What is Home Health

What is Home Health?

Home health care provides skilled services, including nursing care and physical, occupational, speech and respiratory therapy. The agency will send a licensed professional to assess home health needs and develop a complete care plan. These services are usually short-term, as in the case of a person recovering from surgery or other health issues.

Home health care is usually less expensive, more convenient than and just as effective as care you get in a hospital or skilled nursing facility (SNF). Home health is typically delivered by nurses. Examples of skilled home health services include:

  • Wound care for pressure sores or a surgical wound
  • Patient and caregiver education
  • Intravenous or nutrition therapy
  • Injections
  • Monitoring serious illness and unstable health status

Medicare will cover home health if it is ordered by a physician and the person is homebound and in need of skilled services. A home health care agency employs the healthcare professionals sent to the home and must be licensed by the state. Many seek additional accreditation to assure consumers that they have met quality standards. Common accreditations include the Accreditation Commission for Health Care (ACHC), Community Health Accreditation Partner (CHAP), and The Joint Commission (TJC).

What is the cost and what is covered?

Medicare will cover most forms of home health care if it is ordered by a physician or nurse practitioner.  Services can be covered for a 60-day "episode of care." However, if an individual is enrolled in a Medicare HMO, known as a Medicare Advantage Plan, services are authorized on a per-visit basis.  Be sure when you speak with an agency, you ask if they are certified by Medicare and what services are covered.  Long-term care insurance and Medigap plans may also cover some costs of a home health aide.

How to find a home health agency

The Home Care & Hospice Association of NJ website includes a Directory feature where you can search for an agency by location or by the services needed.

Home Health agencies are licensed by the NJ Department of Health.  You can also find more information about a specific agency near you on their website.

If you are receiving Medicare and if you are hospitalized, you may qualify for home health services when you are discharged home.  Your hospital case manager or social worker can help you and you can ask for a list of Medicare-certified agencies in your area. Medicare certification means the agency has met federal minimum requirements for quality patient care and management.  You can also search online to compare hoe well home health agencies perform with Medicare's Home Health Compare tool.

What to ask

When you speak with a home health agency, there are a number of important questions to ask:

  • Are you licensed by the state?
  • Are you certified by Medicare?
  • Do you have accreditations from professional organizations? If so, please tell me about them.
  • Are the workers you send your employees or contracted employees?
  • What type of background checks do you conduct on your employees?
  • If the worker does not show up when scheduled, will you send a replacement immediately?
  • What type of progress reports can I expect from each type of professional providing care?
  • Will you send a replacement if the worker is not compatible with the person receiving care?
  • What can I expect to pay, if services are not covered by Medicare, Medigap, Medicaid or a long-term care insurance policy?
  • Whom do I speak to regarding care status?
  • How do we appeal to Medicare if we think more care is needed?
  • Can you put me in touch with someone who has used your services?