It was our experience, in general, for agencies to aim for the patient that is needing the least services, especially the elderly after hospitalization, etc. Assuming we were ill-informed, the salespe
...Read MoreIt was our experience, in general, for agencies to aim for the patient that is needing the least services, especially the elderly after hospitalization, etc. Assuming we were ill-informed, the salespeople who hang out at the hospital would put imaginary limits on service, visits, duration, scope, episodes, etc. We would always know they were not qualified to assess properly, were not "clinical" or familiar with actual Medicare guidelines, and would imply that the agency would be in charge of decisions, frequency, etc., when in reality it is the doctor who gives the orders and the agency that must follow the orders. If you ask for any of these wild claims in writing, they will back out. Under Medicare, the Home Health Agency can schedule as many as 28 hours per week, and possibly more, up to 35 hours per week if the patient requires the care. A Medicare Beneficiary is entitled to choose to be at home for skilled nursing care, so the agency is not to "decide" that the patient needs to be in a facility. Later, if the agency accepts the patient, the marketing person who made initial intake is out of the picture and not responsible for the commitments that were made. When the patient needs immediate care, then, the agency can be in the driver's seat and only staff and supply as they wish. In my first (and even second) post, I tried not to sound as negative as our experiences have been, even though I did cite the problems honestly.
Frankly, Medicare has entrusted patient care to agencies who are empowered (or so they think) to be controlling, intimidating, and insensitive to the patient's needs. Our doctor and his assistant are worn out, and I can no longer go to them with the constant problems caused by the agency, although we are unable to just quit, as the patient needs the care. They quit us soon enough. Please know that every HH staff who has come to our home to care for the patient has been kind, professional, and outstanding in every way. The administrators are often not qualified to make decisions about the patient, but do so from a business standpoint only. They are not familiar with the patient's needs or condition, nor do they necessarily have information about the medical facts of the patient's need for service.
The patient is NOT required to stay home and never leave. The patient's family, caregiver, etc., are NOT required to learn and assume the care. The HH can "say" many fancifil things, but if they won't put it in writing, be suspicious. The doctor can and will order an aide, as, under Medicare, if the doctor has ordered skilled care under Medicare, the patient can certainly have an aide as well if necessary. This is NOT a rare case.
The less care they give to the patient, the more funds they get to keep as profit. I haven't met one yet that didn't want us to believe that the imaginary Medicare guidelines they repeated. That's why I suggested that you get familiar with terms and policies as soon as you can.