Home health care questions
Will I require home health care after returning home from the hospital?
Home health services are routinely ordered after your initial recovery in the hospital following surgery for a total joint replacement. Patients usually benefit from skilled nursing and physical therapy services when they go home, and these services provide the support, assistance and guidance needed to recover successfully. If needed, occupational therapy, home health aide services, and/or medical social work assistance may also be ordered to meet your individual needs.
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What does each of the different services do for me at home?
Skilled Nursing – A nurse will typically visit you at home one or two times a week for three to four weeks to assess your incision for healing and teach you how to care for your incision, to assess your pain level and teach you about effective pain control, to draw blood for monitoring the effect of blood-thinning medications and report results to your doctor, to instruct you in changes in your medications and side effects of those medications, to teach you about appropriate activities and limitations that might apply, and to contact your doctor with any concerns and/or help you determine when the doctor needs to be contacted.
Physical Therapy – A physical therapist will provide you with skilled guidance, education, individualized instruction in exercises for strength, flexibility and balance, pain management, transfers and progression of your walking skills to help you get the best result from your surgery. Visits generally are two or three times a week for four weeks, depending on your needs.
Occupational Therapy – An occupational therapist can provide training and equipment recommendations to make bathing, dressing and activities of daily living easier and safer. This is most often accomplished in one to two visits.
Home Health Aide – An aide can visit two or three times a week to assist with bathing and personal care, if you are unable to perform these activities on your own safely and have no family available to assist you. An aide can also assist you with the exercise/walking program established by the physical therapist, if appropriate.
Medical Social Work – A social worker can assist you in obtaining community support services, assist with long-term medical decision making, and provide short-term counseling. These services are generally provided in one to three visits.
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How much will it cost me to have home health services?
Medicare, Medicaid and most private insurance plans cover intermittent home health services following your hospital stay during the time you are “essentially homebound.” Patients can take different lengths of time to recover to a point of being able to resume activities that allow them to leave their home frequently for non-medical reasons. During this time period while you are homebound, home health services are covered.
Medicare coverage: Medicare pays for home health services in full during this time period with no out-of-pocket expense to you, the patient. Services covered include skilled nursing, physical therapy, occupational therapy, social work assistance, and home health aide services, if needed.
Medicaid coverage: Medicaid coverage for home health is limited to only skilled nursing and home health aide visits, if needed, during this time period. However, it pays for those services in full as well with no out-of-pocket expense to you.
Private insurance coverage: Your private insurance plan must have a home health benefit in order for home health services to be covered. Your out-of-pocket expense will depend on what that benefit covers, whether the deductible and co-insurance amount have been met, and whether the home health agency is a contract provider. The benefit can have other qualifiers or limitations listed in the plan as well, such as requiring that you are homebound. The home health agency you choose to provide services should verify your insurance benefits ahead of time to find out whether home health is covered and inform you no later than during their first visit of any out of pocket costs you will be expected to pay.
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How do I prepare my home for after surgery?
Prior to surgery it is a good idea to take a close look at your home environment to determine if it is "user friendly" for someone on crutches or a walker. Modifications and equipment needs can be addressed ahead of time to ease your return home. The survey below will help you to identify risks and provide recommendations to improve home safety.
Q. Do you have loose throw rugs, runners, area rugs in pathways?
A. It is best to remove these while you are recovering. They can get tied up in the wheels of a walker, catch on a crutch tip or slide when stepped on. When using rugs make sure they have a non-skid rubber backing to prevent slippage.
Q. Are pathways, halls, entryway and doors clear of obstacles? Can a walker or crutches navigate easily from room to room?
A. Moving furniture to open pathways and making sure doors open fully will make it easier for you to get around once you are home. Bathroom doors are often too narrow to get through. Your physical therapist will instruct you in a safe technique to use
Q. How low is the toilet? Are there grab bars handy to help getting up?
A. A toilet riser, commode, grab bar on wall or arm rests that easily attach to a toilet may be helpful as getting up and down may be difficult initially.
Q. Do you have a bathtub, shower or combination? Is there a seat you can use? Is there a mat or non-skid surface?
A. A step-in shower is the easiest to access. Many have seats built right in, in case you need one. If you have a bathtub only or tub/shower combination a portable shower chair may be necessary for about a month. Having a grab bar is also recommended for optimum safety. Towel racks are not designed to hold the body’s weight and do not replace a grab bar.
Q. Do you have stairs to get into your home or up to the bedroom? Are there railings?
A. Having at least one rail to provide support is recommended.
Q. Do you have adequate lighting between the bedroom and bathroom?
A. Night lights are recommended for all pathways used after dark.
Q. Will you have help at home?
A. Having a caregiver to assist you during your first week home is strongly recommended. If you live alone, consider meals-on-wheels, part-time paid housekeeper or rotating schedule of friends and family to visit regularly. A portable telephone comes in handy when you are alone at home.
Q. Where can equipment be purchased? Is it covered by insurance?
A. Walkers, canes, crutches and commodes are generally covered by Medicare and most private insurers. Grab bars, toilet risers and shower equipment are not covered. Since your need for equipment is short-term, you may be able to borrow equipment from friends, your church, the VFW or other philanthropic organization with whom you are affiliated. If you will be using a walker, consider a basket or tray to allow items to be carried. Equipment can be purchased from many pharmacies and durable medical equipment companies. The hospital social worker or home health physical therapist can assist you in obtaining equipment.
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Can I choose any home health agency to provide my care?
Yes, you have a choice of which home health agency you want to use. A list of agencies in your area should be made available to you in the hospital to assist you in making the decision. Your doctor will work with that agency and provide them with the home health orders needed to care for you at home.
Our patients have reported good experiences with MU Sinclair Home Care and Boone Hospital Home Care. Both home health agencies are familiar with our aftercare protocols, provide quality care that can assist in your seamless transition to home.
If you prefer an alternative home health care agency or source, please let us know and we will plan accordingly.
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What is MU Sinclair Home Care?
MU Sinclair Home Care, the home health agency of the Sinclair School of Nursing, started in 1999 as the care delivery service of the Aging in Place Project (AIP). Since that time, the agency has grown into a fully-licensed Medicare and Medicaid home health agency serving adults, age 16 and above, in Audrain, Boone, Callaway, Cooper, Howard, and Randolph counties. The mission of MU Sinclair Home Care is to “Promote the independence, dignity, and health of adults by providing services and support needed for them to live in the home of their choice.”
MU Sinclair Home Care is a reliable and patient-care driven agency that has a well-deserved reputation for providing excellent care to their patients. For more information about the services they can provide, call 573-884-2689 or toll free 1-866-713-2273.
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What is Boone Hospital Home Care?
Boone Hospital Home Care, originally Visiting Nurses Association, was established in Columbia and began providing care to patients in 1973.The agency became Boone Hospital Home Care after affiliating with Boone Hospital Center in 1998. The agency is fully licensed to serve Medicare, Medicaid and private insurance patients of all ages in an 11-
county area in central Missouri. Boone Home Care is committed to "Bringing Boone Care Home," and promoting the mission of Boone Hospital Center to "Improve the Health of the People and Communities we Serve."
Boone Hospital Center and Boone Hospital Home Care received ANCC Magnet Recognition for excellence in nursing services, and Top 100 Hospital status by Solucient and Modern Healthcare Magazine in 2005. An experienced team of nursing and rehabilitation professionals are fully committed to excellence in patient care and customer service. For more information, please call 573-875-0555 or 1-800-723-2234.
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