Who provides Home Care?
In Virginia, many different organizations provide home care, and most are listed in the Yellow Pages. Your local Health Department, Department of Social Services, and your local Area Agency on Aging may provide home care, or they can help you locate home care providers in your community. You can find the telephone number for your local Area Agency on Aging in the Yellow Pages under headings such as "Aging" or "Senior Citizens". Also, some companies offer non-medical, private pay home care services.
Additional Home Care providers can be found on Google or other search engines. We hope you'll contact us to learn more about the home care services we provide.
How do I choose a Provider?
Many communities have more than one organization that can provide home care services. If this is the case in your community, you should begin by comparing the services offered by the different home care providers.
Use a checklist (like the one on the next page) to help you determine what type of services will be needed. Since each person's needs differ, depending on their health and circumstances, you may need to add services to the checklist that you think are essential. Once you have considered what type of home care services are needed, a checklist will help you gather consistent information from various home care providers. When you are finished collecting information, it will help you compare the types of services offered by the providers in your community.
What questions should I ask?
Before contacting a home care provider, prepare a list of questions you want to ask. Each individual situation is different, but the questions below should be included in your list.
Will the person that receives the home care services get enough care to meet their needs?
Can the home care provider give you references?
Will Medicare or Medicaid pay for the home care services?
If possible, contact more than one provider so that you can compare them. Make sure that you do not feel pressured to accept more services than you need or can afford.
Should I ask for a written agreement?
Once you have selected a home care provider that you feel comfortable with, the provider must give you a written agreement. A written agreement is required for all licensed or certified agencies and all accredited agencies. The agreement should clearly describe:
The home care services that will be performed;
When the home care workers will visit the home, and approximately how long the visits will be (or for how many hours, if the visits are arranged in shifts);
All of the costs involved with receiving the services;
The costs covered by insurance; and
The arrangements for payment.
Both you and the provider should sign the agreement. You should receive and keep a copy of the agreement for your records..
How will I pay for Home Care?
An important consideration in selecting home care services is the cost. The type of home care that you select will probably influence how you will pay for that care. For example, if you are choosing nursing services, the care may be covered by Medicare, Medicaid, or private health insurance. In most cases, a physician will have to authorize the care in order for it to be covered.
Medicare will pay for home health care only if all of the following criteria are met:
A physician has certified the need for home health care and has developed a care plan with the home care provider with input from the care recipient or an authorized family member;
The care is "intermittent," for short periods of time and only on a part-time basis;
The person who will receive the care cannot leave the home without difficulty or taxing effort;
The care to be provided meets all medical criteria identified in the home health manual and is "reasonable and medically necessary"; and
The home care organization has a Medicare number and will accept Medicare payment.
Medicaid may help pay the cost of home care for eligible low-income persons. Medicaid eligibility is based on monthly income limits and limits on assets (savings accounts, property value, etc.) Not all home care providers are approved for Medicaid. If you have Medicaid, ask a provider whether they will accept Medicaid payment. In some cases, home care can be paid for by a combination of Medicare and Medicaid.
Medicaid also has a Personal Care Program which will pay for home care services only if they are necessary to avoid placing a person in a nursing home. Eligibility for this program is determined by a Pre-Admission Screening Committee. Ask your local Department of Social Services or your local Area Agency on Aging for information.
Your private health insurance may cover home care services. Check with your insurance company to determine coverage, then make sure the home care provider accepts payment from the insurance carrier.
Your local Health Department, the local Department of Social Services, and your local Area Agency on Aging may also provide some home care services. These services may be provided at no cost to eligible individuals, or the agency may have a sliding fee scale that is based on a person's ability to pay. Contact each agency to determine which options are available in your area. Their telephone number(s) are available in your local telephone directory.
In most cases, paying for home care services such as homemaking or other non-medical services will be your responsibility. Once the method of payment has been selected, all of your payment arrangements should be agreed to in writing before you accept the services of a home care provider.
What are my rights and responsibilities?
The National Association For Home Care has developed a list of the rights and responsibilities of home care recipients and their families or caregivers. All Medicare providers are required to give each patient a copy of this list. The Virginia Association for Home Care (VAHC) has also developed a Code of Ethics under which each home care provider should operate. Ask potential home care service providers for a statement of their ethical and operational beliefs.
The Virginia Office of the State Long-Term Care Ombudsman investigates and resolves complaints about long-term care. The Ombudsman Program endorses the list of rights and responsibilities shown below.
In Virginia, home care consumers and their families or caregivers have the right to:
Be fully informed of their rights and responsibilities by a home care provider;
Receive appropriate and professional care consistent with physician's orders;
Choose their care provider(s);
Receive the necessary information to give informed consent before the start of any procedure or treatment;
Refuse treatment and to be informed of the consequences of their actions;
Receive a timely response from the provider to their request for service;
Be admitted for service only if the provider has the ability to provide safe, professional care at the level required; Receive reasonable continuity of care;
Be informed of the termination of service or their transfer to another provider in a timely fashion;
Voice grievances and suggest changes in service or staff without fear of retaliation;
Be fully informed about provider policies and charges for services, including eligibility for third party reimbursements;
Be referred elsewhere if they are denied service based on their inability to pay; and
Receive honest, accurate, forthright information regarding the home care industry in general and their chosen provider in particular.
questions should I ask?What if I experience a problem?
If you experience a problem with a home care service provider, you should first try to resolve the problem yourself. Follow these steps:
Define the problem by writing it down. Include information such as: - When did the problem occur or start? - How do you feel about it? - Can you think of a fair solution?
A problem cannot be resolved until all parties know that it exists, so you should discuss the problem with the home care provider. Talk with the person who actually performs the service, or with that person's supervisor. Communicating your concerns will most often resolve a service problem, but be sure to document your efforts by writing down the dates, times, locations and results of conversations you have had, and the names and titles of the people you talked with about the problem.
If you are uncomfortable trying to resolve the problem yourself, or if the problem remains unsolved despite your best efforts to resolve it, you can contact the Complaint Division at the Center for Quality Health Care Services and Consumer Protection at the Virginia Department of Health. Complaints can be submitted in writing, by telephone, fax, e-mail, or in person, and complainants can remain anonymous.