Does your aging parent need Home Health?

Transcript of Interview: “Does your aging parent need Home Health?”

Mike Barnes:

I think we always continue to talk about the difference between home care and home health care because there is a huge difference. But a lot of people, especially when you’re first into it with your aging parents, the terms sound similar, and you don’t really know what the difference is. 

Kim Barnes:

So today, the focus is on home health care, and we are bringing in Stephanie Rice and Kim Hastings from Robinson Creek. Thanks so much for being with us today. It is such a confusing topic because it sounds so similar, but let’s focus on what is home health care.

Stephanie Rice:

Okay, I’ll take that one. Home health care is covered—well, number one, home health care is covered by your insurance. It’s when somebody has a skilled need. So, they need a skilled nurse to come to the house for something, or skilled therapy—physical therapy, occupational therapy, or speech therapy.

Kim Barnes:

And let’s talk about what is a skilled need. Can you give us some examples?

Stephanie Rice:

Sure, a skilled need example could be somebody who just had a total knee replacement done. They’re going to need assistance in their home.

Kim Hastings:

 Another example could be someone who’s diabetic and has a new diagnosis of diabetes. We can teach them about their medications, how to manage their diet, check their blood sugars, when to call their doctor, and when they need to go to the hospital. This applies to all disease processes out there, any acute issues, or chronic issues that have had a lot of medication changes.

Mike Barnes:

Since all of these are medical issues, does a doctor have to be involved, and does a doctor have to send you to get home health care?

Stephanie Rice:

Correct. You need to see your doctor within 30 to 60 days of starting home health care, and your doctor has to write orders for home health care.

Kim Barnes:

So, which starts first? You can actually call in home health care first and then go to the doctor, or you have to go to the doctor first to have the right orders, almost like a prescription?

Stephanie Rice:

You can do both. You just need to make sure that you’re seeing the doctor for the current reason that you need home health care. We prefer patients to see the doctor before they come to us so we know what we’re actually treating them for. However, in instances where somebody’s in the hospital and they go home without seeing their doctor yet, they need that follow-up visit with their physician within 30 days of coming home from the hospital. We can start treating them until they see their doctor.

Mike Barnes:

Does insurance pay for this, or do you have to pay for it? How does the money work?

Stephanie Rice:

It’s covered 100% under Medicare. If someone has traditional Medicare, it’s covered 100% with no responsibility for families. If someone has United Healthcare, supplemental insurances, or retirement insurances, we run them to see how much is covered. Some are covered at 80%, some at 100%, but we never send the family a bill for payment.

Kim Barnes:

How long does home health typically last? Is it usually considered a short-term care when someone gets out of the hospital, or can it last for a long time?

Kim Hastings:

It can vary depending on what they need services for. Some can be on a very short time if they’ve had surgery and get better. Those with more chronic illnesses, especially if they have a lot of medication changes or are in and out of the hospital, can be on service much longer.

Kim Barnes:

What are some of those chronic conditions?

Kim Hastings:

It could be heart disease, diabetes, or something like frequent INR checks, where someone has to go to the doctor weekly or more frequently for their INR levels. Home health can come in to manage those needs at home, keeping them from having to go to the doctor’s office or lab every week.

Mike Barnes:

My dad had COVID and was in the hospital for three days last year. He had home health care right afterward, and he wanted to continue, but the doctor eventually said, “Nope, Mr. Barnes, you’re done.” Do you run into that sometimes where people wish it would last longer?

Kim Hastings:

Yes, most of them love our nurses coming out and doing the physical therapy. It doesn’t happen a lot, but they do sometimes wish it would last longer.

Kim Barnes:

So you need to coordinate with your doctor in that case?

Stephanie Rice:

We do. For home health care, the nurse (RN) goes out every 60 days for a reevaluation. Kim works with our team of nurses to determine if the patient can stay on with us for another 60 days or not. If the patient is stable and nothing is going on, it’s hard to continue them. We notify the family within a five-day notice before discharge.

Mike Barnes:

There’s still a lot of confusion, especially for those new to taking care of their aging parents. If home health care comes out, and you start asking for things that are really home care, is that a problem? Are we doing something wrong?

Stephanie Rice:

No, I think the best way to explain it is that anything non-medical, like someone coming out to stay with your family member for a few hours, helping with meals, house cleaning, or taking them to doctor’s appointments, is home care. Home health care involves clinical needs and is covered by insurance. We don’t exchange money with families for home health care; we work directly with insurance companies.

Mike Barnes:

How do we find a home health provider? Do we just say, “Okay, I need to go to Robinson Creek,” or does the doctor suggest who to go to?

Stephanie Rice:

Both. Some doctors like to work with certain providers, so it’s good to ask your doctor or the doctor’s office if they work with anyone specific. You can also do a Google search or ask for recommendations, and places will give you recommendations of at least three companies.

Kim Barnes:

What should we look for or ask when choosing a home health care company?

Stephanie Rice:

Make sure they have adequate staffing and service in your area. Ensure they have the therapy services you need, like physical or occupational therapy, and make sure they can do lab work if needed. Ask about their capabilities, like portable X-rays and other services.

Kim Barnes:

How long is a nurse typically going to be with the aging parent?

Stephanie Rice:

Generally, it’s 30 to 45 minutes, depending on the need. For wound care, it might be longer. Therapists usually stay about 45 minutes. The initial assessment might be over an hour, but usually, the nurse isn’t in the home for more than an hour unless there are high medical needs.

Mike Barnes:

Do you get many calls from family members who don’t know what to do after the nurse is gone?

Kim Hastings:

Yes, we get calls and take care of what we can. Often, families realize they don’t know what to do, so it’s important to understand the difference between home health and home care. Home care involves having someone there for hours, while home health involves medical care by a nurse or therapist.

Kim Barnes:

Is there anything we’ve missed that adult children should be aware of regarding home health care?

Stephanie Rice:

It’s important to start asking questions about discharge planning right away when a family member is in the hospital. Home health is underused, and it’s great because it’s covered under insurance. If a family member is not walking well or having medication issues, talk to the doctor about getting home health to do an evaluation. Doctors appreciate it because they don’t always know what goes on at home.

Kim Barnes:

And if adult children see concerns like pills everywhere, they can talk to the doctor to see if home health would be a good option.

Stephanie Rice:

Yes, we get a lot of referrals from families directly. We can talk to them and then reach out to the doctor to request orders. If there’s a clinical reason, we can go in and see the parent.

Mike Barnes:

So you can go through the doctor or the agency directly.

Stephanie Rice:

Yes, you can go through either. We’re more than happy to call the doctor’s office and request a referral.

Mike Barnes:

Stephanie Rice, Kim Hastings, you’ve cleared up a lot of home health confusion. Thank you so much.

Stephanie Rice:

Thank you.

Kim Barnes:

I love getting very specific examples of conditions and understanding when to make that phone call. 

Mike Barnes:

We know firsthand that home health is very important and really helps your aging parent. If you’ve got any type of topic you’d like us to discuss, let us know at Parenting Aging Parents.

*This transcript is auto-generated. Please excuse any typos or mistakes.