Home Health Care Flashcards
what is home health care?
a wide range of skilled care that is provided to patients within their living environment
home health is most commonly seen in what populations?
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
t/f: sessions in home health need to be adaptive, personalized, and education-heavy
true
how many visits per week is best practice in home health care?
1-2
rehospitalization is reduced by 82% with how many home visits per week?
2
what are home health care agencies?
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
what are home care aide agencies?
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
what are hospices?
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
what is the PT’s role in management in home health?
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
what is involved in the mission, vision, and goals?
identifying with the organization you represent key for progression and satisfaction
what are the characteristics of working in home health?
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
how long are pt services typically at a time?
45 minutes
t/f: pt services are one on one
true
what are goals centered around in home health?
pertinent and immediate fxns necessary to attain the highest level of independence in the home environment
comprehensive care in home health involves what?
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
why must a PT be creative in home health?
bc of minimal equipment, layout and size of the home, and furniture present
what unique circumstances of home health can impact productivity goals?
circumstances beyond our control such as traffic, road conditions, weather conditions, time commitments and schedules of patients and caregivers
who is involved in interprofessional work in home health?
PTA
Occupational Therapy
Speech Language Pathology
Social Work
Home Care Registered Nurse
Home Health Aide
Physician
t/f: home care agencies prefer to hire physical therapists who have clinical experience in different healthcare settings like output and acute care
true
t/f: managers must be able to guide new hires as they face new challenges during their transition to the home-care setting
true
what is vital for employees as this is an atypical setting with a shift in the patient/therapist relationship?
a structured orientation
it is preferred that home health PTs have how many years experience with interdisciplinary work prior to hire?
2-3
what are the biggest hurdles for PTs in home health?
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
what is the Medicare eligibility for home health?
the pt has to be home bound
what is the PT’s role in revenue management in home health?
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
what is the payment system for home health?
patient-driven grouping model
what are the guidelines of the patient-driven grouping model?
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
what is the national standardized 30 day period payment for home health?
$1901.12 ($166.83 per visit)
what are potential threats to success of a PT in home health?
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
