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
Strives 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.
Health Information Technology Toolkit for Home Health Agencies
Web site
Designed for use in implementing or overhauling a home health agency Health Information Technology or Electronic Health Record system and to evaluate system effectiveness.
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.
Home Health Agency Center (HHA)
Web site
Provides information on the Home Health Care Initiative, coding and billing, policies and regulations, home health agency enrollment, manuals, resources, and contacts.
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.
Home Health Compare
Web site
Provides detailed information about Medicare-certified home health agencies in your area.
MedlinePlus: Home Health Services
Web site
Links to resources related to home health, including organizations, statistics, and publications.
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.
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.
Telemedicine Information Exchange: Home Telehealth
Web site
Provides articles, news, literature, and resources about home telehealth.
Funding
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
Details the forms and other requirements for condition of participation for Home Health Agencies.
Date: 1999
Code of Federal Regulations. 42 CFR 484: Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2006; 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 2006.
Date: 11 / 2005
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 Issue Winter
Date: 02 / 2009
Medicare & You: 2008
Sponsoring organization: Centers for Medicare and Medicaid Services
Highlights what's new, what's covered, health plans, prescription drug plans, and your rights.
Date: 01 / 2008
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 you can get help with questions.
Date: 2006
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 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.
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.
Success Stories
Children's Outreach Program
This program conducted home visits to families with newborns within a few days after the mother’s return home through a consortium consisting of nine hospitals and two public health/social service agencies.
Source: The Outreach Sourcebook, Vol. 7, 1997-2000, Promoting Rural Health
Creating Healthy Adolescents-A Model Prevention Project (CHAMP)
CHAMP’s primary goal was to develop a new foster-homebased health service model designed to reduce substance abuse among adolescents in State custody.
Source: The Outreach Sourcebook, Vol. 7, 1997-2000, Promoting Rural Health
Delmarva Rural Ministries, Inc.
Through an Outreach grant a Community Health Center was created to provide comprehensive primary care health care services to persons in central Delaware who lacked a medical home and were uninsured or underinsured.
Source: The Outreach Sourcebook, Vol. 7, 1997-2000, Promoting Rural Health
Harlan County Homeplace
The majority of the services provided with grant funds included affordable medication; free or low-cost primary health care; vision services; dental care; and assistance in meeting basic needs, such as food, clothing, and shelter.
Source: The Outreach Sourcebook, Vol. 6, 1996-1999, Office of Rural Health Policy
Health Care Network of Park County, Colorado
Park County, CO is a sparsely populated county with both primary care facilities in Fairplay, which is on the western edge of the county. The county offered no hospitals, nursing homes, home health care agencies, or assisted living facilities, so the Health Care Network of Park County was developed.
Source: The Network Sourcebook, Volume 1: Rural Health Demonstration Projects, 1997-2000.
Maximizing Independence of Rural Elderly Through Use of Assistive Technology and Access to Health Care Services
Five organizations joined together to address the health care needs of the aging rural Iowa population by providing assistive technologies and home modifications, increasing access to primary health care and rehabilitative therapies, and educating rural elderly and health care workers to help identify potential hazards in homes.
Source: The Outreach Sourcebook, Vol. 9, 1999-2002, Office of Rural Health Policy
On Different Ground
The program served adults older than 60 years, tribal adults older than 55, and disabled adults older than 18 who were unable to seek traditional services and required in-home substance abuse and mental health counseling, support, or treatment.
Source: The Outreach Sourcebook, Vol. 6, 1996-1999, Office of Rural Health Policy
Project SCOUT
Project SCOUT was created to provide basic health care; referrals to health, social, and human services; provider training; health promotion and disease prevention education; in-home parenting education; and prenatal care to expectant mothers or well-baby care to at-risk families with infants.
Source: The Outreach Sourcebook, Vol. 6, 1996-1999, Office of Rural Health Policy
Rural Health Outreach Elder Care Project
Targeted to adults aged 65 and older living in a six county area, the goal of the program was to enable older adults to remain independent in their own homes and prevent premature institutionalization and repetitive hospitalizations.
Source: The Outreach Sourcebook, Vol. 7, 1997-2000, Promoting Rural Health
St. Thomas More Hospital Rural Health Outreach Demonstration Program
Because Fremont County, Colorado, has a higher than average population of individuals over age 65 as compared to other counties in the state, this outreach project has focused on the needs of the homebound elderly.
Source: The Outreach Sourcebook, Vol. 4, 1994-1997, Office of Rural Health Policy
Vector Control and Prevention Program
This program was designed to educate individuals and communities about the steps they can take to prevent vector borne diseases, and to help control future outbreaks that may jeopardize the health of those who call Palau home.
Source: The Outreach Sourcebook, Vol. 9, 1999-2002, Office of Rural Health Policy
Williamsburg School Health Improvement Project
Three consortium members joined forces to refer students without primary health care to primary care physicians; conduct health screening procedures by a school nurse; provide early periodic screening, diagnosis, and testing services to eligible students enrolled in grades kindergarten through sixth; provide hospitalization intervention for ambulatory-sensitive conditions in children under age 18; conduct health promotion sessions for the 13 county schools; provide counseling intervention services for substance abuse, child abuse, reproductive issues, and violence in each of the 13 county schools; and conduct home visits to provide family support services to families of school students in the 13 local schools.
Source: The Outreach Sourcebook, Vol. 9, 1999-2002, Office of Rural Health Policy
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