|
Home care services are usually provided by home care organizations but may also be obtained from registries and independent providers. Home care organizations include home health agencies; hospices; homemaker and home care agencies; staffing and private-duty agencies; and companies specializing in medical equipment and supplies, pharmaceuticals, and drug infusion therapy. Often, a single organization offers multiple services, or several types of home care organizations may merge to provide a wide variety of services through an integrated system.
Home care services generally are available 24 hours a day, seven days a week. Depending on the patient's needs, these services may be provided by an individual or a diverse team of health care specialists on a part-time, intermittent, hourly, or shift basis. Following are descriptions of the various types of home care providers.
The term home health agency often indicates that a home care provider is Medicare certified. A Medicare-certified agency has met federal minimum requirements for patient care and management and therefore can provide Medicare and Medicaid home health services. Individuals requiring skilled home care services usually receive their care from a home health agency. Due to regulatory requirements, services provided by these agencies are highly supervised and controlled. Some agencies deliver a variety of home care services through physicians, nurses, therapists, social workers, homemakers and health care aides, durable medical equipment and supply dealers, and volunteers. Other home health agencies limit their services to nursing and one or two other specialties. For cases in which an individual requires care from more than one specialist, home health agencies coordinate a caregiving team to administer services that are comprehensive and efficient. Personnel are assigned according to the needs of each patient. Home health agencies recruit and supervise their personnel; as a result, they assume liability for all care.
Hospice care involves a core interdisciplinary team of skilled professionals and volunteers who provide comprehensive medical, psychological, and spiritual care for the terminally ill and support for patients' families. Hospice care also includes the provision of related medications, medical supplies, and equipment. It is based primarily in the home, enabling families to remain together. Trained hospice professionals are available 24 hours a day to assist the family in caring for the patient, ensure that the patient's wishes are honored, and keep the patient comfortable and free from pain. . Although most hospice services are provided in the home, they may be provided in a facility (hospital, skilled nursing facility (SNF), or inpatient hospice facility).. Most hospices are Medicare certified and are licensed according to state requirements.
Home nursing agency means an agency that provides services directly, or acts as a placement agency, in order to provide skilled nursing services to persons in their personal residences. A home nursing agency provides services paid for by the hour. These services are provided by a licensed nurse. Illinois will require these agencies to be licensed effective September 2008 and meet minimum standards established by the Illinois Department of Public Health (IDPH).
Home care agencies employ homemakers or chore workers and companions who support individual's activities of daily living, such as housekeeping, personal laundry, meal preparation, dressing, housekeeping and companionship. Personnel are assigned according to the needs and wishes of each client. Illinois will require these agencies to be licensed effective September 2008 and meet minimum standards established by the Illinois Department of Public Health (IDPH). Most homemaker and home care agencies recruit, train, and supervise their personnel and thus are responsible for the care rendered.
Staffing and private-duty agencies generally are nursing agencies that provide individuals with nursing, homemaker and companion services. Effective September 1, 2008, Illinois requires these agencies to be licensed or meet regulatory requirements. Some staffing and private-duty agencies assign nurses to assess their clients' needs to ensure that personnel are properly assigned and provide ongoing supervision. These agencies recruit their own personnel. Again, responsibility for patient care rests with each agency.
Home infusion therapy companies specialize in the delivery of drugs, equipment, and professional services for individuals receiving intravenous or nutritional therapies through specially placed tubes. Nurses also are hired to teach self-administration in patients' homes. Some home infusion therapy companies are home health agencies, which are certified by Medicare and licensed in Illinois. Each company assumes responsibility for personnel and the services rendered.
Durable medical equipment and supply dealers provide home care patients with products ranging from respirators, wheelchairs, and walkers, to catheter and wound care supplies. These dealers employ staff who deliver and, when necessary, install these products as well as instruct patients on their proper in-home use. Durable medical equipment and supply dealers usually do not provide physical care for patients, but there are a few exceptions. Some dealers offer pharmacy and infusion services, where a nurse administers medication and nutritional formulas to patients and teaches them the proper techniques for self-administration. Some companies also provide respiratory therapy services to help individuals use breathing equipment. Durable medical equipment and supply dealers that bill the Medicare program are required to meet federal minimum standards. Some states, like Illinois, require these organizations be licensed. Each dealer is liable for its personnel and the services provided to patients.
Registries serve as employment agencies for home care nurses and aides by matching these providers with clients and collecting finder's fees. These organizations usually are not licensed or regulated by government. Registries will be required to screen and conduct criminal background-checks on the caregivers. In addition, although not legally required to, some registries offer procedures for patients to file complaints. Clients select and supervise the work of a registry-referred provider. They also pay the workers directly and must comply with all applicable state and federal labor, health, and safety laws and regulations, including payroll tax and social security withholding requirements.
Independent paid caregivers are nurses, therapists, aides, homemakers, chore workers, and companions who are privately employed by individuals who need such services. Aides, homemakers, chore workers, and companions are required to meet government standards if they receive reimbursement through state funded programs. In this arrangement, the responsibility for recruiting, hiring, and supervising the paid caregiver rests with the client. Finding back-up care in the event that the provider fails to report to work or fulfill job requirements is the client's responsibility. Clients also pay the caregiver directly and must comply with all applicable state and federal labor, health, and safety requirements.
|
|
|
