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Choosing a home health care provider

woman with caregiverHelen is 85 years old and fiercely independent. Yet she realizes that she needs some help managing her diabetes and other health concerns as her physical capabilities diminish.

Jake is 35 and recovering from a car crash. He has spent months in the hospital recuperating, and now he's ready to return home. But he knows he'll need a little more assistance than his wife can provide.

Mary is 63 and nearing the end of her battle with breast cancer. She wants to spend her final weeks at home, but needs help managing her pain medications.  

For those who want to be home but need ongoing care beyond what friends and family can manage, a home health care provider can help. Home health care services provide in-home medical treatment, therapy or help with essential activities of daily living to individuals who are recovering, disabled or chronically or terminally ill. A home health care provider plays a key role in a patient's quality of life, so choosing the right one is an important decision. You'll want to consider the quality of care, availability of needed services, personnel training and expertise, as well as how you will pay.

Types of care
The first step in selecting a home health care provider is to evaluate your needs. Services offered by home care providers range from skilled care to household assistance. Physicians, nurses and therapists can help treat illnesses and provide skilled services such as injections and intravenous therapy, wound care and education, as well as rehabilitation. Home health aides can assist with activities of daily living, while chore workers and companions can help with household tasks and offer comfort. Talk to your physician or a hospital discharge planner for help in assessing your needs.

Which one is right for you?
Once you have narrowed your search to a few choices, the following questions may help in your final selection.
What are your qualifications? If you're considering a home care services agency, ask whether they are licensed by the state, accredited by a governing agency and certified by Medicare (see accompanying article for more about Medicare). If you're considering a home health aide, investigate his or her credentials. Check references.

What is the quality of care? Ask an agency about their hiring and training procedures, whether their caregivers are licensed and insured, and how care is supervised. Make sure you or your loved one feels comfortable with the caregiver.

What kind of service can you expect? Request a written care plan before care begins. Inquire about limits on the types of tasks performed, availability and emergency procedures.

What are the costs? Make sure you understand all of the expenses, how billing will be handled and if fees are covered by private health insurance, Medicare or another source.

Making the best choice
Several resources can help you evaluate the quality of home health care providers. For Medicare-certified agencies, you may review their Medicare Survey Report or call your state's Medicare hotline. Home care providers may also seek accreditation from professional organizations such as The Joint Commission to signify that they meet or exceed national standards for quality care. To learn more about home health care options, talk to your physician.

Will Medicare pay for home health services?
Americans older than 65 who are homebound, under a physician's care and in need of medically necessary skilled nursing or therapy may qualify for Medicare-certified home health services. If eligible, Medicare may pay for intermittent or part-time skilled nursing; physical, occupational and speech therapy; medical social work; and medical equipment and supplies. A physician must authorize and periodically review the patient's plan of care, and the services must be provided through a Medicare-certified home health agency.