F.A.Q.’s
Do I (or a loved one) need HomeCare?
Generally, HomeCare is appropriate whenever an individual prefers to stay at home, but requires ongoing care or assistance that cannot be easily or efficiently provided solely by family and friends. Many people prefer to stay at home rather than go to a hospital or nursing home when they can no longer manage their own care without assistance. Assessing the care recipients need will assist in determining if HomeCare is appropriate. Review the following questions. If the answer to any of the questions below is “yes”, then the individual would likely benefit from HomeCare services.
- Does the individual need assistance with activities of daily living – those activities such as bathing, dressing, and eating that people usually do independently?
- Does the individual require ongoing medical treatment such as IV therapy or wound care, or assistance with medical equipment such as catheters, ostomy bags, or prostheses?
- Do you or the family have concerns about safety issues with the individual being alone in the home?
- Does the individual suffer from loneliness, isolation, depression, or need for companionship?
- Are the individual’s family and friends unable to meet his/her needs without significant stress themselves?
Early warning signs that a person needs in-HomeCare include:
- Difficulty with walking
- Difficulty with activities of daily living
- Falling at home
- Errors with medication
- Confusion
- Depression
- Weight loss
- Disheveled appearance
- Frequent, nonspecific phone calls
- Frequent visits to the Emergency Room and/or frequent hospitalizations
- Expressed family concerns about the individual
How do I find a HomeCare provider?
Family, friends, community services and churches or synagogues may also recommend a HomeCare provider.
It is very important that you understand that you have the right to choose a HomeCare provider. Finding the HomeCare agency best suited to you requires identifying your specific needs. Important factors to consider are availability of services (24 hours a day if needed), geographic areas served, ability to provide specific medical services, non-medical and social services provided, training and expertise of agency personnel, quality of care, agency accreditation and certifications, and coverage provided by insurance.
Putnam County HomeCare & Hospice is available to assist our patients 24 hours a day, 7 days a week. Our HomeCare team serves Putnam County and surrounding areas. Putnam County HomeCare & Hospice is Medicare/Medicaid certified and CHAP (Community Health Accreditation Program) accredited. In 2017 and 2018, we were named a Top Agency of the HomeCare Elite®, a recognition of the top-performing home health agencies in the United States.
What are my rights as a HomeCare patient?
The professional nurse is an integral and unique member of the health team, and as such recognizes that the recipient of health care has the right to professional nursing care in all health settings. Therefore, you, the consumer of nursing care, have the following rights:
- Be fully informed in writing, in advance of coming under the care of our agency of your rights and responsibilities.
- Be fully informed in advance about the care and treatment to be provided by our agency including disciplines and frequency of visits.
- Be fully informed in advance of any changes in the care or treatment to be provided by our agency that may affect your well-being.
- To participate in planning care and treatment or changes in care or treatment unless you are adjudged incompetent.
- To confidentiality of your clinical records in accordance with legal requirements.
- To have your property treated with respect.
- To be informed orally and in writing, in advance of coming under the care of the agency, of:
- all items and services furnished by (or under arrangements with) our agency for which payment may be made by Medicare;
- the coverage available for such items and services under Medicare, Medicaid, or other federal programs of which our agency is reasonably aware;
- any charges for items and services not covered under Medicare and any charges you may have to pay with respect to items and services furnished by (or under arrangements with) our agency;
- any changes in the charges or items and services described in the preceding clauses (a), (b), and (c) within 30 days of knowledge of the change.
- To refuse treatment within the confines of the law and to be informed of the consequences of refusing treatment.
- To considerate and respectful care, with recognition of your personal dignity. If our agency can no longer meet your care and service needs, you participate in the prompt and orderly transfer to another organization or level of care.
- To reasonable continuity of care. You will be admitted for care and treatment by our agency only if our agency is able to provide safe and professional care at the level of intensity needed.
- To be informed of anticipated termination of service by our agency or plans for transfers of your care and treatment to another health care provider.
- To voice grievances regarding policies, care, or services, and recommend changes without coercion, discrimination, reprisal, or unreasonable interruption of care or services,
- To be given information on Advance Directives and respect wishes regarding Advance Directives implementation.
- To have appropriate assessment and management of pain and to receive education regarding pain management as part of your treatment.
- To have your legal representative authorized to exercise your rights.
- To have a right to access your medical record.
- To be informed about any beneficial relationship between Putnam County HomeCare & Hospice and any referral source.
What do I do if a problem develops?
If you suspect fraudulent activity involving the HomeCare agency, you should report this to your state department of health. If a case involves delivery of Medicare HomeCare service, contact the Office of the Inspector General hot line at 1-800-HHS-TIPS.
The Food and Drug Administration, Division of Drug Compliance and Surveillance, regulates home medical equipment companies that provide oxygen. Agencies that provide legend devices are licensed as medical device retailers by the FDA Center for Devices and Radiological Health or the Board of Pharmacy in your state. Concerns and complaints regarding these services should be directed to the appropriate agency:
- FDA Division of Drug Compliance and Surveillance: 301-594-2073
- FDA Center for Devices and Radiological Health: 800-638-2041
What is HomeCares role in the Health Care System?
HomeCare has proven effective in reducing the incidence hospitalizations in many patient populations. It provides a safe alternative to institutional care or unsafe situations that arise from patients remaining in the home without assistance or monitoring. Some conditions, such as those involving changes in mental status are treated with best results in the home setting. With advances in telehealthcare and telecommunications, noncompliant patients can often be helped to achieve compliance and better health status with minimal intervention.
What is the criteria to be on Home Health?
- A physician’s order for a skilled need (nursing, physical therapy, occupational therapy, speech therapy).
- A Face-to-Face visit with the physician ordering the services.
- You must be homebound.
- To be homebound means:
- You have trouble leaving your home without help (like using a cane, wheelchair, walker, or crutches; special transportation; or elp from another person) because of an illness or injury, or
- Leaving your home isn’t recommended because of your condition, and you’re normally unable to leave your home because it’s a major effort
- You may leave home for medical treatment or short, infrequent absences for non-medical reason, like attending religious services. You can still get home health care if you attend adult day care.
- To be homebound means:
What questions should I ask about a HomeCare provider?
- How long has the provider served the local community?
- What type of services do they provide?
- Do the services provided match your needs?
- What is the reputation of the provider?
- Is the provider certified by Medicare? Only Medicare certified agencies can provide Medicare covered services.
- Does the provider have a state license?
- What other credentials does the provider maintain?
- Does the provider have written policies relating to description of services, hours of operation, eligibility requirements, fees, patient rights, confidentiality, complaint procedures, and emergency arrangements?
- How does the provider select employees? Does the provider ensure that employees are operating under written personnel policies, clinical protocols, and malpractice or professional liability insurance? What backup systems are in place to ensure continuity of care?
- Will the agency continue to provide services if Medicare or other sources of reimbursement are exhausted?
- What back up plans are in place if the agency fails to continue operating?
What should I expect from my home health care?
- Doctor’s orders are needed to start care.
- Once your doctor refers you for home health services, Putnam County HomeCare & Hospice will schedule an appointment and come to your home to talk to you about your needs and ask you some questions about your health.
- Putnam County HomeCare & Hospice will also talk to your doctor about your care and keep your doctor updated about your progress.
- It’s important that Putnam County HomeCare & Hospice staff see you as often as the doctor ordered.
What types of services can HomeCare Providers deliver?
- Medicare Certified Medical Services – these include skilled nursing care, physical therapy, occupational therapy, speech therapy, and services of home health aides and medical social workers.
- Non-Medicare Medical Services – can include services certified by a physician as medically necessary and custodial care, but most commonly involve primarily nursing care and therapies.
- Home Infusion Services or IV Therapy – these services allow the patient to receive intravenous therapy in the home. This includes various kinds of IV drugs, but most often involves antibiotics and chemotherapy.
- Home Pharmacy Services – typical home pharmacy services include administration of IV drugs, other injectable medications, and medications that are administered as inhalants.
- Home Support Services – these services include many types of support services that allow the individual to remain safely in the home. Common services include: assistance with ADLs (activities of daily living) such as bathing, grooming, dressing, transferring, toileting, etc. Housekeeping, yard work, minor home repairs and modifications may also be included. Custodial care such as sitters and companions also come under this heading. These programs are available through the Area Agency on Aging.
- Home Medical Equipment/Durable Medical Equipment – this includes all medical equipment used in the home setting such as: hospital beds, walkers, canes, wheelchairs, commodes, bedpans, orthotics, oxygen, etc.
The staff of Putnam County HomeCare & Hospice may include any combination of the following:
- Registered Nurses
- Home Health Aides
- Physical Therapists
- Occupational Therapists
- Speech Therapists
- Medical Social Workers
- Physicians / Nurse Practitioners
- Volunteers
Who pays for HomeCare?
When Does Medicare Pay for HomeCare? Medicare Part A (Hospital Benefit) will pay 100% for HomeCare visits if:
- Services are ordered by a physician.
- The patient qualifies as homebound because of illness or injury.
- The patient needs part time or intermittent nursing care, or physical therapy, speech therapy, or occupational therapy.
- Non-medical HomeCare services, or home health aide services (i.e. personal care), are only covered if the patient is receiving nursing care, physical, speech or occupational therapy.
- In addition, routine medical supplies needed by the home health nurses are also covered under the Medicare Home Health benefit.
Services that are not covered include:
- Full-time nursing care,
- Drugs and IV therapy (with some exceptions),
- Homemaker/housekeeping help, and
- Routine custodial care.
Who provides HomeCare?
Putnam County HomeCare & Hospice is a nonprofit county governmental agency. The agency is a small, rural agency operating in Ottawa, Ohio. Putnam County HomeCare & Hospice is Medicare/Medicaid certified and CHAP (Community Health Accreditation Program) accredited. Patients have guaranteed rights and protections. You have the right to choose your home health provider. If you are not given a choice, ask your discharge planner or social worker.
Who Uses HomeCare?
People who may benefit from HomeCare:
- Persons discharged from the hospital who are not fully recovered;
- Persons with chronic conditions such as diabetes, kidney disease, or stroke, which require frequent monitoring;
- Persons with terminal disease, such as cancer or AIDS, who need personal care, pain management, and emotional support;
- Persons with limited mobility who need assistance with activities of daily living;
- Families that need respite from caregiving and emotional support in dealing with a loved one who needs special care;
- A child with special life sustaining medical equipment who can thrive at home and school with nursing support.
Advantages of HomeCare:
- Allows for early discharge from hospitals and prevents or postpones institutionalization;
- Provides an extension of the physician into the home, which imparts confidence and peace of mind.
- HomeCare agencies are the physician’s “eyes and ears” in the home.
- Monitoring of patients allows for early diagnosis of complications or infections.
- Offers personalized, one-to-one care, tailored to the needs of each individual and allows maximum freedom for the client;
- Is cost effective care compared to hospital or nursing homes;
- Supports (does not replace) the family’s efforts in caring for loved ones at home;
- Allows individuals to maintain their independence in their own homes.
Are services available if a visit is needed during non-business hours?
Putnam County HomeCare & Hospice are available for medical and nursing services 24 hours a day and has pharmaceutical access 24 hours a day.
Can I be cared for by hospice if I reside in a nursing facility or other type of long-term care facility?
Hospice services can be provided to a terminally ill person wherever they live. This means a patient living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility.
Do state and federal reviewers inspect and evaluate hospices?
Yes. There are state licensure requirements that must be met by hospice programs in order for them to deliver care. In addition, hospices must comply with federal regulations in order to be approved for reimbursement under Medicare. Hospices must periodically undergo inspection to be sure they are meeting regulatory standards in order to maintain their license to operate and the certification that permits Medicare reimbursement.
Does Putnam County HomeCare and Hospice provide care in facilities such as nursing facilities and assisted living facilities? If yes, which area facilities work with the hospice?
Hospices are not able to provide care in facilities unless they have a contract to do so. Facilities are not required to have contracts with hospices. If you already reside in a nursing or assisted living facility, you will want to know what hospice providers are able to serve you. Should you need to transfer to one of these types of facilities in the future, it is most often best for the continuity of your care if you are able to receive hospice services from the same hospice provider as you did prior to transferring to the facility.
Putnam County HomeCare & Hospice has a hospice contract and can provide hospice care with all area nursing and assisted living facilities.
Finding a Hospice Agency
Putnam County HomeCare & Hospice offers families the chance to talk to our staff about hospice services before they make this difficult decision. Please call 419-523-4449 to speak with one of our staff members about Hospice.
How and where does Putnam County HomeCare and Hospice provide respite care?
Respite care is provided for periods of up to five days at a time to provide relief to a patient’s caregiver(s). Respite care can be provided in most area nursing facilities.
How can I be sure that quality hospice care is provided?
Many hospices use tools to let them see how well they are doing in relation to quality hospice standards. In addition, most programs use family satisfaction surveys to get feedback on the performance of their programs. To help hospice programs in making sure they give quality care and service, the National Hospice and Palliative Care Organization has developed recommended standards entitled ‘Standards of Practice for Hospice Programs’ as one way of ensuring quality.
There are also voluntary accreditation organizations that evaluate hospice programs to protect consumers. These organizations survey hospices to see whether they are providing care that meets defined quality standards. These reviews consider the customary practices of the hospice, such as policies and procedures, medical records, personal records, evaluation studies, and in many cases also include visits to patients and families currently under care of that hospice program. A hospice program may volunteer to obtain accreditation from one of these organizations.
The Ohio Department of Health surveys Putnam County HomeCare & Hospice every 5 years. Putnam County HomeCare & Hospice is CHAP (Community Health Accreditation Program) accredited. A surveyor visits our agency every 3 years from CHAP.
Compare hospices based on quality of care by clicking here.
How does hospice care begin?
Typically, hospice care starts as soon as a formal request or a ‘referral’ is made by the patient’s doctor. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, providing the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day of the referral. However, in urgent situations, hospice services may begin sooner.
How does the hospice work to keep the patient comfortable?
How long after requesting services will it take to get signed up?
If you are covered under commercial insurance, is Putnam County HomeCare and Hospice an approved provider with your insurance company?
Is Hospice Available After Hours?
Is Putnam County HomeCare and Hospice licensed by the state of Ohio and is it Medicare and/or Medicaid Certified?
Is Putnam County HomeCare and Hospice staff certified in hospice care?
What happens if I cannot stay at home due to my increasing care need and require a different place to stay during my final phase of life?
Many hospice programs have their own hospice facilities or have arrangements with freestanding hospice houses, hospitals or inpatient residential centers to care for patients who cannot stay where they usually live. These patients may require a different place to live during this phase of their life when they need extra care. However, care in these settings is not covered under the Medicare or Medicaid Hospice Benefit. It is best to find out, well before hospice may be needed, if insurance or any other payer covers this type of care or if patients/families will be responsible for payment.
Putnam County HomeCare & Hospice can provide care at any area skilled nursing facility or assisted living.
What hospice services are provided?
What is the Hospice Care Admission Criteria?
- A diagnosis of a terminal illness has been made by a physician, with a person’s life expectancy now measured in months rather than years.
- A person/family requesting hospice care understands that medical therapies can no longer be used for cure and are seeking palliative measures for pain control and/or symptom management.
- A person’s attending physician orders hospice care and continues to direct that care throughout the illness.
- A person who is willing and able to assume responsibility for your care with the help of the Hospice Interdisciplinary Team.
What role does the hospice volunteer serve?
Because hospice volunteers spend time in patients’ and families’ homes, Putnam County HomeCare & Hospice has an application and interview process to assure the person is right for this type of volunteer work. In addition, our hospice program has an organized training program for our patient care volunteers. Areas covered by these training programs often include understanding hospice, confidentiality, working with families, listening skills, signs and symptoms of approaching death, loss and grief and bereavement support.
What type of bereavement services does Putnam County HomeCare and Hospice provide?
What type of care is provided by the hospice volunteers?
When is the right time to ask about hospice?
When Should Hospice Care Begin?
Hospice is appropriate when:
- A patients has a serious illness with a life expectancy of 6 months or less
- Comfort care and symptom management become the primary focus
- Curative treatment is no longer the patient’s choice or option
Will I be the only hospice patient that the hospice staff serves?
All visits, however, are based on the patient and family needs as described in the care plan and the condition of the patient during the course of illness. The frequency of volunteers and spiritual care is often dependent upon the family request and the availability of these services. Travel requirements and other factors may cause some variation in how many patients each hospice staff serves.
Can I have curative treatment together with palliative care?
How do I get palliative care?
How do I know if Palliative Care is right for me?
How does palliative care help me choose the best treatment option?
How does Palliative Care work with my own doctor?
What can I expect from Palliative Care?
What Does a Palliative Care Provider do?
If you have a serious illness, you may have pain from the illness or from your medical treatments or both. You also may have other uncomfortable or alarming symptoms such as shortness of breath, nausea, constipation, and depression or anxiety. Perhaps you are comfortable now, but fear that pain or other symptoms will get out of control as your illness progresses.
You should know that there is almost always something that can be done to diminish pain and other serious, but common, symptoms and there are many ways to improve your quality of life.
As palliative doctors, we believe strongly that:
- You should not have to suffer.
- You should not have to fear unmanageable pain or other symptoms.
- We are experts at relieving pain and symptoms while promoting quality of life and at developing a treatment plan that will work best for you.
What does the palliative care team do?
To do this, the palliative care team will:
- Relieve your symptoms and distress
- Help you better understand your disease and diagnosis
- Help clarify your treatment goals and options
- Understand and support your ability to cope with your illness
- Assist you with making medical decision
- Coordinate with your other doctors
What is the Palliative Care Admission Criteria?
In order to be admitted into the Putnam County Palliative Care:
- Appropriate at any age and at any stage of an illness.
- Can be provided along with treatments that are meant to cure.
- Offered in long term care facilities, assisted living facilities and at home.
When should I ask for palliative care?
Recent cancer guidelines say that cancer patients should receive palliative care early and together with their other treatments. People who are newly diagnosed with advanced cancer should receive a palliative care consult within 8 weeks of their diagnosis.