Home Health Agencies
Home Healthcare Explained
Home health agencies provide skilled medical care in your home. Doctors prescribe home healthcare when someone needs help recovering from surgery, an accident, or a serious illness. Home healthcare is a great option when your loved one is not ill enough to be in a hospital but is not yet well enough to be home alone. Home healthcare agencies are licensed by the state and must also adhere to federal regulations.
Home health agency nurses do some of the work that doctors used to do when they made house calls: They administer medications, change dressings, manage catheters and intravenous lines, give injections, and provide other skilled care. Therapists assist patients with recovery and help them safely regain mobility. The nurses and therapists can also teach patients and family caregivers how to perform many of these tasks. Less skilled workers, such as certified nursing assistants (CNAs) and home health aides, also help with care under the supervision of an agency nurse.
Note: Home healthcare, which is short-term medical care, is different from in-home care, which is short- or long-term personal assistance but not medical care. Sometimes the same agency can provide both types of care.
Jump to: Cost of home healthcare | What certified nursing aides do | What physical therapists or occupational therapists do | What speech therapists do | What visiting nurses do | Home healthcare plan | How to find home healthcare
In most cases, home health care agencies are not set up to provide fee-for-service; they offer services that are reimbursed by Medicare or other insurance. If they do charge fee-for-service, Home healthcare costs range from $15 to $75 per hour, depending on the training and expertise of the specific healthcare worker who comes to your home. Nurses and physical therapists are more expensive; home health aides charge less.
When your loved one is recovering from surgery, accident, or illness and home healthcare is prescribed by a doctor, it's generally covered by Medicare. Here's the tricky part: Medicare provides coverage for a specific ailment. Once recovery from that ailment is complete, Medicare coverage ends. And Medicare coverage also ends if your loved one ceases to make progress in recovery efforts.
When home healthcare is not covered by Medicare, you can explore additional options, such as veterans benefits, Medigap, Medicaid, long-term care insurance, or private pay. Learn more about How to Pay for Home Healthcare.
Also called: CNA, home health aide, certified nursing assistant, certified nurse aide
A certified nurse aide is a caregiver who will come to your home to provide medical care. Home health aides and CNAs may also help with other day-to-day care needs, such as bathing, dressing, light housekeeping, or meal preparation.
Generally, home health aides and certified nurse aides have undergone formal training and certification. They can administer medications, and many have received special training to change simple dressings, give massages, and assist with braces and mobility devices. Some are also trained to operate and troubleshoot medical equipment, such as home oxygen or ventilators. Training and certification requirements for this type of caregiver vary by state, so be sure to ask about each caregiver's unique qualifications. You should expect any home health worker to be supervised by a nurse and to provide care as outlined in your loved one's home healthcare plan.
After a stroke, fall, broken bone, or serious illness, your loved one will likely need help with movement and muscle strength. Your home healthcare agency may send a physical therapist or occupational therapist to your home. A physical therapist can help your loved one with overall mobility: walking, getting in and out of bed, sitting, and standing. An occupational therapist will help your loved one with activities of daily living, such as eating, buttoning clothes, and brushing hair. These types of caregivers can also help relieve pain, improve range of motion, and build up and retain muscle performance.
When a physical therapist or occupational therapist comes to your home, you can expect him to teach your loved one to do specialized exercises. Ideally, the therapist will also provide you with detailed instructions, with each step illustrated and clearly explained. Ask your therapist how frequently your loved one should do the exercises and how to be sure the exercises are being done correctly. You can also ask a physical therapist or occupational therapist to help you figure out how to make these exercises a routine part of your loved one's daily routine.
Physical therapists and occupational therapists may also use massage, heat, water, passive exercise, or electricity to help your loved one recover.
Also called: speech language pathologists (SLPs)
If your loved one's illness or injury has affected her speech, your home health agency might send a speech therapist to your home. Speech therapists provide care to improve a loved one's speech, language, cognition, voice, and swallowing. They may provide drills and activities to improve skills, or they may provide strengthening exercises for the muscles of the lips and tongue.
Also called: registered nurses (RNs), licensed practical nurses (LPNs), licensed vocational nurses (LVNs), advanced practical nurses (APNs)
These nurses provide skilled care, including administering medications, changing dressings, managing catheters and intravenous lines, and giving injections. You can expect a visiting nurse to evaluate your loved one, take vital signs, and write detailed notes about your loved one's progress.
Visiting nurses are highly trained and tend to have higher hourly rates than other types of caregivers -- up to $75 per hour.
Home healthcare agencies will assess your loved one's specific healthcare needs and propose a healthcare plan, sometimes called a plan of care. Your loved one's doctor will then review the healthcare plan and sign it to show approval. The healthcare plan details what type of medical care your loved one will receive, what types of workers will provide the care, how frequently they will come to your loved one's home, and how long the care is expected to last. You should receive a written copy of the plan of care.
Depending on how the patient's needs progress, the home care agency may request an extension of services. They'll send additional paperwork to the doctor for approval. And you'll want to be sure to confirm that your loved one's insurance will cover extended services.
Note: It can take time for the doctor of record to approve the original healthcare plan or the extension of services. In the meantime, most experienced nurses and therapists just get started with what they think the patient needs, unless they see an area of concern. This usually works well. Be aware, though, that care providers and doctors aren't necessarily conferring closely (or at all) about what's happening. So don't assume that everyone's on the same page about what's needed. If you have a question about any service, be sure to ask the home care agency and the doctor.
In most cases, the doctor or hospital will make arrangements for home healthcare. If you'd like to know more about any agency, search right here in the Caring.com Home Healthcare Directory to see reviews and ratings from other families.
It is also possible for you to choose a home healthcare agency rather than having one assigned. If you'd like to find your own home healthcare agency, start your search below.
For additional guidance about how to choose a home healthcare agency, see 15 Questions to Ask When Interviewing a Home Healthcare Agency.