Elite Top 500 Agency, a compilation of the most successful Medicare-certified home health care providers in the United States. This annual review identifies the top 25 percent of agencies, ranked by an analysis of performance measures in quality outcomes, quality improvement and financial performance.
The professional staff of The Homemakers Health Services is available to take patient referrals for nursing, physical and occupational therapies and other home health care services 24 hours a day, seven days a week. While the office is open from 8 a.m. to 4:30 p.m. Monday through Friday, a nurse is always on-call to take referrals from hospitals, rehabilitation facilities, physicians and individuals interested in obtaining any of these services for themselves, friends or loved ones. Simply call (603) 335-1770.
The Homemakers is Medicare/Medicaid certified and also accepts several insurances including Blue Cross Blue Shield, Harvard Pilgim and Martin's Point, as well as long term care insurances. Personal financial arrangements may also be made for services.
Skilled Home Health Care Qualifying Criteria For Medicare
To meet Medicare guidelines for Skilled Home Care services from The Homemakers Health Services, each of the following four criteria must be met:
1. The patient must be homebound.
2. A MD, DO or Podiatrist must order care.
3. The patient must require part-time or intermittent care (limited restricted daily benefit).
4. The patient must need at least one service that requires the skills of a licensed nurse, physical therapist or occupational therapist.
Physicians should also note that in accordance with the Patient Protection Affordable Care Act, CMS issued a Final Regulation that goes into effect January 1, 2011 whereby Medicare will pay for home health services only when a physician certifies in the home health plan of care that the patient has had a face-to-face encounter with their physician in the 90 days prior to or within 30 days of the start of services. The primary reason for home health services must be addressed during this encounter.
If a physician works in collaboration with a nurse practitioner or clinical nurse specialist, or supervise a physician's assistant, the face-to-face encounter may be carried out by that non-physician practitioner who must have documented their clinical findings and communicated those findings to you. However, only a physician may order home health services, certify that a face-to-face encounter occurred, and certify that other eligibility criteria are met (medical necessity and homebound status).
The face-to-face encounter must be:
- Made by the physician responsible for certifying home health (or non-physician practitioner as described above)
- Related to the primary reason for which the patient requires home health services
- Made within 90 days prior to, or within 30 days of, the start of home health.
The encounter must be documented on the home health plan of care, or an addendum to that plan of care. Documentation of the certification of a face-to-face encounter must include:
- The date of the encounter
- Indication that the encounter was related to the primary reason for home health
- An explanation of how the clinical findings of the encounter support the need for skilled nursing or therapy services.
- An explanation of why the clinical findings of the encounter support that the patient is homebound
- Your signature and the date of that signature.
The Homemakers Health Services also provides Medicare-eligible home health aide and medical social worker services in conunction with nursing, physical therapy or occupational therapy services.
The following checklist has been developed to serve as a guide to help you determine whether or not a patient is eligible to receive skilled home health care services. Patients may be eligible for covered home care services when any of the following apply to them:
1. Have a complex medical need such as: a new diagnosis, exacerbation of an existing illness (COPD, CHF, Diabetes), home infusion therapy, multiple diagnoses or pain management.
2. Are at risk for problems due to, a history of falls, new, multiple or changed medication. Poor understanding of diseases and symptoms to report to MD.
3. Require skilled nursing nursing treatment at home, such as: catheter care and routine changes, intravenous line care and maintenance, dressing changes for wound care, enteral feedings and tube care, ostomy care and assisted teaching relating to all of the above, as well as many other medical conditions.
4. Recently had surgery or a long hospitalization, and: are at risk for complications of infection, are concerned about safety at home, need instruction in symptoms to report to MD; need physical or occupational therapy to progress to previous level of function, need prosthetic and adaptive equipment training, need initial assessment and monitoring at home.
The Agency must determine whether services can be delivered safely at home. Some conditions that affect safety, and therefore eligibility for home health care are:
1. The patient cannot walk or transfer safely and will be home alone.
2. The patient requires 24-hour care and or supervision and has no adequate caregiver.
3. The patient exhibits behavior that would place him/herself or a provider at risk.
Referrals For Home Support And Adult Day Care Services
Adults in need of home support (homemaker, in-home care provider and companions) and or adult day care services do not have to meet the above criteria.
If you or a loved one are in need of home support or adult day care services, please call us at (603) 335-1770. One of our case managers is always available to discuss your needs and assist you in receiving just the right care you need, when you need it.