Visiting Nurses Association - Frequently Asked Questions

Below are some frequently asked questions about home health care services:

1. What is home health care?
Home health care is an excellent, cost-effective alternative to hospital or other institutional care. Service is based on the individual's need as defined by his or her physician's plan of care and may range from 24-hour-a-day care to monthly visits from skilled nurses, therapists, social workers and/or home health aides.

2. What are the advantages of home health care?
In many cases, home health care permits a person to be discharged earlier from a hospital, reduces hospital admissions, and assists with a more rapid recovery. Most importantly, people are happier at home and receive more care and attention from family, friends and home health care professionals.

3. Who uses home health care?
People of all ages use home health care services. Some examples include:

-those who are able to be discharged from a hospital or nursing home but need additional care

-those who are terminally ill and want to live their final days with dignity surrounded by their loved ones in the comfort of their own home

- those who have short-term health needs

- those who need assistance, due to age or disability, to remain at home

- those who need education about the disease process and training on how to best care for themselves

4. What types of home care agencies are there? In Illinois, there are two main types of home health care agencies: certified agencies and private duty (or non-certified) agencies.

Certified Agencies
Certified home health care agencies comply with Medicare and Medicaid regulations. An individual's Medicare benefit defines the conditions that qualify for service. The need for service typically arises after hospitalization or a significant change in medical condition. Care is prescribed by a physician and is generally restricted to skilled services that may include nursing; physical, occupational or speech/language therapy; medical social work; and/or home health aides to assist with personal care needs. While a physician must prescribe care, the patient has the right to select the provider of his/her choice. VNA of Rockford Illinois is a Medicare and Medicaid-certified agency.

Private Duty Agencies
Private duty agencies offer a wide variety of services including medical and non-medical care. For example, private duty services, in addition to nursing, could include assistance with shopping, laundry, meals and companionship. The patient/family generally incur the cost of care, although some insurance plans may also cover all or a portion of it.

5. What types of professionals comprise the home health care team? The home health care team consists of physicians, nurses, home health aides, medical social workers and therapists who coordinate care based on an individual's needs.

6. Who pays for home health care services?
Medicare, Medicaid or other health insurances may cover the cost of home health care services. Some insurance policies will not cover all home health care services unless certain conditions are met. You can still obtain care without insurance coverage through a private duty agency on a private pay basis. Additionally, some agencies may have funding to help people who cannot afford the private pay option. The home health care agency will be able to assist in determining if the services you need are covered or if you need to make other arrangements.

7. When does service begin?
A physician, patient or family member can initiate service. However, Medicare, Medicaid and most insurance require physician oversight. Once the physician prescribes home health care, he/she authorizes a coordinated treatment plan, commonly called a "plan of care," and periodically reviews services and the patient's progress. If a physician does not prescribe home health care, but the individual still desires services, a private duty agency can suggest a plan of care to meet a wide variety of needs and budgets. While some insurance may pay for private duty services, typically, they are an out-of-pocket expense.

8. How do I choose the right agency for my loved one's needs?
Information regarding home health care services can be obtained from many sources. Resources include: hospital discharge departments, your physician, public health departments, telephone directory yellow pages under "home care," "home health care" or "nursing" or through Web site search engines using similar headings.

9. What if VNA can’t resolve my problem or concern?
Anyone can contact the Joint Commission’s Office of Quality Monitoring to report any concerns or complaints that an agency has not addressed. This can be done by calling 1 800- 994-6610 or emailing complaint@jcaho.org.

10. Some questions you may want to ask a prospective home health care agency, along with VNA's answers to these questions, appear below:
Does the agency have information explaining its services, fees, and eligibility requirements?
VNA has several brochures describing its programs and services. Call (815) 971-3550 to receive brochures on our Medicare-certified home health care, hospice, home medical equipment or older adult services.

How does the provider select and train its employees?
VNA's visiting staff are bonded and insured. Employees' are screened through background checks. In addition, they receive regular company-provided training.

Are nurses or therapists required to evaluate the patient's home care needs? If so, what does this involve?
A patient's first visit consists of a thorough assessment of physical, mental, emotional and social needs. From this assessment, an individualized plan of care is developed with input from the family and authorization from the patient's physician.

Will the provider consult the patient's physicians and family members?
VNA always welcomes family involvement in a patient's care. Medicare guidelines require physician consultation, and in instances where Medicare is not used, VNA will contact the patient's physician at the individual's request.

Is the patient's course of treatment documented, detailing specific tasks to be accomplished by each professional caregiver?
Yes. A patient's course of treatment and progress is documented at each VNA home visit.

Does the patient and his or her family receive a copy of this plan, and is the plan updated as changes occur?
Yes. A copy of the patient's plan of care, along with a list of patient's rights and responsibilities, and an emergency plan is left in the patient's home.

Will the provider take time to teach family members about the care given to the patient?
Yes. Education is an important part of VNA's patient care plan and family members are an integral part of the care team.

Who can the patient and his or her family members contact with questions or complaints?
VNA patients and family members can call (815) 971-3550.

How does the agency follow up on and resolve problems?
As a Medicare/Medicaid home health agency, VNA is mandated to have a structured process in place to follow up and resolve problems.