Physician's FAQ

What is home health?

Skilled nursing, therapy services, social work, and home health aide care provided to your patients in the home. When appropriate, patients are connected with local community resources.

Can home health care be an advantage to me?

Twenty-four hour on-call service is provided by the home health agency, saving the physician many night calls. Emergency visits are done with a timely report made to the doctor of the patient's condition. It is satisfying to know that the patient is receiving frequent attention for an unstable condition when it would be very difficult to come to the office.

What kind of things can be done in the patient's home?

Skilled Nurse:

• Assess blood pressure pulse, and respirator status
• Assess nutrition, hydration, bowel and bladder function
• Assess and teach medication regime and response to medications
• Diabetic teaching, check glucose levels and administer insulin
• Dietary teaching
• Wound care - dressing changes
• Catheter care/changes urethral or suprapubic
• Colostomy / ileostomy care
• Bowel care - impaction removal
• Draw blood samples venous arterial
• IV therapy, continuous antibiotics/TPN internal feedings
• Chest percussions, pain and symptom management

Physical Therapist:

• Gait training
• Bed mobility transfers
• Strengthening and therapeutic exercises
• Assess home environment for possible need of DME

Speech Therapist:

• Language and communication retraining
• Dysphagia

Occupational Therapist:

• ADL retraining - dressing, eating, use of special equipment

Medical Social Worker:

• Social services
• Financial/emotional counseling
• Facilitate community resources

Home Health Aide:

• Bathing
• Dressing
• Oral and hair care
• Catheter care

What are some problems my patients may have that would help me recognize the need for home care?

• Any patient who has difficulty leaving home without assistance and:
• Has a severe exacerbation of an illness
• Has a diagnosis of a new illness
• Was just placed on new medications
• Has fluctuating blood pressure
• Is an unstable diabetic
• Has any condition that is not responding to treatment
• Is a patient you suspect may not be taking medications or following a diet properly
• Is a patient and/or a family who is calling your office frequently with many concerns
• Is a patient who has been discharged from the hospital or extended care facility with new instructions for care
• Is a patient who is coming home after fractured hips, THR, TKR, CVA. Even if he/she has been in a nursing home, Medicare will pay for a patient to readjust to the home setting and continue a therapy treatment plan alter returning home
• Is a patient with wounds, decubiti, diabetes, or venous statis ulcers that are not healing or are frequently infected
• Is a patient who needs periodic blood work - pro-times, FBS's

Will I be informed of my patient's condition?

Yes. You will be informed immediately of any significant changes in your patient's condition. Telephone calls are made to you for orders and instructions. Written letters of progress are sent to your office on a regular basis. Orders are renewed in writing every sixty days.

What paperwork is involved?

Orders are prepared by the agency, sent to you for your signature, and then submitted to Medicare or other insurance agencies for payment.

Who pays for home care?

Medicare is the largest payer of home care services and can pay 100% if a patient is eligible. Medicaid also reimburses for home care. Nearly all private insurance companies have some home care coverage. Patients may be billed by private companies for the difference between charges and the amount covered by the policy.

How do I know if my patient is eligible?

Legacy Home Care will assess any patient and research eligibility status. Just CALL our office: Legacy Home Health (208) 888-3669 Fax (208) 888-3675

Can my patient receive home care with out a recent hospitalization?

Hospitalization is not necessary to qualify. A phone call from your office to the agency of your choice is all that is necessary. A new diagnosis or change in condition can qualify a patient for skilled care.

What are some guidelines specific to Medicare?

• The patient must he homebound. Medicare defines a homebound patient as one who requires considerable effort and assistance to leave home.
• Care must be medically reasonable, necessary and ordered by an MD.
• The patient must require skilled care.
• Care must be intermittent.

How often can a home care nurse visit my patients?

Frequency of visits depends on the acuteness of the condition and the care needed. Under Medicare, visits can be made up to QID to provide IV antibiotics, BID for dressing changes, QD for insulin administration, 2-3 times a week to teach and assess, once a month for pro-time or catheter changes, or every sixty days for FBS. Home health aide services are usually provided three times a week but can be more often in some cases. Medicare regulations allow an aide to visit daily, or as needed, according to the level of personal care required.

Is hospice a covered benefit?

It is for many insurance companies. In addition to skilled nursing services, hospice provides volunteers, bereavement and pastoral care. Details can he provided by your home health agency.

Is mental illness a diagnosis that can be assisted through home care?

Yes, if the services are ordered by a psychiatrist and provided by a nurse with a psychiatric background. Medication compliance, assessment for side effects, toxicity etc. are skilled services that qualify for reimbursement.

What if my patient is assessed and does not qualify for home care?

Legacy Home Care's referral staff will help your patient find an alternative type of care or assistance at no charge.