By Judith Boyko
Imagine this: you’re getting ready for surgery. Your hospital bag is packed. Your family is prepared to take over your daily tasks while you’re incapacitated. And you’re ready for your imminent hospital stay.
Now imagine this: post-surgery, your treating physician says that you are eligible for a visit (or several) from a visiting nurse to help you get back to optimal health. “Okay,” you say and leave it at that.
What you may not know, however, is that you have a choice as to where that visiting nurse comes from.
Although the law applies to anyone who has insurance, Medicare.gov indicates that, “As a person with Medicare, you have certain guaranteed rights and protections,” including the right to “choose your home health agency. (For members of managed care plans, choices will depend upon which home health agencies your plan works with.)”
Further, the American Hospital Association’s The Patient Care Partnership – Understanding Expectations, Rights and Responsibilities indicates that patients “can expect us to help … identify sources of follow-up care and to let you know if our hospital has a financial interest in any referrals.”
Myriad home health agencies exist in most urban and suburban areas of the country. Throughout Massachusetts, there are about 200 members of the Home Care Alliance of Massachusetts, “a non-profit trade association of home care agencies that promotes home care as an integral part of the health care delivery system,” according to its website.
With so many choices, how do individuals identify the right agency for them or their loved ones?
If you’ve ever been treated by a particular home health agency and you were pleased with the service you received, simply ask for a referral to the same one.
Those conducting initial research should understand that there are certain criteria that should be met by the agency providing care. Those measures ensure that the agency is licensed, certified or accredited.
The Centers for Medicare and Medicaid Services provides certifications to home health agencies that enable them to provide home health care to patients covered by Medicare and Medicaid.
The Community Health Accreditation Program (CHAP) is a national organization that accredits community-based home health agencies and hospice organizations. Its “purpose is to define and advance the highest standards of community-based care.”
Membership in trade organizations like the Visiting Nurse Associations of America, Visiting Nurse Association of New England, Home Care Alliance of Massachusetts and others lend further credibility to providers. Additionally, Medicare-certified agencies named to the HomeCare Elite list are ones whose performance measures in quality outcomes, best practice implementation, patient experience, quality improvement and consistency, and financial performance have ranked above others.
Prospective home health care recipients and their families should conduct due diligence when choosing a home care agency. Looking at the websites of the organizations mentioned is a great place to start.
Judith Boyko, MBA, MS, RN, is CEO of Century Health Systems, Distinguished Care Options and Natick Visiting Nurse Association. She can be reached at info@natickvna.org. For additional information, visit www.centuryhealth.org, www.dco-ma.com or www.natickvna.org or call 508-651-1786. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.
