OBJECTIVE: This article provides information about Home Health Nursing in Indiana.
Table of Contents
- Home Health Nursing
- Quick Overview of Payor Sources
- Medicare Homebound Status
Home Health Nursing
What is Home Health?
- Home Health provides the patient the ability to receive the services they need to stay safely in their home.
- Home can be their own home they lived in for years, an assisted living, or even group home. It is where the patient calls home.
- In home health we are not just treating the patient we are looking at their home, their family dynamics and everything that affects their healing process and ability to safely remain at home.
Home Care Terminology
- Certification Period - “Cert” period or Episode, it is 60 days in length unless the patient is discharged.
- Start of Care - This is the visit that starts the episode and begins the services
- Recertification - This is the next 60 days we are going to provide services if we are going to continue services after the first 60 days we will have to “recert” them based on medical need.
- Frequency - This is the amount of visit per episode per service (SN, HHA, etc)
- Plan of care - This is the care plan that is generated that is our “job” to take care of the patient.
- OASIS - A standardized assessment that all agencies use for skilled services to assess a patient.
- Non-Oasis assessment - An assessment used for non-skilled patients that may only be getting aide services.
- Face to Face - This is an assessment between a patient and their physician that happens 90 days before the start of care or 30 days after the start of care to certify the patient for home health care.
Quick Overview of Payor Sources
Medicaid services (state plan)
Covered Skilled Services:
Home Health aide
Up to 14 hours of SN and Aide Services, is for personal care but can perform Incidental services such as light housekeeping, trash, meal prep
Department of Aging Programs and waiver
Medicare Homebound Status
Patient must meet:
1. Criteria One
The patient must either:
- Because of illness or injury need the aid of supportive devices such as crutches, canes, wheelchairs, and walkers; the use of special transportation; or the assistance of another person to leave their place of residence, or
- Have a condition such as leaving his or her home is medically contraindicated
If the patient meets one of the Criteria one conditions, then the patient must ALSO meet two additional requirements defined in Criteria two below
2. Criteria Two
There must exist a normal inability to leave home AND leaving home must require a considerable and Taxing Effort
Examples of homebound clients:
- A patient paralyzed from a stroke who is confined to a wheelchair or requires the aid of crutches to walk.
- A patient who is blind or senile and requires the assistance of another person in leaving their place of residence.
- A patient who has lost the use of their upper extremities and, therefore, is unable to open doors, use handrails on stairways, etc., and requires the assistance of another individual to leave their place of residence.
See attachment: Overview of Home Health training document
Source: Indiana Branch Staff