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Home Health and Hospice Care: Choosing a Provider

Choosing a provider:

Finding appropriate home health and hospice care providers requires some research. You will need to consult with your physician to evaluate your home health or hospice care needs. When looking for a provider, consider the following:

• quality of care
• availability of services
• personnel training and expertise
• payer coverage

Who provides home health and hospice care services?

Home health and hospice care can be provided by many different types of organizations, agencies, companies, and individuals. Choosing the service that is right for your family requires some research. Some of the more common types of providers are:

• home health agencies
  More than 20,000 home health agencies exist in the US today. Some home health care agencies are Medicare certified (which means they have met federal minimum requirements). Home health agencies may offer a wide range of services, including physician care, or may just offer a few services, such as basic nursing care. Most home health agencies assemble a care team for the patient based on his or her needs. Because home health agencies are responsible for their personnel, they assume liability for all care. Home health agencies are usually available 24 hours a day, seven days a week.
  
• homemaker and home care aide agencies
  Homemaker and home care aide agencies provide patients with the day-to-day care in the home, such as cooking meals, bathing, and dressing the patient, cleaning the house, and providing companionship. Some agencies are licensed, depending on state requirements.
  
• pharmaceutical and infusion therapy companies
  Pharmaceutical and infusion therapy companies provide patients with drugs, equipment, and training to administer drugs and feedings in the home. Sometimes a pharmaceutical and infusion therapy company is also a Medicare-certified home health agency.
  
• durable medical equipment and supply dealers
  Like pharmaceutical and infusion therapy companies, durable medical equipment and supply dealers provide equipment to the patient at home. Equipment may include respirators, wheelchairs, walkers, catheters, and more. The equipment is often delivered to the home and installed if necessary. If the patient requires it, the company may also train the patient and family to use the equipment. Some companies are licensed, depending on state requirements.
  
• staffing registries and private duty agencies
  Staffing registries, or private duty agencies, are employment agencies for home health care workers. Workers are matched up with patients depending on need, such as nursing, homemaker, home care aide, or companionship. Usually the agency receives a "finder's fee."
  
• independent providers
  Health care workers can also be hired outside of any agency. The patient can privately employ nurses, homemakers, companions, or other professionals. The hiring, supervision, and payment of these health care workers are the responsibility of the patient and family.

Evaluating the quality of a provider:

When evaluating the quality of a provider, you may encounter the following terms:

• Licensure - Some states require providers to have licenses to operate. Basic legal and operating requirements mandated by the state must be met to obtain a license.

• Bonding - A bond is a type of insurance policy for a provider. To become "bonded," a provider must pay a set amount. The bond protects the provider from bankruptcy in the event of a lawsuit by a consumer.

• Certification - State certification by state health departments makes a home health or hospice care provider eligible for Medicare (and sometimes Medicaid) payments. To become certified, a provider must meet basic federal and state standards in patient care and financial management.

Certified health care professionals are certified by their respective national organizations. The certification usually requires passing a national test and/or work experience.

• Accreditation - Nationally recognized accrediting organizations evaluate and accredit quality health care services. A provider must voluntarily seek out this accreditation. Some organizations who accredit home health care include:
  
  
  • Accreditation Commission for Home Care, Inc.
  • Community Health Accreditation Program
  • Joint Commission on Accreditation of Healthcare Organizations
  • National Committee for Quality Assurance
  • National Home Caring Council

Questions to ask when choosing a provider:

When choosing a provider, consider asking the following questions:

• How many years has the provider been serving the community?
• Does the provider have literature describing its services, cost, and funding?
• Is an evaluation of the patient's home health care needs required?
• Is there a written plan of care for the patient?
• When are caregivers available?
• Is there a nursing supervisor on-call 24 hours a day?
• Can the provider ensure patient confidentiality?
• How is quality of care and services monitored?
• What types of payments are accepted?