Home Health Care Flashcards

1
Q

what is home health care?

A

a wide range of skilled care that is provided to patients within their living environment

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2
Q

home health is most commonly seen in what populations?

A

patients post-acute stay at a hospital or rehab facility

those with transportation struggles

those who qualify under their disability

those with hospice/end of life care

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3
Q

t/f: sessions in home health need to be adaptive, personalized, and education-heavy

A

true

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4
Q

how many visits per week is best practice in home health care?

A

1-2

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5
Q

rehospitalization is reduced by 82% with how many home visits per week?

A

2

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6
Q

what are home health care agencies?

A

provide clinical or skilled care by nurses and therapists using a team based approach

covered by Medicare/Medicaid/private insurance and patients must meet eligibility criteria

PTs play important role in interdisciplinary skilled care

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7
Q

what are home care aide agencies?

A

provide non clinical or non skilled care by professional caregivers to assist with activities of daily living

paid out of pocket or may be covered by long term insurance/Medicaid

PTs may play teaching role in the agency by preparing home care aides for their duties with complex patients

homemaker, personal care services to assist with activities of daily living and provide companionship

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8
Q

what are hospices?

A

medical and social services provide individualized care plans to manage symptoms and pain in patients who have a prognosis of 6 months or less

to be eligible, patients must have documented proof of only 6 months to live, but can live longer and continue to receive care and must agree to palliative care rather than life-prolonging care

PTs may have a range of roles that focus on assisting caregivers as a patient’s condition declines to collaborating with an interdisciplinary team

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9
Q

what is the PT’s role in management in home health?

A

mission, vision, and goals

upholding SELF moral, ethical, and legal standards

interprofessional interaction and communication

advocating for one’s own services and protections (insurance, legal etc)

be experts on resources within the community that can assist you AND the patient in achieving goals set

managing safety, fiscal, and communication barriers

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10
Q

what is involved in the mission, vision, and goals?

A

identifying with the organization you represent key for progression and satisfaction

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11
Q

what are the characteristics of working in home health?

A

PT services are patient focused and occur for approximately 45 minutes with one patient at a time

goals are centered on pertinent and immediate functions necessary to attain the highest level of independence in the home environment

an interdisciplinary team is involved in comprehensive care that emphasizes activities of daily living, assessing and instructing the use of durable medical equipment, and providing caregiver training to ensure the patient remains functional in their home environment

PTs must be creative when developing care plans and obtaining clinical outcomes within a patient’s home due to minimal equipment, layout and size of the home, and furniture present

circumstances beyond our control such as traffic, road conditions, weather conditions, time commitments and schedules of patients and caregivers can all impact productivity goals

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12
Q

how long are pt services typically at a time?

A

45 minutes

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13
Q

t/f: pt services are one on one

A

true

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14
Q

what are goals centered around in home health?

A

pertinent and immediate fxns necessary to attain the highest level of independence in the home environment

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15
Q

comprehensive care in home health involves what?

A

activities of daily living

assessing and instructing the use of durable medical equipment

providing caregiver training to ensure the patient remains functional in their home environment

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16
Q

why must a PT be creative in home health?

A

bc of minimal equipment, layout and size of the home, and furniture present

17
Q

what unique circumstances of home health can impact productivity goals?

A

circumstances beyond our control such as traffic, road conditions, weather conditions, time commitments and schedules of patients and caregivers

18
Q

who is involved in interprofessional work in home health?

A

PTA

Occupational Therapy

Speech Language Pathology

Social Work

Home Care Registered Nurse

Home Health Aide

Physician

19
Q

t/f: home care agencies prefer to hire physical therapists who have clinical experience in different healthcare settings like output and acute care

A

true

20
Q

t/f: managers must be able to guide new hires as they face new challenges during their transition to the home-care setting

A

true

21
Q

what is vital for employees as this is an atypical setting with a shift in the patient/therapist relationship?

A

a structured orientation

22
Q

it is preferred that home health PTs have how many years experience with interdisciplinary work prior to hire?

A

2-3

23
Q

what are the biggest hurdles for PTs in home health?

A

community Resources

paperwork

Medicare eligibility

communication

insurance constraints

one-to-one handling

patient living situations

safety

adaptability to patient scheduling

windshield time

equipment

patient family/home dynamic

24
Q

what is the Medicare eligibility for home health?

A

the pt has to be home bound

25
Q

what is the PT’s role in revenue management in home health?

A

billing accurately and efficiently

making use of available and logical resources (travel time and cost budgeting)

explaining insurance benefits and self-pay rates to clients

enforcing policy of timely patient payments

proper scheduling to make the most of time

overwhelming majority of patients are medicare so revenue is largely fixed

26
Q

what is the payment system for home health?

A

patient-driven grouping model

27
Q

what are the guidelines of the patient-driven grouping model?

A

30 day period of care
- if the visit threshold is not met for the 30 day period, the PT is paid per visit
- if the threshold is reached, they recieve a standardized payment rate depending on the subgroup

POC is created on 1st visit with recert required after 60 days; PTs use OASIS to determine functional impairments

information obtained from medicare claims: comorbidities, admission source, clinical grouping, and timing of 30-day period

from these results, CMS will put each patient into one of 432 subgroups for predetermined base payment

28
Q

what is the national standardized 30 day period payment for home health?

A

$1901.12 ($166.83 per visit)

29
Q

what are potential threats to success of a PT in home health?

A

managing staff shortage/schedule/burnout

pt and PT safety due to the high risk nature of a home

adverse working conditions: pets, smoking, hazardous home, crime

abuse within the home

CHILDLINE, PROTECTIVE SERVICES, 911, etc

not as many DIRECT resources compared to an outpatient clinic

agency support

availability of other health professionals within the area

closed-mindedness