Home Health Care vs. Home Care
Home Health Care vs. Home CareH
ome Care and Home Health Care are similar in that they both provide services in the patient’s home. Both share the goal to help clients stay as active and independent as possible, while maintaining their ability to safely stay in their own homes. These services are not limited to the elderly, as many qualifying clients are young adults and even pediatrics.
There are several notable differences between Home Care (often referred to as PCS or personal care services) and Home Health Care (Skilled services). The first of these is who is delivering the services. In a PCS episode, services are delivered by CNA’s (Certified Nursing Assistants) or Caregivers. Skilled episodes are referred to as such because the services are delivered by “skilled” medical professionals, such as Registered Nurses, and Physical, Occupational or Speech Therapists. Any one of these professionals or all may work collaboratively with the client to regain their independence.
Coverage of services is another difference in the two types of care. PCS is generally covered by Medicaid, Long term Care Insurance, and some private insurance, but it is not covered by Medicare or Medicare HMO insurances. Skilled services are covered by Medicare and Medicare HMO’s as well as Medicaid and most private insurances.
Because Home Health Care is a “skilled” service, patients must have a qualifying condition and a Dr.’s order for services to be covered by insurances. Skilled needs are those needs that must be performed by or under the supervision of a health care professional. Examples would include wound management, dressing changes or establishing exercise programs after joint replacement. Home care does not require a Dr.’s order but often require some sort of assessment by the insurance in order to cover care. Medicaid sends a nurse reviewer out to establish a need and the number of hours for which a patient qualifies before they can begin getting PCS services.
Another important difference to remember between PCS and Skilled Services is duration of services. PCS episodes tend to last a lot longer than Skilled Services as they help patients maintain their current level of function by assisting with ADLs (activities of daily living) such as laundry, meal prep and transportation, and can go on for years. Skilled services tend to be short in duration and focused on helping patients return to their former level of function after some sort of medical episode: hip replacement, fall with fracture, pneumonia or an open wound the patient is unable to dress themselves. Medicare approves 60 day episodes to facilitate recovery and allow clients to return to their prior activity level.
A conversation with your Doctor is the first step in determining what your health needs are and how best to address them. Once you are sure what help you need, you then can begin looking into which company best fits your needs. There are many resources for helping you find a home health or home care company, one of the best can be personal recommendations. If you have a friend or family member that has used a company in the past and had a good experience, that may be the best testament to the quality of their care. There are many resources online, just search home health or home care agencies in your zip code, and you should get a list of those licensed in your area. Many of these websites rate the companies and/or tell how they have done in past surveys, all helpful information when making a decision. Always remember that if you make a decision and find that you have chosen a company that doesn’t fit your needs, for whatever reason, you can change companies without repercussions.