Questions
to ask when choosing a Home Health Care Agency, Hospice, or Private Care in the Home
Whether one requires routine housekeeping chores such as laundry, shopping and bathing, or
skilled nursing care such as wound care, diabetic monitoring or medication monitoring on a
visiting or live in basis; Home Health Agencies provide a wide range of services in the
individual's home environment. Hospices provide pain management, grief counseling and
volunteer support.
To help you to select an agency which best suits your needs, take
the following under consideration:
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Number of years in business
Medicare and Medicaid certification
Qualifications of Staff
Patient eligibility in writing
Services provided:
Hospice
Skilled Nursing
Home Health Care
Light Housekeeping
Therapy
Live in (24 hour care)
Durable medical equipment
Minimum Charges:
Daily:
Weekly:
Monthly:
Rate for night care:
Rate for week-end care:
Clearly written and complete
schedule of fees?
Free initial patient assessment, at home and without further
obligation?
Patient care plan written in understandable terms?
Required notice to client for schedule changes?
References from agency's clients?
Amount of notice required before services begin:
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Home
Health Agencies
Home Health
Care Agencies that accept Medicare and Medicaid are certified by the Colorado Department
of Public Health and Environment. Presently, Medicare pays a "per visit" charge
for personal care providers and licensed nursing care. Private pay rates vary, and the
majority of agencies surveyed refused to share their price structure.
Of those who responded, the average hourly charge for a homemaker or companion (PCP)
ranged from $16.00 to $17.00 per hour. CNA (Certified Nursing Assistant) rates varied from
$16.20 to $20.00. Rates for a private duty nurse are between $30.00 and $40.00 per hour.
Contact the agency to discuss your needs and cost of services. Some prefer to do an
evaluation visit at no charge before quoting prices. Remember to ask how much lead time is
required if response time is important to you. (Senior Answers also maintains a list of
home health agecies that provide private home health services without medical supervision.
These services include laundry, meal preparation, cleaning, personal care, respite care,
line-ins and sleep overs.)
The Hospice
Not just "a place to die", Hospice Services encompass a wide range of
medical and social services to assist the terminal patient and their loved ones. Services
include pain management, grief counseling and home health services such as bathing,
laundry and companionship.
Hospices also offer respite services to allow family members to get away for a while.
While these services may be provided in a hospital or nursing facility, most are made
available to the patient in their present home environment. Medicare and Medicaid will pay
for Hospice services. If the individual goes to a nursing home or hospital based hospice,
they will be responsible for paying room and board charges.
Choosing a Live In Caregiver
While there are many reasons why individuals seek assisted living arrangements, the
inability to maintain the residence is often one of the motivating factors. Routine
chores, meal preparation and general upkeep can become a burden.
If you hire help on a daily basis, or are considering "live in" assistance, it
is important to take precautions before allowing anyone access to your home or personal
property. The exchange of room and board for services rendered may not be a good idea.
Actual payment for services establishes the business relationship from the onset, leaves
less room for misunderstandings and allows for easier termination of an arrangement that
may be difficult to dissolve otherwise.
A registry for private "live-in" caregivers does not exist, although some non-
certified, as well as certified home health agencies provide these services. Another
option is to advertise in the newspaper. For the Rocky Mountain News, it is section
#"1265-Adult Care". For the Denver Post, it is sections # "2470-In Home
Care Wanted" and #2490 - In Home Care Provided".
Before allowing anyone access to your home
or personal belongings consider the following:
Did you feel comfortable with the person when you first visited?
Did they answer your questions frankly and willingly offer additional information?
Does the person have experience performing the duties you will require?
Is the person bonded - and if not can they be?
If the duties require anything other than completion of menial tasks, or if they will be
expected to assist you with personal care, are they certified or do they have appropriate
licenses?
If you have a Long Term Care Policy, does this person meet the qualifications specified
for the type of services they will be performing?
If you expect the individual to run errands or escort you in a vehicle did you:
Ask to see their current driver's license?
Confirm that they have liability insurance?
Check their driving record with the Dept. of Motor Vehicle?
(Your own insurance agent may be able to assist you with this search)
Has the person provided you with at least three references from prior employers?
Have you contacted each reference and inquired about their behavior and temperament as
well as their work performance?
Resolving Care Problems
Federal laws give you the right to complain to home health agency staff
or outside sources without fear of discrimination or retaliation.
If you or a relative are receiving home health services, it is possible
that problems may arise. To prevent problems, the best tool is open
communication with your direct care givers and other agency staff.
Develop and maintain good relationships with the nurses, aides
and others who are providing you with services. Do not hesitate to ask questions.
Bring issues to the attention of the staff as soon as they arise.
Work up the chain of command: if you have a care problem,
talk to the direct care giver first. If that doesn't work,
ask to speak to that person's supervisor.
If visits are missed or staff is very late for an appointment, call the agency.
If problems persist, contact the agency's administrator. If this doesn't help,
contact the agency's governing body.
The agency should have written policies explaining how to file a
complaint or grievance by contacting the governing body. This information
is included in the packet you receive.
It is best to put your complaint in writing; you can later show others that
you gave the agency an opportunity to address your concerns.
Filing a Formal Complaint
If previous steps fail, you may file a complaint with the Colorado Department
of Public Health and Environment, Health Facilities Division by calling
303-692-2800 (Denver Metro Area) or the Home Health Hotline at 1-800-842-8826.
A complaint may also be filed in writing or by fax. Write to Colorado Department
of Public Health and Environment, HFD A-2, 4300 Cherry Creek Drive South, Denver
CO 80246 or FAX to 303-782-4883.
The Health Facilities Division will investigate all complaints related to patient
care, abuse and violation of patient rights. Complaints about billing and
insurance coverage are not addressed by the health department. You should call
your insurance carrier.
Provide the Following Information:
Dates, times, names, and the people involved.
Your name, address, and daytime phone number where you can be reached.
If there are witnesses or other parties who can provide additional information,
include their names, addresses, and daytime phone numbers.
At the end of the investigation, you will receive a letter containing a summary
of the investigation and findings.
You can also file a complaint without giving your name.
To Check On a Nurse or Nurse Aid
If you wish to check on the license or certification status of a nurse or nurse
aide who is providing care to you, the Colorado Board of Nursing operates
ALIS, a 24-hour state-sponsored Automated Licensure Information System at 303-894-7888.
All you need provide is that person's name or their nursing license number.
Other Resources About Home Health Care
The Colorado Department of Health Care Policy and Financing, Medicaid Home
Health -- 303-866-3864
The Colorado Foundation for Medical Care -- 1-800-727-7086
(Medicare Hot-line and Questions); 303-695-3333 (Medicare questions -- metro area);
303-695-3300, ext. 3112 (Medicaid Home Health) Home Care Association of Colorado --
303-694-4728
Note: An employer of household help must withhold 7.65% of wages for Social Security
and Medicare tax, and pay another 7.65% in matching funds. You may also be responsible
for other payroll taxes. To receive a complete list of Hospices, certified Home Health
Agencies, and non-certified home health agencies, mail $5 for your personal copy of
Senior Resource Guidebook
to Senior Answers and Services, 3006 East Colfax, Denver CO 80206 or call 303-333-3482.
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