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Chapter 7. Home Health Care

Chapter 7. Home Health Care. Long-Term Care: Managing Across the Continuum (Second Edition). Learning Objectives. Define and describe home health care Identify and define the components of home health care Identify and describe regulations affecting home health care providers

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Chapter 7. Home Health Care

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  1. Chapter 7. Home Health Care Long-Term Care: Managing Across the Continuum (Second Edition)

  2. Learning Objectives • Define and describe home health care • Identify and define the components of home health care • Identify and describe regulations affecting home health care providers • Understand the financial, ethical, and managerial issues affecting home health care • Identify trends affecting home health care and the impact of those trends

  3. Definitions Home Care: Supportive services Home Health Care: Skilled nursing and other health-related services Community-Based: Any service provided outside of a facility, including home care and home health care

  4. How Home Health Care Developed • Public health department visiting nurses • Freestanding visiting nurse associations • Growth based on better reimbursement

  5. Philosophy of Care • Takes services to the consumers’ homes • Eligibility requirements (based on Medicare regs): • Physician-ordered • Intermittent • Homebound

  6. Types of Home Health Care • Home health agencies • Hospice agencies • Homemaker and home care aide agencies • Staffing and private duty agencies

  7. Ownership of Home Health Care Agencies • Mix of nonprofit, for-profit, and government-owned • Growing number are affiliated with other health care organizations: • Hospitals • SNFs • Rehabilitation facilities

  8. Services Provided • • Nursing • Therapies • • Dental care • Laboratory • • Nutrition • Care Mgt. • • Personal care • Homemaking • • Transportation • Education

  9. Consumers ofHome Health Care • Largely elderly • Some need on-going care • Others need only temporary care following a hospital stay

  10. Market Forces • Consumer choice • Cost-effectiveness

  11. Regulations • Medicare “Conditions of Participation” • State licensure

  12. Accreditation • JCAHO • CHAP • ACHC

  13. Financing Home Health Care • Medicare - PPS • Medicaid • Other government programs • Managed care • Private insurance • Self-pay and other sources

  14. Staffing Combination of professional and non-professional staff • Nurses • Home Health Aides • Therapists • Social Workers • Other specialists

  15. Legal & Ethical Issues • Patient noncompliance • Patient Safety • Fraud and reimbursement abuse • Patients’ rights

  16. Management Qualifications • Not regularly licensed • Medicare “Conditions of Participation” • Certifications

  17. Management Challenges& Opportunities • Supervision of staff • Staffing shortages • Prospective payment

  18. Significant Trends • Technology • Managed care • Wellness programs

  19. In Summary: • Home health care has a long history, but has become increasingly attractive in recent years, and should continue to grow.

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