Choosing a Home Health Agency Can be Overwhelming

by Amy Potter - Monday, December 03, 2018

A few times a week, I have the pleasure of speaking to a loved one of a senior who is seeking information about home health. With each call I am reminded how overwhelming finding the right type of service and the best of the particular type of service can be. Generally, the search is happening at a stressful time because the senior has either declined to a point of needing caregiver assistance or has an illness or injury that requires home medical care. The presenting concern only adds to the stress of finding good services.


During these calls, I attempt to help the caller define what he or she is seeking. Often times, it is personal care or caregiving assistance. These services are not a Medicare benefit and are not a service that Home Therapy provides. Personal care or caregiving services are called Private Pay or Private Duty services as the payment is generally out-of-pocket. There can be payment through the VA, long-term care insurance and Medicaid but, most often it is a personal cost. To add to the confusion these services are often referenced as home care versus home health care, a medical benefit through Medicare, that Home Therapy offers. 


If the caller is seeking private duty services, I attempt to help them with references to companies we know to be good and guide them on questions to ask the provider prior to selection.


If the caller is seeking skilled medical care in the home, we discuss the fact that these services are a 100% Medicare benefit and what the services entail – skilled nursing, physical therapy, occupational therapy, speech therapy, social work and home health aide – if the patient qualifies. I share that the services are for as much as a 60 day period and are designed to be short-term and intermittent. The services are under the order of the patient’s physician and are supervised by that physician.


We also discuss the fact often the physician and more often someone in the physician’s office selects the home health agency on behalf of the patient. If the patient is in the hospital the selection is influenced or directed by the Case Manager. Many times the selection might be based on what is important to that individual and not what is important to the patient and family. Most often the family is happy to have the selection made for them since they are unaware of how to choose a good option. It is a Medicare right that the patient (family representative) have the ultimate right to choose his/her home health provider and the physician’s office and the hospital are to inform the patient/family of that right.


In 2015 Medicare created a star system to assist patients and family members distinguish between exceptional agencies (5 and 4.5 stars), average agencies (3 star) and poor agencies (2 and 1 stars). The stars reflect how often the Agency created positive clinical and functional outcomes and positive patient experiences. The star system is a good way for consumers to make a decision. The star system does not reflect ethics however – a big concern in the home health industry. There can be a highly ranked star agency that still puts profit over the patient by withholding services or limiting services. Only a conversation with an Agency representative can assist the consumer determine ethics. This is another reason that I am delighted to have the chance to talk to the patient’s loved one.


Each year, the top 25% of agencies in the Nation achieving the best clinical and functional results and patient satisfaction are identified by the companies Decision Health and Ability. This ranking is referenced as Home Care Elite. Additionally, the Top 500 and Top 100 are identified. Home Care Elite recognition is another way for those seeking home health care to have some assurance regarding their decision.


I am very pleased that since 2011, Home Therapy of Austin, LLC has been a Home Care Elite winner. In the past seven years, we have been a Top 100 agency three times and a Top 500 agency two times – including last year. I hope that the care, compassion and ethics that are behind these recognitions assist those seeking the best home health option to choose Home Therapy and I invite you to call me if I can assist you with more information or guide you to other resources. Thank you, Amy Potter, Founder and CEO, 512-637-1550.