Skilled Nursing Care in South Florida
Skilled Nursing Care at Home
What Does Skilled Nursing Care at Home Include?
Medication Management: Partnering with the patient’s doctor, nurses develop a medication schedule, evaluate the effectiveness of medications, and educate the patient and/or his or her caregiver on proper dosage, frequency and side effects.
Disease Management: For patients with chronic conditions, such as heart failure, diabetes and chronic obstructive pulmonary disease (COPD), these programs help patients maintain independence and a healthier lifestyle. Services include nursing care, rehabilitation, & patient education.
Rehabilitation Nursing: After suffering from a severe injury, like burns, stroke, or amputation, patients often need rehabilitative nursing care to safely transition from a hospital or treatment center to home. Initially, the nurse will assess the patient’s abilities, then create a plan of care to address his or her individual needs.
In-Home IV Therapy: Nurses teach patients and their caregivers how to manage IV medications and nutritional support, like tube feeding, at home.
Activities of Daily Living Support: To assist patients in resuming their daily routine at home, home care agencies provide home health aides to help with activities of daily living. These activities include bathing, grooming, dressing, walking, and much more.
Wound Care: For patients with complex, non-healing wounds or new stage III and IV pressure ulcers, wound care nurses provide specialized, in-home care and education to ensure wounds heal.
Ostomy Care: With the guidance of certified wound, ostomy and continence care nurses, patients learn how to care for an ostomy and live comfortably with an ostomy pouch.
Continence Care: Understanding the level of discomfort and embarrassment associated with incontinence, skilled nursing offer comprehensive in-home continence care for patients. Services include urinary catheter maintenance, toileting programs and home accessibility assessments.
Does Medicare Cover Skilled Nursing Care at Home?
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Part-time or intermittent home health aide services (personal hands-on care)
- Injectible osteoporosis drugs for women
Usually, a home health care agency coordinates the services your doctor orders for you.
Medicare doesn’t pay for:
- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need
All people with Part A and/or Part B who meet all of these conditions are covered:
- You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
- You must need, and a doctor must certify that you need, one or more of these:
- Intermittent skilled nursing care (other than drawing blood)
- Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition. The home health agency caring for you is approved by Medicare (Medicare certified).
- You must be homebound, and a doctor must certify that you’re homebound.
You’re not eligible for the home health benefit if you need more than part-time or “intermittent” skilled nursing care. You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.
Home health services may also include medical supplies for use at home, durable medical equipment, or injectable osteoporosis drugs.
- $0 for home health care services.
- 20% of the
Before you start getting your home health care, the home health agency should tell you how much Medicare will pay. The agency should also tell you if any items or services they give you aren’t covered by Medicare, and how much you’ll have to pay for them. This should be explained by both talking with you and in writing. The home health agency should give you a notice called the Advance Beneficiary Notice” (ABN) before giving you services and supplies that Medicare doesn’t cover.
If you get services from a home health agency in Florida, Illinois, Massachusetts, Michigan, or Texas, you may be affected by a Medicare demonstration program. Under this demonstration, your home health agency, or you, may submit a request for pre-claim review of coverage for home health services to Medicare. This helps you and the home health agency know earlier in the process if Medicare is likely to cover the services. Medicare will review the information and cover the services if the services are medically necessary and meet Medicare requirements.
Your Medicare home health services benefits aren’t changing and your access to home health services shouldn’t be delayed by the pre-claim review process. For more information, call us at 1-800-MEDICARE.
How Do I Choose a Home Health Care Agency?
Choosing the right home health care agency for your loved one is not a task you need to do alone. We’re here to refer you to the agency that makes the most sense for your location and needs. Whether it’s skilled services like IV Therapy or private duty non-medical services, Senior In-Home Care Experts have options that fit all levels of need.
The fastest way to get the care that you need is to have a care plan set out with your doctor prior to the medical treatment. If you are recovering from an unexpected accident or illness, then consulting with your doctor post-treatment can help guide the conversation.
Home Health Care Agencies will work with your doctor and insurance carrier every step of the way to provide you and your family with the assistance you need.