Discussion Question Answers: Chapter 7 Home Health Care 1. What is home health care?

? Care delivered in the consumers home or other community setting Skilled nursing and other health care services, plus Non-health (supportive) services, including assistance with personal care, activities of daily living (ADLs), housekeeping, making meals, shopping, and sometimes transportation Medicare eligibility (generally accepted criteria): Care must be physician-ordered Care must be intermittent Patient must be essentially homebound 2. Who provides home health care? Home health and hospice agencies Homemaker and home care aide agencies (non-health home care) Staffing and private duty agencies About evenly split between nonprofit and for-profit Some freestanding, others affiliated with other health care organizations 3. What are the patient services most commonly provided by home health organizations? Skilled health services Nursing Physical, occupational, and speech/language therapy Dental care Nutritional counseling Laboratory services Social services Patient education Supportive services Personal care Homemaking Chores Transportation 4. How is home health care financed? Medicare Prospective payment system (PPS) Set amount per 60-day episode of care Medicaid Other government sources Private insurance and managed care Out-of-pocket

5. What are some of the human resource issues confronting home health providers? Shortages of nurses Supervising staff working at a distance 6. What are some of the legal and ethical issues facing home health providers and consumers? Patient noncompliance Patient safety Fraud and reimbursement abuse Patients rights 7. In reference to the case at the end of this chapter, consider the following: a. Should Joan and Jerry have applied for home health care sooner, and, if so, who should have made them aware of the benefits of home health care? Yes, they should have applied sooner, but didnt because: Lack of awareness of services Stubborn independence Any of the health care professionals with whom they came into contact should have made them aware b. Given what you have learned about the accessibility and financing of home care services, are such services as readily available to other consumers as they were to Joan and Jerry? No. It depends heavily on location and insurance coverage