Home Care Resources
Think about ordering home care or nursing services for patients who do not seem to do well with disease management at home. Examples of these patients may include your poorly controlled HTN or diabetics, or patients who get hospitalized or visit the ER frequently. Although many people in NYC would like to have home care services, physicians need to practice responsibility and make sure that there truly are clear indications to justify the expense of home care, and that there are visible health improvement with the presence of health aides or nurses at home.
Other patients who may be eligible include:
o Elderly with ADL/ambulation difficulties and poor family support
o patients with dementia or organic mental syndrome
o patients with CHF/CVA impairing ADL
o terminally ill patients
o elderly with poor gait/suspicions for neglect or abuse/malnutrition
o patients with wounds who need frequent dressing changes
∑ What is a home attendant? A home attendant is someone that can assist with personal care and chores. They have no health care training, and therefore can not help administer medicines or load pill boxes. They are able to remind pts to take meds, bring them to doctor visits, do chores at home like cooking and laundry. A M11Q form needs to be filled to obtain this level of home care. This form spells out the actual care needs and functional capacity of the patient. It is considered a physician order. Home attendant service is provided by the state, there is generally no nurse involved, and home care is only reimbursed by Medicaid, not medicare. Since this state funded service is provided by private companies, some with very poor service delivery, this is the State complaint contact line 212 360 2400 for your patients.
∑ What is a home health aide- this person generally works with a skilled nurse through a private home nursing company. Home health aides have some health care training. For example, they can load insulin syringes but can not administer the shots. They can take and record vitals. The quarterly VNS 485 form will need to be signed. This service is covered by most commercial Insurances/Medicare and Medicaid. Medicare will provide a more limited service than Medicaid. †
∑ Home Nursing Companies provide nurses to visit ptsí home to provide a higher level of care delivery. Nurses can do medication reconciliations, prepour meds, check vital signs/glucose testing, and report back to you on the ptís health status. See this link for more information http://www.medicineclinic.org/VNS.html
∑ Centers for Medicare and Medicaid (CMS) http://cms.hhs.gov
∑ NYC Home Care Complaint Line 212-360-2400