Home Health Care in Florida
Introduction
This brochure contains information about health care services
provided
in the
home. Such services may be needed during recovery after a hospital
stay, or to
help a disabled or elderly person live independently in their own home.
Topics in this Brochure Include
Home Health Care Services
Home Health Care Providers
When a Patient Receives Skilled Services
Choosing a Home Health Care Provider
Medicare and Medicaid
Other Resources and Information
Home Health Care Services
Health care services offered in the home may include:
- Nursing care
- Physical, occupational, respiratory, or speech therapy
- Home health aide services
- Medical social services
- Nutritional counseling
- Medical equipment and supplies
- Homemaker/companion services
Home Health Care Providers
Home health care providers include companies and independent health care professionals. Listed below are types of home health care
providers that are licensed or registered by the Florida Agency for Health Care Administration (AHCA) to provide services in the home
as well as information on independent health care professionals. You can find a list of these companies on
Facility Locator
on www.FloridaHealthFinder.gov.
Home Health Agencies
Home health agencies provide nursing care; physical, speech,
occupational, respiratory and IV therapy; home health aide and
homemaker/companion services; home medical equipment; nutritional
guidance; and medical social services in the patient’s home
or place of residence.
Nurse Registries
Nurse registries arrange for nurses, certified nursing assistants
(CNAs), home health aides, or homemakers/companions to provide services
to patients in their home or place of residence.
Hospices
Hospices provide nursing, physician, social work, and pastoral
services; nutritional counseling; and bereavement counseling (dealing
with the grief of death and dying) for terminally ill patients and
their families. Additional services may include: physical,
occupational, speech, and massage therapy; home health aide and
homemaker/companion services; home medical equipment and supplies; and
respite services (temporary relief for the caregiver). The staff is
specially trained to help the patient and family members who are
dealing with death and dying. These services are provided in the
patient’s home or place of residence, a hospital, or a
hospice facility.
Home Medical Equipment Providers
Home medical equipment providers sell or rent home medical
equipment
and services for use in a patient’s home or place of
residence. Equipment includes, though is not limited to, oxygen,
respiratory equipment, and customized wheelchairs. Services include
delivery, set up, instruction, and maintenance of equipment. A home
health agency or hospice can also provide this service.
Homemaker/Companion Services
Services provided by homemakers and companions include housekeeping,
meals, shopping, and trips outside the home.
These services can also be offered by a home health agency, nurse
registry, or hospice.
Independent Health Care Professionals
An individual health care professional may provide health care services
in the home, within the scope of his or her state license or
registration, or within his or her training. Health care professionals
can include registered nurses (RNs); licensed practical nurses (LPNs);
physical, occupational, respiratory, and speech therapists; certified
nursing assistants (CNAs); home health aides; and
homemakers/companions.
If you employ an independent health care professional, you should ask
them who will be responsible to pay household employment taxes, income
withholding taxes, and unemployment taxes. If he or she does not pay
these taxes, you may be required to pay them.
When a Patient Receives Skilled Services
The Florida law includes the following requirements for those home
health care companies that serve patients who need skilled services.
Skilled services are provided by a nurse or by a physical, speech,
occupational, or respiratory therapist.
- If a patient is receiving skilled services the
patient’s doctor must sign a treatment order, stating the
services needed. Then a plan of care must be created, giving details of
how the care will be given (sometimes a plan of care is called a POC or
a plan of treatment). A plan of care is not required for people
receiving home health aide services without a treatment order or for
those receiving only homemaker/companion services.
- A patient has the right to be a part of the planning of his
or her care and to receive, upon request, a copy of the plan of care.
- For patients receiving skilled services, a health care
professional licensed to perform these services must do an assessment
of the patient’s condition.
- The plan of care must be reviewed at certain times by the
patient’s doctor, and the care must be coordinated and
supervised by the home health care provider. These requirements vary
depending on the provider offering the services, so ask the provider
and your doctor what to expect.
Choosing a Home Health Care Provider
The following are some suggestions in choosing a home health care
provider.
- You may want to talk with two or more home health care
providers to find one that meets your needs. You may also want to talk
with your doctor about your choice.
- If you need nursing care, therapy, home health aide
services, or home medical equipment, discuss this with your doctor. The
doctor might write a treatment order for your care. If you have a
treatment order the cost might be paid by your private insurance or by
Medicare or Medicaid, if you and the home health care provider are
eligible (See the Medicare and Medicaid section
of this brochure).
- If you need help with bathing, dressing, feeding, or other types of personal care,
but you do not need any other medical care, you may want to talk
with your doctor about this, or you can arrange these services
yourself. A home health aide or certified nursing assistant (CNA) would
provide these services (a homemaker/companion cannot provide these
services).
Most often these services would be paid with your own money. For possible assistance, check with your insurance company,
the Department of Children and Families,
Department of Elder Affairs,
or Agency for Persons with Disabilities.
- If you need someone to help you with shopping, meals,
household chores, or driving, these services can be provided by a
homemaker/companion. Most often these services would be paid with your own money.
For possible assistance, check with your insurance company,
the Department of Children and Families,
Department of Elder Affairs,
or Agency for Persons with Disabilities about their programs.
- You can use Facility Locator
on FloridaHealthFinder.gov to find a home health care provider in your area.
After you have a provider or list of providers on the website, click on a provider name to find the address, phone number, and driving directions.
This profile page also includes the administrator and owner, emergency actions (where applicable), and a link to inspection reports.
Additionally, the profile page for home health, hospice, and homemaker/companion will list the counties they serve; home health will
also list if it is Medicare or Medicaid certified; and home medical equipment will list the type of equipment they provide. You can
also choose to search for these particular categories in your search option on the first page of Facility Locator by clicking
Advanced Search before clicking the Search button.
- To find out about Medicare eligibility, contact Medicare.
For Medicaid eligibility contact the Department of Children and
Families. Further information about these programs is listed under the
Medicare and Medicaid section of this brochure.
What to Ask the Home Health Care Provider
Following are topics you might want to ask the provider about, along
with any other questions you may have.
- Ask what services will be provided.
- Ask for a written description of fees and ask how billing
will be handled.
- Tell the home health care provider if you have insurance
and ask if they will submit bills to your insurance company. If you are
covered by Medicare or Medicaid, ask if the provider is eligible to
bill one or both of them.
- Ask for proof of current liability insurance.
(Homemakers/companions are not required to carry liability insurance.)
- If you are receiving skilled services or are on
life-support equipment, the home health care provider is required to be
on-call 24-hours a day, 7 days a week. Be sure the provider gives you
their 24-hour phone number. If you are receiving only non-skilled
services or equipment that is not life supporting, the provider should
give you the phone number where you can call during regular service
hours.
- Ask about who you should contact in the company if you have
a complaint or problem with the service. You also have the right to
file a complaint with the
Agency for Health Care Administration through
the toll-free number (888) 419-3456.
- The local offices of the
Florida Division of Emergency Management
maintain a Special Needs Registry for patients who will need
help with evacuation and sheltering during a disaster, like a
hurricane. This is for special needs patients who have a physical or
mental condition that requires medical oversight during evacuations. If
this describes your situation, ask the home health care provider to
help you register with the Special Needs Registry.
- Ask for references.
Medicare and Medicaid
Conditions that usually need to be met in order to get Medicare or
Medicaid home health benefits include the following:
- To qualify for Medicare you must be 65 years or older,
disabled or with end-stage kidney disease. To qualify for
Medicaid you must meet low-income requirements.
Medicaid covers mostly children, pregnant women, disabled adults, and seniors.
- The home health care provider must have a Medicare or
Medicaid provider number. All hospices serve Medicare and Medicaid
patients. Home health agencies and home medical equipment providers may
or may not have a Medicare and/or Medicaid provider number, so if you
are eligible for Medicare or Medicaid ask the company if they are
eligible too. Some nurse registries may be able to serve clients on
certain Medicaid waiver programs. Homemaker/companion companies are not
eligible for Medicare or Medicaid.
- For Medicare coverage of home health services you must be
under the care of a doctor, be homebound, need skilled nursing care,
physical therapy, speech therapy, or have a continuing need for
occupational therapy. “Home” can be a house,
apartment, assisted living facility, or adult family-care home. When
you leave home, it is for infrequent or short time periods, such as a
doctor’s appointment. For further information contact
Medicare.
- For information on Medicaid view the
Florida Medicaid website at the
Agency for Health Care Administration or contact your local area Medicaid office (click “Area Office” on the Web page).
To apply for Medicaid contact the Department of Children and Families.
- Services must be on a part-time basis (not 24 hours).
- Your doctor must sign a treatment order for you to receive
care. However, some of the Medicaid waiver programs do not require a
doctor’s treatment order.
Medicaid Waiver Programs
In addition to the regular Medicaid program there are a variety of Medicaid Waiver programs
that target certain populations, including disabled adults, elderly, brain and spinal cord injured,
developmentally disabled, and AIDS patients, among others. The following state agencies administer waiver programs:
Department of Elder Affairs,
Agency for Persons with Disabilities,
Department of Health,
Agency for Health Care Administration, and the
Department of Children and Families.
What Is Not Covered by Medicare
- Help with bathing, dressing, feeding or other types of personal care unless skilled services are also ordered
- 24-hour care at home
- Meals delivered to your home
- Homemaker/companion services
Other Resources and Information
Health Insurance and Long-Term Care Insurance
Talk with your health insurance plan to learn what kind of home health
care services your plan might cover. If you have long-term care
insurance, or are thinking about buying this type of insurance, find
out exactly what it covers, under what conditions you can receive
coverage, any restrictions that may apply, and what you need to do when
coverage is needed.
The Florida Department of Financial Services (DFS) regulates insurance
in Florida and provides consumer publications on health insurance,
long-term care insurance, and other types of insurance. For further
information call the DFS toll-free number (877) 693-5236 or view
the websites of the Department of Financial Services and the
Office of Insurance Regulation.
Florida Department of Elder Affairs
The Department of Elder Affairs offers a variety of programs for
seniors. To learn more about the programs listed below and other
programs call the Elder Care Helpline toll-free number (800) 963-5337
or view the website of the Department of Elder Affairs.
- Older Americans Act (OAA) - Provides homemaking services,
home-delivered meals, medical transportation, home health aide, adult
day care, and other services. The OAA is for people 60 years or older,
especially those in economic or social need.
- Community Care for the Elderly - Provides homemaking,
home-delivered meals, and personal care services to frail elders, age
60 and older. Eligibility is based, in part, on a person’s
inability to perform certain daily tasks needed for independent living,
such as meal preparation, bathing, or grooming.
- Home Care for the Elderly - Provides some financial help so
relatives can keep a low-income elder in their own home or in the home
of a caregiver. A participant must be at risk of nursing home placement
and be 60 years or older.
- CARES (Comprehensive Assessment and Review for Long-Term Care
Services) - Provides evaluation of seniors or people with a disability
who need long term care
services, to see what level of care they need. It also provides help in
getting in-home and community services to avoid nursing home care. Call the toll-free number
(800) 963-5337 or
view the CARES website
at the Department of Elder Affairs.
-
SHINE Program – Serves seniors and people with a disability and provides counseling on health insurance,
Medicare, Medicaid, long-term care insurance, prescription assistance programs, and other health insurance needs.
Call the toll-free number (800) 963-5337 or view the
Florida Shine website at the Department of Elder Affairs.
Florida Agency for Persons with Disabilities
The Agency for Persons with Disabilities (APD) helps people who have
developmental disabilities and their families, including supportive
living and Medicaid Waiver. You can view the ADP website
or call the toll-free number (866) 273-2273.
The website includes a list of the district offices or look in your
local phone book for contact information.
Additional consumer brochures include:
A Patient’s Guide to a Hospital Stay
Assisted Living in Florida
End-of-Life Issues – A Practical Planning Guide
Florida Medicaid
Health and Human Services Programs
Health Care Advance Directives
Home Health Care in Florida
Nursing Home Care in Florida
Long-Term Care
Patient Safety
Understanding Prescription Drug Costs
Note: This brochure is not designed to offer medical or legal advice. Please talk with your doctor for medical advice and an attorney for legal advice.
Information in this brochure is current as of June 2011.
This brochure may be copied for public use. Please credit the Agency for Health Care Administration for its creation.
If you have comments or suggestions, please call (850) 412-3730.