New to Home Care?

Let’s talk home care, like any other specialty there are certain terms and phrases used in this industry, in this resource we will call it the Home Care “language” if you will. We will explain and define the most commonly used acronyms or abbreviations, the different payor sources for home care, who is on the home care team, the differences between Medical and Non-Medical, and how the collaboration of both work together to have better outcomes for home care patients.

It’s time to get down to the home care basics. Let’s discuss the different types of Home Care.

There are 3 types of home care: Home Health Care, Private Duty Homecare, and Hospice Care. Home Health Care and Home Care are often used interchangeably as if it were one in the same, this is where most of the misconceptions are.

Medicare and most private insurance companies, define home care as: Skilled (Medical) and (Non-Medical). The third type of home care, which Medicare does not recognize and has minimal regulation, is often referred to as personal or companion care. In fact, you may be surprised to learn in the state of Michigan currently there are no licensing requirements for non-medical home care companies. The fact that there are no safeguards to protect the vulnerable is concerning. This is an unregulated industry and it is up to the consumer to determine suitability. *

There may be confusion about whether “home care” and “home health care” are the same. The two terms are often used interchangeably because both services are types of care that are provided in the home. The main distinction between the services is whether the care is non-medical or medical.

Home Care is non-medical care provided in the home by licensed and unlicensed professionals known as Home Health Aides, Certified Nurse Assistants, Companions, and specialize in personal care assistance, companion care, housekeeping, meal preparation, laundry, shopping, and incidental transportation, and respite care. Even though private duty home care is Non-Medical be definition Some companies such as Crystal Cares Home Care offers skilled nursing services.  Skilled nursing services must have a physician’s order and are provided by Registered Nurses and Licensed Practical Nurses. Examples of skilled nursing 

services in a private duty or (non-medical) home care company are medication set up, medication administration, injections, catherization care, wound care, blood draws, care management and more. Services do not include therapy, or other medical services. Home care is also referred to as custodial care, senior care, private duty, personal care, companion care, home care, or private duty home care.

Home Health Care is medical health care provided in the home for homebound patients by licensed professionals, such as Nurses, Physical Therapists, Occupational Therapists, Speech Therapists, Social Workers, and Home Health Aides. It is a benefit of Medicare, Medicaid, and most private health insurances however, the patient must meet very specific criteria. Home health care is referred to as skilled or medical care. It is important to note that home health care also used to be referred to as home care. The names of these services were changed to better describe the difference between each type of home care.

Private Duty Home Care often works in collaboration with Home Health Care agencies. There are many Home Care companies that are not well versed in the different types of home health care services and may not feel comfortable making referrals for their clients. Crystal Cares Home Care always assesses the need for Home Health Care services for our clients both prospective and current. The collaboration of Home Health Care and Private Duty Home Care allows the client to have a multi-disciplinary team of care providers.

Some of the benefits of collaboration with Home Health Care and Crystal Cares Home Care:

• Reduce incidents of hospital readmissions
• Monitor for critical issues and act quickly to prevent exacerbation of an illness or condition
• Improve patient care compliance and outcomes
• Prevent post-discharge complications by monitoring for critical red flags

Definition of common terms you may here regarding Home Health Care and Private Duty Home Care.

HOMEBOUND: According to Medicare.gov to be homebound means:

• You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or help from another person) because of an illness or injury, or leaving your home isn’t recommended because of your condition.
• You’re normally unable to leave your home, but if you do it requires a major effort. You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like an occasional trip to the barber, a walk around the block or a drive, or attendance at a family reunion, funeral, graduation
• You can still get home health care if you attend adult day care or religious services

HOME CARE: Consists of any non-medical care. Involves help with daily activities like bathing and dressing. In some cases where care is received at home, care can also include help with household duties such as cooking and laundry.  Private Duty Nursing services are provided either by shift or hourly by a Registered Nurse (RN), Licensed Practical Nurse (LPN) These services are covered by various payors, but not Medicare.

HOME HEALTH AIDE SERVICES: Medicare will pay for part-time or intermittent home health aide services (like personal care), if needed to maintain your health or treat your illness or injury. Medicare doesn’t cover home health aide services unless you’re also getting skilled care. Skilled care includes: Skilled nursing care, Physical therapy, Speech-language pathology services, and continuing Occupational therapy.

What isn’t covered? Here are some examples of what Medicare doesn’t pay for: Meals delivered to your home, Homemaker services, (shopping, cleaning, and laundry), Custodial or personal care like bathing, dressing, and using the bathroom when this is the only care you need.

Did you know in the state of Michigan currently there are no licensing requirements for non-medical home care companies? The fact that there are no safeguards or standards of care is a huge concern.

With the increased demand for caregivers coupled with the fact there is not state mandated supervision or regulations non-medical home care agencies continue to place caregivers with vulnerable patients where there is absolutely no supervision or accountability. At Crystal Cares Home Care, we meet and often exceed industry standards. The checklist below is also available on the state of Michigan government website.

This is an unregulated industry and it is up to the consumer to determine suitability. *

*Resource Attorney Bill Schuette mi.gov/ce