What To Ask To Find The Right Home Health Care Provider For You

What To Ask To Find The Right Home Health Care Provider For You

At Colorado Visiting Nurse Association (VNA) we know that inviting someone into your home to care for you or your loved one is an incredibly important and personal choice. Having the right person can make the experience more pleasant, ensure the appropriate services and in many cases even reduce the likelihood of hospital re-admission. Whether you’re looking for home health care or non-medical support knowing what questions to ask can help ensure that you receive quality assistance.

What To Ask To Find The Right
Home Health Care Provider For You

If you’re recovering from surgery or need long-term care for a chronic illness — or you have a loved one facing a similar situation — you might be interested in home care services. Home care services range from skilled care provided by nurses or therapists to household support, such as cleaning, cooking and running errands. If you’re considering home care services, ask these questions to choose the best provider for your needs.

Qualifications

If you’re considering a home care services agency:

  • Is the agency licensed by the state? Most states — but not all — require agencies to be licensed and reviewed regularly. Reviews might be available through your state health department.
  • How long has the agency been in business?  Experience is one way to measure reliability.
  • Is the agency certified by Medicare to meet federal requirements for health and safety? If not, ask why.
  • What type of employee screening is done? Background and drug testing may go a long way toward your piece of mind.
  • Can the agency provide references? Ask for a list of doctors, hospital discharge planners or other professionals who have experience with the agency.

If you’re considering a home health aide:

  • What are the aide’s credentials? If he or she claims to be licensed, check with the licensing body.
  • Can the aide provide references from at least two employers? Check them thoroughly.

Be sure to ask your or loved one’s doctor, family and friends for recommendations.

Quality of care

If you’re considering a home care services agency:

  • How does the agency train, supervise and monitor caregivers? Does the agency provide continuing education?
  • Are the caregivers licensed and insured?
  • Do the agency’s employees seem friendly and helpful?

If you’re considering a home health aide:

  • Does the home health aide have a positive attitude?
  • Are you and your loved one comfortable with the home health aide?

Costs

If you’re considering a home care services agency:

  • How does the agency handle expenses and billing? Ask for literature explaining all services and fees, as well as detailed explanations of all costs associated with home care.
  • Will agency fees be covered by health insurance or Medicare? Check to see what kind of coverage your health insurance offers.
  • What resources does the agency provide for financial assistance, if needed? For instance, is a payment plan available?

If you’re considering a home health aide:

  • How much does the aide charge for home health services? Make sure you’re comfortable with the fees and the included services.
  • Does the aide require payment for sick days, vacation days or holidays? If so, clarify how many sick and vacation days are allowed, as well as which days are considered holidays.

Understanding services

Whether you’re considering a home care services agency or a home health aide, you might ask these questions about services:

  • Will you receive a written care plan before service begins? The care plan should include details about medical equipment and specific care needs, contain input from the doctor, and be updated frequently.
  • Will you receive a list of the rights and responsibilities of all parties involved? This is sometimes known as a patient’s bill of rights.
  • Will you or your loved one be referred to dietitians, counselors, therapists or other specialists, if needed?
  • Will the agency work directly with you or your loved one, family members and health care providers?
  • Must you identify a primary family caregiver? If so, what’s required of that person?
  • When will service be provided? Is care available round-the-clock, if necessary?
  • What procedures are in place for emergencies? Ask how the agency or home health aide will deliver services in the event of a power failure or natural disaster.
  • How are problems addressed and resolved? Whom can you or another family member contact with requests, questions or complaints?
  • When can services begin?

Monitor your home care services

After you’ve found a home care services provider, monitor the situation. If you’re concerned about the care or services provided, discuss it promptly with the agency or home health aide. If necessary, involve your doctor or your loved one’s doctor as well.

Post updated from article by Mayo Clinic.

Founded in 1889, Colorado VNA is Colorado’s first nonprofit home health care agency and provides expert care throughout the care continuum: wellness, home care and hospice services. For the past three years Colorado VNA has been awarded Home Care Elite Status by the National Research Corporation for placing in the top 25% of home care agencies based on health performance measures.

Colorado VNA earned a four star rating from the Centers for Medicare and Medicaid (CMS) for quality patient care, and is licensed by the State of Colorado to provide home health care. Colorado Visiting Nurse Association is accredited by the Community Health Accreditation Program (CHAP), a national, independent, nonprofit accrediting body for community-based healthcare entities.

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Colorado VNA’s Role In Colorado’s Growing Senior Population

By Chris Lee, President and CEO

The State of Colorado is grappling with one of the fastest growing older adult populations in the country. The Colorado State Demography Office estimates [that the] “aging of the younger population, especially the ’Baby Boomers’ …, is forecast to increase the population over 65 by 150% between 2010 and 2030.”[1] The numbers will grow from 550,000 people over 65 in 2010 to 1.2 million in 2030.

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Fortunately, Colorado is not leaving future administrations to deal with the challenges. Our State has created the Strategic Action Group on Aging, in addition to other initiatives, to get out in front of aging-related challenges. The Group’s initial ideas on how to address the challenges associated with a rapidly aging population are detailed in the Colorado Aging Framework, which includes 10 distinct goals that the State aims to achieve. Colorado VNA is a leading partner in the efforts to support the needs of older adults. We are evolving existing services and creating deep partnerships with a variety of stakeholders to position ourselves as a critical provider of older adult services.

In particular, three of the Aging Framework goals directly relate to our work:

  • Goal 3: Strengthen support systems and environments that enable individuals to remain in their homes and communities as they age.
  • Goal 5: Support health care programs and services that provide a continuum of care to Colorado citizens as they age to give individuals the right services at the right time.
  • Goal 7: Promote support for caregivers, including family caregivers, to support citizens as they age

Goal 3 articulates several strategies that are focused on strengthened supportive services for older adults so that they can remain in their homes and communities, one of which “make home-maker services available to support individuals’ ability to remain in their homes as long as possible” is superbly aligned with our current work. Just this past week, I traveled with one of our Certified Nursing Assistant (CNA), Dennis, to visit two of our veterans in their homes. Dennis visits each of these patients several times a week to help with bathing, ensuring that the care plan is implemented, and providing patient and family support. In addition to Dennis, Colorado VNA provides homemakers for these two patients as well. Our homemakers help the patients and families keep their homes clean and safe while also helping with laundry and other household tasks, activities that many of us take for granted even as our ability to conduct them declines with age. Goal 3 seeks to implement similar support functions for those individuals that may not have the resources to pay for private-pay homemakers and/or CNA services. The Denver Regional Council of Governments (DRCOG) has long funded Colorado VNA to provide homemaker services to low-income and vulnerable adults, and Goal 3 seeks to provide even more support to DRCOG and ultimately Colorado VNA.

Senior Living Conditions in Colorado

Goal 5 takes Goal 3 further by identifying strategies to more closely connect homemaker services that are supported by DRCOG to primary care providers. Both of the patients I visited are veterans, and the VA has long understood the importance of connecting skilled nursing and therapy care with paraprofessional care while under physician supervision. Goal 5 seeks to create the same connections between the primary care community and the long-term services and supports (LTSS) community. Additionally, Goal 5 provides direction to study the connection between LTSS and decreasing overall healthcare cost. In summary, the State hopes to answer the question: Do the homemaker services Colorado VNA provides decrease overall healthcare spending, and if so, by how much? To this end, I have been appointed to a guiding committee that will help implement the study that will answer this question.

Healthy-Aging-in-Colorado-Infographic-high-resolution4 smallaAnd finally, Goal 7 seeks to provide more financial support and training for family caregivers as well as other non-family caregivers. Those of you who have cared for an elderly parent know just how difficult, time-consuming, and stressful it is to provide the necessary care to keep your loved one in the home, especially if you must also work outside the home to earn a living.  Goal 7 seeks to find ways to provide more support and guidance for family and friend caregiving. Though not an area we are currently operating within, Colorado VNA has the capabilities to train caregivers, as well as the necessary clinical oversight, to be a viable part of the solution for an expanded family- and friend-based caregiving network. In addition to supporting family caregivers, Goal 7 also acknowledges the need for more expansive wellness services for the elderly, services like our Senior Medical Foot Care run by our Wellness Division.

 

As you can see, there is much change in the aging landscape in Colorado. Thanks to the innovative and compassionate care of our staff, Colorado VNA is well positioned to be a part of an expanded Colorado strategy to respond to a dramatically growing elderly population.

 

 

 

[1] Department of Local Affairs, State Demography Office, July 2012, page 1

 

 

 

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Colorado VNA Speaker Series 2016

Colorado VNA’s Speakers Series is designed to offer information and education to help a variety of individuals including seniors, caregivers, and health and wellness professionals navigate the changing landscape of healthcare and foster older adult independence. Admission to all events is free, but space is limited so please RSVP by visiting http://bit.ly/2cCuSmu, emailing hurdl@vnacolorado.org, or calling 303-698-6308.

Donations and sponsorships are gladly welcome. For more information, contact Jodie Deshmukh, Development Manager, at deshmukhj@vnacolorad.org or 303-698-6308.

UPCOMING SESSIONS


aging-in-placeAging and Dying In Place,
A Community Panel Conversation

6:00PM at Anschutz Medical Campus
Fulginiti Pavilion for Bioethics and Humanities, Gossard Forum
13080 E 19th Ave, Aurora, CO 80045

Click on the flyer on the right for more information or RSVP at http://bit.ly/2cCuSmu.

PAST SESSIONS

Thursday, July 21st – Autism to Alzheimer’s
6:00 PM at Anschutz Medical Campus

Thursday, May 12thAdvance Directives: Know Your Rights, Share Your Wishes
5:30 PM at Colorado VNA (390 Grant St. Denver)

Holiday Depression

Holiday Depression: How to Recognize It and Take Action

Holiday Depression

At the Colorado Visiting Nurse Association, we know that people facing medical challenges are more susceptible to Depression —especially during the Holidays.

Social isolation is one of the biggest predictors of Depression. It can be difficult for people who are homebound or not fully physically able to maintain active social lives and take part in social events including family gatherings and holiday parties. For many people, holidays can also be a painful reminder of the past. This is especially true for people who have experienced a significant loss, such as the death of a spouse.

Contributors to Depression include:
• Minor or serious medical problem
• Chronic pain or complications of an illness
• Memory loss
• Poor diet
• Loss of a spouse or companion
• Lack of exercise or sleep
• Change in routine
• General frustrations with aging

Symptoms to look for include:
• Irritable or hopeless mood
• Feelings of worthlessness or sadness
• Expressions of helplessness
• Anxiety
• Loss of interest in daily activities
• Changes in appetite
• Significant weight loss or gain
• Lack of attention to personal care and hygiene
• Fatigue
• Difficulty concentrating
• Thoughts about death and suicide

How to Help
• Allow the person to talk about their feelings. It can be as simple as asking, “how are you feeling?” and listening to what they say. They may not volunteer how they are feeling unless you ask, because they don’t want to be ‘a burden.’ Taking a real interest in their wellbeing also demonstrates how much you care.
• Discuss foods with better nutrition. Some depression can be exacerbated by lack of good nutrition. Share tasty food or recipes that are high in Vitamins and Minerals.
• Increasing physical activity improves mood. Physical limitations of most elderly may make this hard so use simple exercises (like talking a walk) or reinforce what they are working on with Physical Therapy and Occupational Therapy.
• Get enough sleep. Emphasize the importance of sleep and encourage them to ask their doctor for help if they routinely experience disrupted sleep patterns.
• Fresh Air and Sunshine – If possible, encourage them to get outside or sit on the front/back porch (wearing appropriate clothing). Sunshine and fresh air is good for the soul and also helps with Vitamin D, which boosts mood.
• Encourage them to ask their Colorado VNA care providers about additional resources, including our visiting Medical Social Workers and our Holiday Adopt-a-Patient program.

Take a Mental Health First Aid training with the Colorado VNA to learn more about recognizing and responding supportively and constructively to common mental health problems. The trainings are free to community members and offered as paid trainings to VNA staff through a grant from Community First Foundation. For more information about this program or to reserve your seat, call (303) 698-6367 or email mhfa@vnacolorado.org.

Moving from home care to home-based services

Photo courtesy of Gretta Blankenship

Photo courtesy of Gretta Blankenship

It’s time to change what we call ourselves…move from thinking of the Colorado Visiting Nurse Association (VNA) as a “non-profit home health care agency” to a “non-profit organization that provides home-based services”. This may seem like a small distinction, but it there are three reasons we should make this change:
1) “Home health care” agencies are defined by outdated Medicare regulations specifically focused on controlling home care as a way to decrease fraud and abuse within a fee-for-service payment environment.
2) Second, there is very little government and/or insurance company reimbursement for para-based services focused on helping patients remain independent in the home.
3) Further, there is very little coordination of care across our various divisions because of the differing ways we are paid for care that we provide.

The Colorado Visiting Nurse Association has begun to think differently about the care we provide as healthcare transitions from a fee-for-service (FFS) payment system to one where healthcare organizations are paid for overall care and health outcomes.
Currently there are many differences between the care provided by each of our home-focused divisions; home health, paraprofessional home services and hospice/palliative. Care provided by our home health professionals is mostly regulated by Medicare and requires patients to be “home-bound” and have a documented needed for care provided by an RN, PT, LPN, etc.

By definition, paraprofessionals are workers who are not qualified or licensed to serve in particular professions but who handle tasks in support of qualified professionals in those fields. Paraprofessionals often work alongside fully qualified professionals, but they also sometimes work more independently, such as in the case of the health care paraprofessionals who provide home visits to the disabled, ill or elderly.

Care provide by paraprofessionals is more proactive in nature and is provided to help patients remain independent in the home, e.g., bathing, shopping, house-keeping, getting in and out of bed, etc. Hospice visits for appropriate patients are similar to home health visits in that hospice patients have to meet strict criteria for admission, i.e. patients must have a terminal diagnosis and patients must have a prognosis of having less than six months to live.

As one can see, there is a big barrier between the care provided by paraprofessionals and home health and hospice; the barrier has to do with the strict Medicare definitions put in place to help decrease overuse and abuse of skilled home health. Bottom line: the way home health services are reimbursed in our country is too focused on decreasing costs and abuse, rather than on improving care for patients.

The good news is that the old ways of paying for the care we provide are beginning to change as Medicare begins to move to paying for the value provided in the home, rather than just for an episode of care. Here is an excerpt taken from the recent U.S. Department of Health and Human Services Report to Congress: Plan to Implement a Medicare Home Health Agency Value-Based Purchasing Program. The report details a summary of Medicare’s view of the problem of fraud, as well as the limited connection between payments and quality of care.

“…the Medicare Payment Advisory Commission (MedPAC), the Office of the Inspector General, the General Accounting Office (GAO), and other stakeholders have raised significant concerns with fraud and abuse in the Medicare home health benefit. While the benefit is designed to encourage teams of skilled professionals to provide patient-focused care to homebound beneficiaries, there is growing concern that the existing payment system does not provide the necessary incentives to provide such high quality patient focused care.”

There is a lot that is changing in healthcare. Care provided in the home is fast becoming of vital importance to improving the health of populations of patients.

– Christopher Lee, Colorado VNA President & CEO, July 13, 2015

The Centers for Medicare & Medicaid Services Awards Colorado VNA 4-Star Rating

Logo artwork courtesy of cms.gov

Logo artwork courtesy of cms.gov

Colorado Visiting Nurse Association (VNA) announced today that it received a 4-star rating from Centers for Medicare & Medicaid Services (CMS) Home Health Compare’s debut star rating program. Colorado VNA is one of only two Denver-based agencies to achieve a 4-star rating or higher (and only 21% of agencies statewide scored 4 or higher). The state and national average is 3 stars.

“Colorado VNA is committed to compassionate, patient-centered care, and our above average rating affirms this,” said President and CEO Chris Lee.

CMS developed Home Health Compare as a key tool for consumers to use when choosing a home health provider. However, the site includes an abundance of information that can be cumbersome to wade through. In December 2014, CMS announced the addition of the star ratings program, which, according to the CMS website, is designed to help “consumers more quickly identify differences in quality and make use of the information when selecting a health care provider. In addition…star ratings can also help the agencies identify areas for improvement.” Key criteria of the CMS rating system include timeliness of start of care, patient satisfaction, hospital readmissions, and other important quality indicators.

Colorado VNA’s Lee further noted that the organization is “proud of our rating at the debut of this program, but we will not rest on our laurels. We have developed a culture of continuous improvement to ensure the best care and outcomes for our patients, and we are committed to achieving a 5-star rating.”

To view the CMS source material, click here for the related July 16, 2015 article written by Sabriya Rice of ModernHealthcare.com.

 

June 27 is National HIV Testing Day

June 27 is National HIV and AIDS Testing Day (photo courtesy of aids.gov website)

June 27 is National HIV and AIDS Testing Day (photo courtesy of aids.gov website)

The Centers for Disease Control and Prevention (CDC) recommends that everyone between the ages of 13 and 64 be tested for HIV at least once as part of their routine health care. Tomorrow is national HIV and AIDS Testing Day to build awareness about the importance of being assessed.

At Colorado Visiting Nurse Association (VNA), our vision statement reflects our commitment to excelling as a valued leader, trusted partner and provider-of-choice recognized for quality health care delivery and optimal outcomes achieved in collaboration with patients and their families, our dedicated, caring staff and our established network of health care agencies.  This is why we encourage everyone to make one of the most adult decisions of their lives and get tested for HIV and AIDS this month.  A very positive story about the importance of testing is told by Patrick, Blogger, New Media Expert and Athlete. Click here to hear his powerful story.

The population of the State of Colorado is 5,355,866, according to the U.S. Census Bureau.  Here below are some Colorado Data Highlights related to HIV and AIDS diagnoses (source: http://aidsvu.org/state/colorado/).

  • People living with an HIV or AIDS diagnosis in 2012: 11,558
  • New HIV diagnoses in 2013: 329
  • Deaths in 2012 due to HIV/AIDS: 106
  • 89% of people living with an HIV diagnosis in 2012 were men, 11% were women.
  • 14% of people living with an HIV diagnosis in 2012 were black, 20% Hispanic/Latino, and 64% white.
  • In 2012, 78% of HIV cases in men were from male-to-male sexual contact, 6% were from injection drug use, and 12% were from injection drug use and male to male sexual contact.
  • In 2012, 72% of HIV cases in women were from heterosexual contact, and 26% were from injection drug use.

Did you know that the Colorado VNA, as part of its Workplace Wellness Program, offers TB tests and Hep A & B (3-part series) vaccinations at schools, dentist offices, businesses, property management offices and community organizations?  Colorado Visiting Nurse Association’s compassionate, dedicated, and experienced healthcare professionals are recognized for their expert, personal medical attention and for their strong tradition of ensuring continuity of care while creating warm relationships with patients.

A portion of the proceeds from our Workplace Wellness clinics support our home nurse visits to ill, disabled and elderly adults. By selecting the Colorado VNA as your Workplace Wellness immunizations provider, you are protecting your health and supporting the community. Colorado VNA proudly celebrated 125 years of service in our state in 2014.  To learn more about our year-round Workplace Wellness services, call 303-698-6517.