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Home Health

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Related Guides on this Topic

You may also want to see these guides on related topics: Hospice and Palliative Care, Informal Caregiving, Long-Term Care

Introduction

A young, stay-at-home mother needs assistance and training in learning how to administer parenteral nutrition to her chronically ill baby.

A young child, recuperating at home after a serious illness, needs physical therapy. 

A teenager, with a terminal illness, is too sick to travel to his doctor to receive pain medication.

An elderly woman, living alone on a farm, needs assistance with her household tasks as well as a friendly face to talk to. 

According to the American Heritage Dictionary of the English Language, Home is defined as a place where one lives; an environment offering security and happiness; a valued place regarded as a refuge or place of origin; where one was born or has lived for a long period; comfortable and relaxed; at ease.

It's no wonder then that people of all ages want to recuperate or have their final days spent at home.

Home health care is for people of all ages, in cities and rural areas. Home health services range from helping the smallest baby to helping the elderly who choose to live independently in their own home.  Most people want to recover and rehabilitate from an illness or injury at home, where they have both comfort and security. 

Home health care is an essential part of health care today.  It encompasses a wide range of health and social services that may not easily or effectively be provided solely by family and friends.  Services range from highly skilled and technical nursing care to assistance with the essential activities of daily living. These services are delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment.

Frequently Asked Questions

Tools

Assisted Senior Living
Web site
Designed to help seniors and caregivers locate adequate care and senior living facilities. Site includes options to search by state and type of facility and provides resources for gathering more information on this topic.

Eldercare Locator: Community Assistance for Seniors
Database
Connects older Americans and their caregivers with sources of information on senior services. Links those who need assistance with state and local area agencies on aging and community-based organizations that serve older adults and their caregivers.
Sponsoring organization: Administration on Aging

Health Information Technology Toolkit for Home Health Agencies
Web site
Designed for use in implementing or overhauling a home health agency Health Information Technology (HIT) or Electronic Health Record system and to evaluate system effectiveness.
Sponsoring organization: Stratis Health

Home & Community Based Services
Web site
Assists states in improving the overall quality of services provided to Medicaid recipients, provides states with assessment and improvement systems, and helps develop effective methods to utilize implementation and improvement strategies. Allows states to request and provide homemaker/home health aide services, personal care services, adult day health, case management, and respite care.
Sponsoring organization: Centers for Medicare and Medicaid Services

Home Health Agency (HHA) Center
Web site
Provides information on the Home Health Care Initiative, coding and billing, policies and regulations, home health agency enrollment, manuals, resources, and contacts.
Sponsoring organization: Centers for Medicare and Medicaid Services

Home Health Care During an Influenza Pandemic: Issues and Resources
Web site
Provides information and resources to aid in and improve influenza pandemic planning and preparedness.
Sponsoring organization: Agency for Healthcare Research and Quality

Home Health Compare
Web site
Provides detailed information about Medicare-certified home health agencies in your area.
Sponsoring organization: Centers for Medicare and Medicaid Services

MedlinePlus: Home Care Services
Web site
Links to resources related to home health, including organizations, statistics, and publications.
Sponsoring organization: National Library of Medicine

Program of All-Inclusive Care for the Elderly (PACE)
Web site
Developed to address the needs of long-term care clients, providers, and payers. Permits loved ones to continue living at home while receiving services rather than being institutionalized.
Sponsoring organization: Centers for Medicare and Medicaid Services

Rural Health Research: Home health
Web site
Provides summaries of current and completed rural health research projects and related publications addressing the topic of home health, produced by the Office of Rural Health Policy's funded rural health research centers.
Sponsoring organization: Rural Health Research Gateway

Telemedicine Information Exchange: Home Telehealth
Web site
Provides articles, news, literature, and resources about home telehealth.
Sponsoring organization: Telemedicine Information Exchange

Funding

Grants for Native Americans and Native American Caregiver Support Program
Funding for programs to increase home and community based services to older Indians, Alaska Natives and native Hawaiians, which respond to local needs and are consistent with evidence-based prevention practices.

Inactive Funding

Inactive Funding Opportunities - Lists additional funding programs for this topic that are not currently accepting applications. Programs that are inactive may be offered again in the future.

Regulations, Forms & Other Useful Documents

Around the Country: Program Helps Frail Rural Elderly Live at Home
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Highlights the Rural PACE grant program and how it is helping providers meet the needs of seniors who want to live at home.
Journal citation: Rural Monitor Issue Fall
Date: 08 / 2008

Basic Statistics About Home Care
Sponsoring organization: National Association for Home Care and Hospice
Provides information on home health agencies, including Medicare certified agencies and hospices, Non-Medicare certified agencies, home care expenditures, and statistics and data.
Date: 2004

Code of Federal Regulations. 42 CFR 484: Conditions of Participation: Home Health Agencies
Sponsoring organization: U.S. Government Printing Office
Details the forms and other requirements for condition of participation for Home Health Agencies.
Date: 10 / 2008

Code of Federal Regulations. 42 CFR Parts 409, 424, and 484: Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2010; Final Rule.
Sponsoring organization: Centers for Medicare and Medicaid Services
Sets forth an update to the 60-day national episode rates and the national per-visit amounts under the Medicare prospective payment system for home health agencies. The first update of the home health prospective payment system (HH PPS) rates that uses the revised area labor market Metropolitan Statistical Area designations for calendar year 2010.
Date: 11 / 2009

Expanding Rural Elder Care Options: Models That Work
Author(s): Peter Fitzgerald, Andy Coburn, Sharon K. Dwyer
Sponsoring organization: National PACE Association
Relays proceedings from the 2008 Rural Long Term Care Access and Options Workshop, which discussed model options for home, community, and facility-based care by care coordination systems that enhance autonomy and quality of life for rural elders.
Date: 06 / 2009

Forgotten Population
Author(s): Zak Stambor
Sponsoring organization: American Psychological Association
Describes the use of telehealth and home-based health-care interventions to address a mental health crisis among elderly Americans in rural areas.
Journal citation: APA Monitor on Psychology Volume 37 Issue 10 Pages: 52-53
Date: 11 / 2006

Home Health Payment Reform: Trends in the Supply of Rural Agencies and Availability of Home-Based Skilled Services
Author(s): Janet P. Sutton
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Focuses on gaining an understanding of the factors that drive agency supply and service mix in order to understand how refinements to the payment system will affect home health access and quality.
Date: 03 / 2005

Home Health Services Taking Hold in Rural Areas
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Describes how the growth of home health services and related technological advances help people live in their rural homes.
Journal citation: Rural Monitor Volume 2009 Issue Winter
Date: 02 / 2009

Medicare & You: 2010
Sponsoring organization: Centers for Medicare and Medicaid Services
Highlights what's new, what's covered, health plans, prescription drug plans, and your rights.
Date: 09 / 2009

Medicare and Home Health Care
Sponsoring organization: Centers for Medicare and Medicaid Services
Explains how to find home health agencies, the Medicare Home Health Benefit, what Medicare covers, and where to get help with questions.
Date: 09 / 2007

Medicare Home Health Care in Rural America
Author(s): Sheila J. Franco
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Describes results of a study evaluating the degree to which Medicare beneficiaries received home health care from agencies outside of their county and the extent to which urban agencies served rural beneficiaries.
Date: 01 / 2004

Medicare Home Health: Payments to Freestanding Home Health Agencies More Than Covered Their Costs
Sponsoring organization: Government Accountability Office
Discusses an evaluation of Medicare payments to freestanding home health agencies (HHAs). Includes comparison of Medicare margins for urban and rural HHAs.
Date: 02 / 2004

Medicare Payment Basics: Home Health Care Services Payment System
Sponsoring organization: Medicare Payment Advisory Commission
Overview of Medicare payments for home health care services. Includes information on setting Medicare payment rates.
Date: 10 / 2008

Performance of Rural and Urban Home Health Agencies in Improving Patient Outcomes
Author(s): Janet P. Sutton
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Describes the results of a study to determine whether rural and urban home care agencies differ in terms of patient care outcomes, and to ascertain whether there are agency characteristics that are associated with better or worse outcomes.
Date: 05 / 2006

Rural Home Health Care Agencies Stretched to Provide Services
Author(s): Candi Helseth
Sponsoring organization: Rural Assistance Center
Addresses challenges many rural home health care agencies face in providing services. Identified challenges include high fuel costs, long travel distances in rural areas, and inadequate reimbursements from Medicare. Presents solutions to these challenges such as fundraising and telemedicine.
Journal citation: Rural Monitor Volume 2009 Issue Winter
Date: 02 / 2009

Rural Hospitals' Ability to Finance Inpatient, Skilled Nursing and Home Health Care
Author(s): Jeffrey Stensland, Ira Moscovic
Sponsoring organization: University of Minnesota Rural Health Research Center
Study investigates how rural hospitals are restructuring their operations in response to the Balanced Budget Act of 1997 (BBA), which reduce Medicare payments for inpatient, outpatient, skilled nursing care, and home health care. Discusses Critical Access Hospitals. Makes policy recommendations.
Date: 10 / 2001

Story of David Olds and the Nurse Home Visiting Program
Author(s): Andy Goodman
Sponsoring organization: Robert Wood Johnson Foundation
Discusses the Olds Model, a nurse home-visitation model developed in the 1970's, which has bloomed into the Nurse-Family Partnership, a nonprofit organization serving more than 20,000 mothers in 20 states. This project was designed to help low-income, first-time mothers take better care of themselves and their babies.
Date: 07 / 2006

Utilization of Home Health Services Among Rural Medicare Beneficiaries Before and After the PPS
Author(s): Janet P. Sutton
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Describes the results of a study on the rural effects of the Medicare prospective payment system (PPS), including whether the PPS contributed to changes in the demographic and clinical characteristics of home care users; the likelihood of using each of six home care disciplines; and the intensity of services.
Date: 08 / 2005

Organizations

Collaboration for Homecare Advances in Management and Practice (CHAMP)
National organization
National initiative to advance home care excellence for older people so that their chronic conditions may be better managed.

Home Care Technology Association of America (HCTAA)
National organization
Advocates to help increase the access to and use of technology in home and health care settings.

Meals on Wheels Association of America (MOWAA)
National organization
Works to bring meals to seniors in need including men and women who are elderly, homebound, disabled, frail, or at risk.

National Association for Home Care and Hospice (NAHC)
National organization
Represents the interests and concerns of home care agencies, hospices, and home care aide organizations. Works to make home care and hospice providers lives easier.

National Family Caregivers Association (NFCA)
National organization
Works to support, empower, and educate those who care for a chronically ill, aged, or disabled loved one. Provides guides and information for congregations and parishes on informal caregiving.

National Private Duty Association (NPDA)
National organization
Supplies information for providers of private duty home care, which includes non-medical home care services. Works to add strength and professionalism of private duty home care providers through education and best practices.

Visiting Nurse Associations of America (VNAA)
National organization
Serves as the official national association for not-for-profit, community based home health organizations. Created the profession of home health care more than 100 years ago. Works to bring compassionate, high-quality and cost-effective home care to individuals in their respective communities.

Terms & Acronyms

Approved Amount The fee Medicare sets as reasonable for a covered medical service. It may be less than the actual amount charged. Approved amount is sometimes called "approved charge."

Community-Based Services Services, such as meals on wheels and adult day care, designed to help people remain independent and in their own homes.

Durable Medical Equipment Medical equipment that is ordered by a doctor for use in the home. These items must be reusable, such as walkers, wheelchairs, or hospital beds.

Formal Care Care which is provided by a home health aide or homemaker arranged or supervised by a home care agency, or provided by a nurse or therapist.

Home Health Agency An organization that provides homecare services, including skilled nursing care, physical therapy, occupational therapy, speech therapy, and care by home health aides.

Home Health Aides Individuals who provide care to older adults or people with disabilities at home such as assistance with activities of daily living, managing medications, and some household tasks.

Home Health Care Skilled nursing care and certain other health care that you get in your home for the treatment of an illness or injury.

Homebound Those who are unable to leave home. A person may leave home for medical treatment or short, infrequent absences for nonmedical reasons.

Medicare Part A Hospital insurance that helps pay for inpatient hospital care, limited skilled nursing care, hospice care, and some home health care. Most people get Medicare Part A automatically when they turn 65.

Medicare Part B Medical insurance that helps pay for doctors' services, outpatient hospital care, and some other medical services that Part A does not cover (like some home health care). Part B helps pay for these covered services and supplies when they are medically necessary. A monthly premium must be paid to receive Part B.

Out-of-Pocket Costs Health care costs that you must pay on your own because they are not covered by Medicare.

Plan Of Care A plan written by your doctor that describes what kind of services and care you must receive for your health problem.

Provider A doctor, hospital, health care professional, or health care facility.

Regional Home Health Intermediaries A private company that contracts with Medicare to process claims and make checks of home health care.

Skilled Nursing Care A level of care that must be given or supervised by licensed nurses and is under the general direction of a doctor. All of your needs are taken care of with this type of service, including giving direct services.

Contacts

For questions about CMS regulations:
CMS Regional Rural Representatives

To find home health agency in your area:
Listing of state home health associations

Article Searches & Bibliographies

RAC Documents Search: Home Health Care

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Page last updated 8/30/2010
Topic last reviewed 12/31/2009

About this Page
Credits

Thanks goes to:

Bob Wardwell, formerly with
Visiting Nurse Associations of America

Maintained by:
Aubrey Madler
aubrey@raconline.org



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