if the agency you are considering is licensed and
bonded. In the case of a home health agency, this
means that the quality of care being provided has been
surveyed/accredited by an outside accrediting agency
such as Medicare or the Joint Commission on
Accreditation of Healthcare Organizations (JCAHO).
The agency should also be licensed by the state in which
it operates. Agency outcomes can be researched by
going to www.Medicare.gov and going to their new “home
health compare” tool, or calling the Medicare helpline
LICENSING OF EMPLOYEES
of employees, confirm that all home health employees
(nurses, physical therapists, home health aides, and
social workers) are certified or licensed in the state
they are working (regulations may vary by state), in
order to ensure they meet minimum requirements to
perform their duties. Also important is to make
sure that the agency does screenings of employees to
ensure that not only do they not have a criminal
background, but that they are free of communicable
diseases which could affect the compromised immune
system of a patient.
policies are in place to ensure patient confidentiality,
and find out how far that policy extends. Many
caregivers, particularly ones who arrange for assistance
long distance, find themselves frustrated after they
arrange for care for a loved one, only to be told that
due to HIPAA regulations, the agency cannot provide
information on their health status. At the outset
of care, make sure of what the company’s policy for
communication is and ensure that it is noted who may and
may not receive information about the patient.
found communication a problem with one home health
agency while caring for her stepmother cross- country.
She faxed a durable power of attorney right to the home
health agency but “they still wouldn’t tell me
anything!” She states that “especially when you
are working from a distance, your hands are tied when
there is no communication.”
people, it is a far better choice to choose a “full
service” agency which provides for all their needs
(nursing, home health aide, physical therapy) than to
pick and choose services from different agencies.
This ensures that caregivers are free to communicate
amongst themselves on a patient’s progress and work
collaboratively to resolve any issues, rather than if
they are all from different agencies and forced to stab
blindly at problems as they arise.
CONTINUITY OF CARE
patients fare better when they see one or two familiar
faces rather than a steady stream of strangers passing
through their lives. Find out if the same person
will be caring for your loved one, or if they will see a
new person on a continual basis. Having one or two
familiar caregivers is particularly helpful in the case
of people who are confused or frail, as this helps both
the patient and caregiver get used to a routine.
It also helps the caregiver know what is “normal” for a
patient and what is not normal and warrants a call to
the doctor. Also important to find out is what
will happen should the regular worker call in sick.
Will the person be forced to wait for assistance until
the next day? Will a substitute come out at the
same time? Will the person have to wait for hours
until another worker has time in their schedule?
what the procedure is if there is an emergency. Is
there always someone on call? Will a patient need
to wait until the next business day to speak with
someone should an emergency happen after the regularly
scheduled service is performed? A good agency
should have someone on call 24 hours a day, seven days a
week, so urgent matters need not wait until the next
FINANCIAL RESPONSIBILITY – A reputable agency will not
hesitate to address the patient’s financial
considerations and should provide the patient/caregiver
with a written statement explaining what is/is not
covered by insurance/Medicare, and what services the
patient will be responsible for out of pocket, if any.
with friends, your physician, ask people at your place
of worship, or attend a support group and ask which home
care agencies others are using. One of the best
ways to assess how an agency performs in the home is to
look past the glossy brochure and ask people how they
feel about the service that has been given to their
loved ones. Chances are that good or bad, people
will be happy to share their experiences.
IS THE SERVICE COVERED BY INSURANCE?
people who look for home care erroneously assume that if
their loved one needs assistance in the home, Medicare
will cover the service. This is not always the
case. Medicare limits itself to “reasonable and
necessary part time or intermittent skilled nursing care
and home health services,” and does not include 24 hour
care, services which are limited to “homemaking”
services, assistance with transportation, or companion
services. Unless a person has a long-term care
insurance policy which provides for these services in
the home, home care can be cost prohibitive.
Although most people prefer to “age in place,” there are
times that due to financial resources and the
availability of finding good, reliable, continuous care,
that an assisted living community may be a better choice
than in-home care, both financially and for the
assurance of the safety and health of a loved one.
popular commercial for menswear states, “An educated
consumer is our best customer.” There is possibly
no arena in which this is truer than in the search for
good, reliable home health care. Ronnie Thomas,
who is a part owner/administrator for a home health
agency in Broward County, states that when a person is
considering home health care for a loved one, one should
make an informed decision and weigh all the options.
She believes that first and foremost to remember is that
the services the patient is receiving is paid for by
insurance (usually Medicare) and since this is money the
loved one worked hard for and paid into the system, they
are entitled to and deserve good, quality care which
puts the patient’s needs first, out of the system.
“Attentive, kind, quality care from committed
professionals who involve the family as much as
possible,” are things she believes should be insisted
on. Kathy R. believes the same. “Compassion
and good communication between caregiver, patient, and
the home health provider are paramount,” she states, and
although she has had many sleepless nights worrying
about her stepmother’s health, she knows that the home
health provider she now uses provides her with one less
thing over which to worry.