Frequently Asked Questions
What is Home Health care?
Home Health care is skilled care provided in the comfort of a patient’s residence by a skilled nurse or therapist. Care is focused on helping individuals manage a chronic condition and/or recover from illness, surgery, accident or change in medical status. At Pacific Home Health & Hospice, we create individual care plans specific to the patient’s needs.
Who pays for Home Health care?
Medicare pays 100 percent for those who qualify. Medicaid and private insurance may also pay for home care. Benefits vary by policy and verification of benefits is required.
Who qualifies for Medicare-reimbursed services?
Patients must be 65 years of age or older, have a skilled need and be homebound. The primary care physician must provide a referral and order for home health care. Patients younger than 65 may qualify if they have received Social Security disability benefits for at least two years or they currently receive Medicare disability benefits.
What is homebound?
Medicare considers you homebound if you have:
- Functional Deficits:
- Difficulty Ambulating, Transferring
- Vision Deficit
- Fraility with Assistive Devices
- Difficult or Labored Breathing (Dyspnea), Shortness of Breath on Ambulation
- Post-Operative Restrictions
- Congnitive Problems
- Patient Environmental Considerations, such as Stairs In/Out of House
This is just a partial list. Feel free to contact our office for further assistance or information regarding being homebound.
Will Medicare pay for Home Health services if the patient is still working at 65 years of age or older?
Yes. The patient can use Medicare. If the patient is covered by the employer’s health insurance plan, that plan could be used in conjunction with Medicare benefits. However, a patient cannot be working outside the home and also considered home bound.
Does Medicare cover home visits?
Yes. However, the patient must meet the following criteria:
- The patient’s physician has established a plan of care, including the request of home health care services.
- The patient is homebound.
- The patient is in need of a nurse’s care or requires reasonable speech or physical therapy that is considered a necessity throughout the completion of care.
- The care needed is part-time and intermittent.
What is Hospice care?
Hospice is a service. It is designed to provide a caring environment for the physical, spiritual and emotional needs of the terminally ill. Care can be provided for patients in their home, a nursing facility or a foster care home without repeated hospital stays. The goal of Pacific Home Health & Hospice personnel is symptom management and pain control. Hope of remission or cure is never abandoned but the focus is on providing palliative (comfort) care not curative care. Our services allow patients to retain their dignity while realizing quality is more important than quantity in their remaining days.
Is all Hospice care provided in the home?
Not always, hospice care can be provided in most long-term care facilities, hospitals, nursing homes and assisted living facilities.
Who qualifies for Hospice care?
Once a patient has been diagnosed with a life-limiting illness and life expectancy is less than six months, a physician then refers the patient to hospice. Once it is confirmed the hospice patient and caregivers understand the definition of hospice care and that it is aimed at comfort rather than an actual cure, a form called “Election of Benefit” will be signed by the patient and then hospice services begin.
How is Hospice care different from Home Health services?
Home Health focuses on patient recovery. Hospice focuses on facilitating comfort and providing support when recovery is no longer an option. Hospice care is provided by an interdisciplinary team of specialists including physicians, nurses, grief support counselors, social workers, aides, and volunteers. At Pacific Home Health & Hospice, hospice centers on the patient and family. Family focus is imperative, as caregivers must feel empowered to care for the patient. Furthermore, family members must be prepared to manage the inevitable grief that accompanies this process. That is why our entire team supports the family while hospice care is actively being provided to the patient, along with offering grief counseling and bereavement after death of the loved one.
Who pays for Hospice care?
Medicare pays 100 percent for those who qualify. Medicaid, private insurance and HMOs will also pay for hospice care. Benefits vary per policy and verification of benefits is required. Most insurance policies cover the entire cost of hospice services, although some may require a co-pay.
What if by chance the patient gets better?
The patient can then be discharged from hospice care to return to some form of aggressive treatment and even resume daily life. Additional coverage is allowed by Medicare and by most insurance should the patient need to return to hospice care.
Who refers the patient to Hospice?
A physician must refer a patient to hospice after medically determining the patient has a terminal illness. At that time the patient would proceed with the qualifications process.
What should the patient do if the doctor does not recommend or mention Hospice care?
The patient and their family should always feel free to discuss this type of care with their health care professional(s) and even their friends, because it is necessary to prepare for the type of care the patient wishes to receive at the end of life.
What is involved in the Hospice admission process?
Once a patient is referred to Pacific Home Health & Hospice for hospice care, the office will contact the patient’s physician to ensure hospice care is appropriate for the patient. A staff member will contact the hospice patient or caregiver confirming that the patient understands the definition of hospice care and that it is aimed at comfort rather than an actual cure. A form called “Election of Benefit” will be signed by the patient and then hospice services begin.
If I need to reach Pacific Home Health & Hospice, when can I call?
Our offices are open from 8 a.m. to 5 p.m., Monday through Friday. Our on-call 24-hour phone number for contacting a registered nurse in our Springfield Office is (541) 746-0482 or Toll Free at (888) 746-0482.