Live Free Home Health Care, LLC. - Bristol, New Hampshire

Tuesday, October 17, 2006

Should You Use a Licensed Home Health Care Agency?

New Hampshire Home Health Care

The case for using an agency as opposed to hiring someone directly

As anyone who has had to look for home care for a parent, child, or loved one may have discovered, home care rates can be less if you hire help (sometimes referred to as a “private duty nurse”) on your own rather than using an agency like Live Free Home Health Care. This is could be one of the most important decisions you make in regards to looking for in-home care, and if you are contemplating hiring on your own to save a few dollars, it’s important to know what your responsibilities will be. Here are some things you should ask yourself:

1. Are you prepared to place ads, screen responses, conduct interviews, check references, do criminal background checks, and drug screening? Also will you know whether a potential candidate has the right training and skills?

2. Have you calculated the cost of required taxes? You will be responsible for paying social security taxes, unemployment taxes, and workers’ compensation.

3. Do you want the responsibility of supervising workers and resolving misunderstandings when they (and they will) happen?

4. What are you going to do when your caregiver calls in sick? Are you always going to be available to provide back-up? If so, doesn’t that mean you will be on-call around the clock?

5. What about insurance? Does the person you are considering hiring have professional liability insurance?

A quality agency that directly employs its home care associates will assume each of these responsibilities for you. That’s what we do at Live Free Home Health Care. We have carefully screened our caregivers, done criminal background checks and drug screening. We have made sure they have the right training and licenses. We are responsible for paying our caregivers and making sure the appropriate payroll taxes are paid. If one of our caregivers has to miss work at the last minute, we are responsible for finding a replacement. Live Free Home Health Care has the appropriate insurance and we are licensed by the State of New Hampshire as a Home Health Care Provider.

You will have the comfort of knowing we have a Registered Nurse on-call 24 hours a day and are here to handle the unexpected for you. We will anticipate your needs and respond to changes before a potential problem may arise. Let us take the job of employer and care case manager from your shoulders so you can concentrate on relating with your parent, child, or loved one how it matters most: as family.

Jason M. Harvey

Owner, Business and Finance Manager

Live Free Home Health Care, LLC

603.346.4214

Tags:   caregiver, in-home care providers, insurance, Jason Harvey, Live Free Home Health Care

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Monday, October 02, 2006

How To Care For An Aging Parent Without Sibling Rivalry

Tips on how to help and stay on speaking terms with other family members

As a New Hampshire based home health care agency, we know how difficult it can be to watch mom or dad’s health decline and not know what services are available to help them maintain independence and dignity and stay in the comfort of their own home. It can make it even more difficult when multiple siblings are trying to coordinate care; it’s hard enough when everyone concerned lives in close proximity. Imagine how difficult it is when mom and dad live towns or even states away. Here at Live Free Home Health Care, we have heard stories on more than one occasion of siblings squabbling over how best to help; this can make an already difficult situation a nightmare. Maybe one sibling isn’t doing his fair share of the hands-on work or there is another sibling who perhaps is better situated financially, yet hasn’t contributed a penny. This can cause hostility to build and create grudges that can last a lifetime, to develop. Everyone has mom and dad’s best interest at heart but without anyone to coordinate how best to help, it can not only place more stress on the siblings but also cause more stress for your aging loved one. Imagine how hard it is for them to see their kids bicker over them! Live Free Home Health Care can help; this is one of the many areas we excel. Coordinating care between family members and physicians, acting as the quarterback if you will. We can provide home health aides in the home to assist with daily living activities or a registered nurse to provide case management and to ensure everyone concerned is on the same page and understands what is going on. We can even accompany your parent or aging loved one to his or her doctor appointments to help relay what can be at times complicated information and act as a patient advocate. These are just some of the services we can provide, check out our website at http://www.livefreehomehealthcare.com/ to learn more or call us at 603-346-4214 to discuss your needs. Here are four tips to help ease the tension and get your parent or aging loved one the best possible help.

1. Understand the situation – conflicts often arise because of misunderstandings about your loved ones condition. After all, if your out-of-state sibling isn’t around to witness it, he may not know that dad sometimes forgets to turn off the stove or that mom has difficulty remembering to take her medication (medication management is another service Live Free Home Health Care offers). Fill siblings in so they’ll know why it is imperative to spend the money for in-home help. If they’re still in denial, ask the doctor to discuss your parent’s care needs with the whole clan (maybe a conference call) or hire a registered nurse to help everyone understand the situation.

2. Share the load – We all know the saying of why you should never assume anything. Just because one sibling lives closer to mom and dad doesn’t mean they will or can do most of the care giving. Have a family meeting to create a list of tasks and divide them fairly, says Linda Fodrini-Johnson of Eldercare Services. Ask for volunteers first, but make sure everyone has a suitable job. For instance the sibling that lives the furthest away may pay dad’s bills online, while one who lives closer takes on more of the day-to-day care.

3. Talk frankly about money – Money does strange things to people unfortunately. The best approach is just to be straightforward. Just because you suspect your sibling opposes a pricey nursing home or paying for in-home care because she wants an inheritance, she really could just be worried that mom will go broke by 85. If discussing the cost of care and how the family is going to pay for it is done openly, it can clear the air and prevent misunderstandings.

4. Seek out a middleman – still bickering? Get objective advice from a professional. If you have a tax problem, you call your CPA, if you have a legal problem, you call your attorney, and if your tooth hurts, you call your dentist (hopefully). The same should be true with something as important as helping your parents or loved one age with dignity while getting the care they need. If an agreement can’t be reached, perhaps you should seek out an impartial third party, like Live Free Home Health Care, to help with a care plan.

You can always count on Live Free Home Health Care to provide objective and caring advice to assist you with caring for an aging parent or loved one.

Jason Harvey

Owner, Business and Finance Manager

Jennifer L. Harvey RN BSN

Owner, Director of Patient Services

Home care is what we do; Dignity and Independence is what we provide.

Source: Money Magazine, Oct. 2006

Tags:   home care, home health care

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Monday, October 02, 2006

Who Pays for Home Care Services?

Home care services can be paid for directly by the patient and his or her family members or through a variety of public and private sources. Hospice care generally is provided regardless of the patient's and/or family's ability to pay. Public third-party payors include Medicare, Medicaid, the Older Americans Act, the Veterans Administration, and Social Services block grant programs. Some community organizations, such as local chapters of the American Cancer Society, the Alzheimer's Association, and the National Easter Seal Society, also provide funding to help pay for home care services. Private third-party payors include commercial health insurance companies, managed care organizations, CHAMPUS, and workers' compensation.

Self-pay:

Home care services that fail to meet the criteria of third-party payors must be paid for "out of pocket" by the patient or other party. The patient and home care provider negotiate the fees.

Public Third-party Payors Medicare:

Most Americans older than 65 are eligible for the federal Medicare program. If an individual is homebound, under a physician's care, and requires medically necessary skilled nursing or therapy services, he or she may be eligible for services provided by a Medicare-certified home health agency. Depending on the patient's condition, Medicare may pay for intermittent skilled nursing; physical, occupational, and speech therapies; medical social work; HCA services; and medical equipment and supplies. The referring physician must authorize and periodically review the patient's plan of care. With the exception of hospice care, the services the patient receives must be intermittent or part time and provided through a Medicare-certified home health agency for reimbursement.

Hospice services are available to individuals who are terminally ill and have a life expectancy of six months or less; there is no requirement for the patient to be homebound or in need of skilled nursing care. A physician's certification is required to qualify an individual for the Medicare Hospice Benefit. The physician also must re-certify the individual at the beginning of each six-month benefit period. In turn, the patient is required to sign a statement indicating that he or she understands the nature of the illness and of hospice care. By signing this statement, the patient surrenders his or her rights to other Medicare benefits related to terminal illness.

Medicaid:

Administered by the states, Medicaid is a joint federal-state medical assistance program for low-income individuals. Each state has its own set of eligibility requirements; however, states are only mandated to provide home health services to individuals who receive federally assisted income maintenance payments, such as Social Security Income and Aid to Families with Dependent Children (AFDC), and individuals who are "categorically needy." Categorically needy recipients include certain aged, blind, and/or disabled individuals who have incomes that are too high to qualify for mandatory coverage but below federal poverty levels. Individuals younger than 21 who meet income and resources requirements for AFDC, yet otherwise are ineligible for AFDC, also qualify as categorically needy. Under federal Medicaid rules, coverage of home health services must include part-time nursing, HCA services, and medical supplies and equipment. At the state's option, Medicaid also may cover audiology; physical, occupational, and speech therapies; and medical social services. Hospice is a Medicaid-covered benefit in 38 states. The Medicaid hospice benefit covers the same range of services that Medicare does.

Older Americans Act (OAA):

Enacted by Congress in 1965, the OAA provides federal funds for state and local social service programs that enable frail and disabled older individuals to remain independent in their communities. This funding covers HCA, personal care, chore, escort, meal delivery, and shopping services for individuals with the greatest social and financial need who are 60 years of age and older. Increasingly, individuals who can afford to pay for some of these services are being asked to contribute in proportion to their income. Individuals often request the services they need through an Area Agency on Aging, which will provide them directly or in cooperation with local organizations.

Veterans Administration:

Veterans who are at least 50% disabled due to a service-related condition are eligible for home health care coverage provided by the Veterans Administration (VA). A physician must authorize these services, which must be delivered through the VA's network of hospital-based home care units. The VA does not cover nonmedical services provided by HCAs.

Social Services Block Grant Programs:

Each year states receive federal social services block grants for state-identified service needs. The government allocates these funds on the basis of the state's population and within a federal limit. Portions of the funding often are directed into programs providing HCA and homemaker or chore worker services. Individuals should contact their state health departments and local offices on aging for additional information.

Community Organizations:

Some community organizations, along with state and local governments, provide funds for home health and supportive care. Depending on an individual's eligibility and financial circumstances, these organizations may pay for all or a portion of the needed services. Hospital discharge planners, social workers, local offices on aging, and the United Way are excellent sources for information about community resources.

Private Third-party Payors Commercial Health Insurance Companies:

Commercial health insurance policies typically cover some home care services for acute needs, but benefits for long-term services vary from plan to plan. Commercial insurers, including Blue Cross and Blue Shield and others, generally pay for skilled professional home care services with a cost-sharing provision. Such policies occasionally cover personal care services. Most commercial and private insurance plans will cover comprehensive hospice services, including nursing, social work, therapies, personal care, medications, and medical supplies and equipment. Cost-sharing varies with individual policies, but often is not required.

Individuals sometimes find it necessary to purchase Medigap insurance or long-term care insurance policies, for additional home care coverage.

Medigap insurance is designed to bridge some of the gaps in Medicare coverage. Some Medigap policies offer at-home recovery benefits, which pay for some personal care services when the policyholder is receiving Medicare-covered skilled home health services. The policyholder's physician must order this personal care in conjunction with the skilled services. Home care coverage in Medigap policies is not designed to cover extended long-term care. This type of coverage is most helpful to individuals recovering from acute illness, injuries, or surgery.

Long-term care insurance primarily was intended to protect individuals from the catastrophic expense of a lengthy stay in a nursing home. However, as the public need and preference for home care has grown, private long-term care insurance policies have expanded their coverage of personal care, companionship, and other in-home services. Considerable care should be taken in selecting a long-term care insurance policy, as home care benefits vary greatly among plans. Consumers should be aware of limitations on coverage, such as prior hospitalization requirements, and pre-existing condition exclusions. Some policies may only pay for services that are already covered by Medicare.

Managed Care Organizations: Managed care organizations (MCOs) and other group health plans sometimes include coverage for home care services. MCOs contracting with Medicare must provide the full range of Medicare-covered home health services available in a particular geographic area. Medicare beneficiaries who are enrolled with an MCO may elect their hospice benefit from the hospice of their choice. These organizations only pay for services that are pre-approved.

CHAMPUS:

On a cost-shared basis the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) covers skilled nursing care and other professional medical home care services for dependents of active military personnel and military retirees and their dependents and survivors. CHAMPUS offers a comprehensive hospice benefit to its terminally ill beneficiaries, which covers nursing, social work and counseling services, therapies, personal care, medications, and medical supplies and equipment.

Workers' Compensation:

Any individual requiring medically necessary home care services as a result of injury on the job is eligible to receive coverage through workers' compensation.

http://www.nahc.org/famcar_whopays.html

Tags:   Alzheimer's Disease, home care, home health care, insurance, long-term care

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