| Q. Where do I report if i have any concerns regarding Patient care? | |
| A. Any concerns about patient care can be reported to
JCAHO at (800) 994-6610. | |
| Q. How do I qualify for home health care and have Medicare pay for it? | |
| A. In order to qualify for home health and have medicare pay for it, you must be considered homebound, be under the care of a physician and require a skilled service. | |
| Q. What does homebound mean? | |
| A. The patient is homebound if he/she experiences a normal inability to leave home. The patient's physical condition and/or physical limitations are such that it would be a considerable and taxing effort for the patient to leave home. | |
| Determination of homebound status depends on the illness or limitations of the patient. The need for supportive devices for assistance alone does not necessarily render the patient homebound. | |
| Homebound status is not affected by frequent absences from the home when the reason is to receive medical treatment. | |
| The patient is allowed brief and infrequent absences from the home for non-medical reasons, such as barber/beauty shop, to attend church, etc. However, these absences should be infrequent and of short duration. | |
| Q. Can I go to Church on Sunday and still be considered homebound? | |
| A. Yes. Medicare recently changed the definition of homebound to allow patients to go to Church on Sunday. However, you would still need to meet the above requirements for homebound status. | |
| Q. Do I have to pay anything if I have Medicare? | |
| A. If you qualify for home health through Medicare, you will not have to pay anything. Medicare pays for the care. There is no deductible or out of pocket expense. | |
| Q. If I don't qualify for Medicare to pay for home health, can I still have it? | |
| A. Yes. If your physician orders home health and you do not qualify under Medicare guidelines, you may pay for the services yourself. Call us for a fee schedule. | |
| Q. How often will you come see me? | |
| A. At the time of admission to the service, an RN will assess your condition and needs and will set up a plan of care with you. The RN will discuss the frequency of visits with you and will also discuss expectations at that time. | |
| Q. What does Home Health Aide do? | |
| A. The primary function of a home health aide is to perform personal care, such as bathing, dressing, grooming, caring for hair, nails and oral hygiene. The aide spends anywhere from 45 minutes to 1 hour in the home. Once the personal care pis complete, the aide may also perform other duties for the patient. | |
| The aide may straighten the bedroom, clean the bathroom, change the bed linens, or fix a snack for the patient. The aide does not perform spring-cleaning, sweep and mop floors, vaccum etc. These duties are the duties of a provider, not an aide. | |
| Q. MEDICARE AT A GLANCE (Coverage Highlights) | |
|
Type of Care
|
Time limits
|
You Pay
|
Medicare Pays
|
Eligibility
|
Not Covered
|
| Hospital Inpatient including semiprivate room,meals and regular nursing services |
First 60 Days Day 61-90 |
First 60 days: $840 Deductible Days 61 - 90 |
Balance |
Over 65:Eligible for Social Security Under 65:Certain |
Private Rooms, Private Nurses, Doctor's Visit Services |
| Lifetime Reserve |
Lifetime limit of 60 days |
$420 co-payment per day |
Balance |
Same as for Hospital Inpatient Care |
Same as for Hospital Inpatient Care |
| Skilled Nursing Care Facilities: certified by Medicare such as THI Health and rehabilitation Centers. |
Frist 60 Days Days 21 - 100 |
First 20 Days: Nothing Days 21-100 $105 per day |
First 20 Days: 100% Days 21-100 Balance |
Must be an extension of at least 3 days of hospital inpatient care and authorized by a physician |
Same as for Hospital Inpatient Care including personal convenience items |
| Home Health Care performed by nurses, therapists and home health aides |
Intermittent care recertified every 60 days by physician |
No co-payment |
100% |
Homebound authorized by your physician |
Full-time, Long term nursing care at home, drugs, meals and homemaker services |
| Inpatient Psychiatric Hospital Care |
Lifetime limit of 190 Days Days 21 - 100 |
Same as for Hospital Inpatient Care |
Balance |
Same as for Hospital Inpatient Care |
Same as for Hospital Inpatient Care |
| Hospice Care performed by nurses, therapists and home health aides |
Unlimited |
5% Copay (upto $5) each prescription related to terminal illness. Respite Care: 5% of Respite Care |
Balance |
Certified by physician as terminally ill. |
Treatments other than pain relief and symptom management of terminal illness |
|
