Ozark Total Healthcare
fREQUENTLY ASKED QUESTIONS
FAQ Home Health
Home health refers to medical and health-related services that are provided to individuals in the comfort of their own homes. This type of care is typically administered by healthcare professionals, such as nurses or therapists, who visit patients on a regular basis to provide a range of services, including medication management, wound care, physical therapy, and more. Home health services are often used by individuals who have recently been discharged from a hospital or who have a chronic medical condition that requires ongoing care. By receiving care at home, patients can often maintain their independence and quality of life while still receiving the medical attention they need.
You’ll receive the services you need based on an individual plan of care developed by your doctor with our clinical team. Some of the home health care services we offer include:
- Skilled nursing care
- Home health aides
- Physical therapy
- Occupational therapy
- Speech therapy
- Medical social work
- Pain management
- Medication management
- Wound care
- Infusion therapy
- Psychiatric services
We also offer several specialized home health programs for patients with COPD, heart failure and conditions that increase their risk of falling.
Eligibility for home health services typically depends on a number of factors, including the individual’s medical condition, the type of care needed, and the availability of family or other caregivers. In general, individuals who are homebound due to an illness, injury, or disability and require skilled nursing or therapy services may be eligible for home health care. This includes individuals who have recently been discharged from a hospital or rehabilitation center, as well as those with chronic conditions such as diabetes, heart disease, or COPD. Eligibility for home health services is typically determined by a healthcare provider, who will evaluate the individual’s medical history, current condition, and care needs to determine if home health services are appropriate. It is important to note that eligibility requirements may vary depending on the specific healthcare provider and the type of insurance coverage the individual has.
Yes, Medicare and Medicaid may cover home health services for eligible beneficiaries. Medicare is a federal health insurance program that provides coverage for individuals aged 65 and older, as well as those with certain disabilities or medical conditions. Medicare Part A covers home health services for eligible beneficiaries who meet certain criteria, including being homebound and requiring skilled nursing or therapy services. Medicare Part B may also cover certain home health services, such as medically necessary skilled nursing care or physical therapy.
Medicaid is a joint federal and state program that provides healthcare coverage for individuals with limited income and resources. Medicaid may cover home health services for eligible beneficiaries who require skilled nursing or therapy services and meet certain criteria, such as being homebound and having a medical condition that requires ongoing care.
It is important to note that coverage for home health services may vary depending on the specific healthcare provider and the individual’s insurance coverage. Eligibility requirements and coverage details should be discussed with the healthcare provider and insurance provider for specific information. Call us today to see if you qualify.
- We provide a patient advocate that manages all the services throughout the treatment.
- We provide individual care plans based on your specific needs.
- Allows individuals to receive care in the comfort and familiarity of their own homes
- May improve overall quality of life by maintaining independence and avoiding unnecessary hospitalizations or institutionalization
- Can provide individualized care and attention from healthcare professionals, including skilled nursing care, therapy services, and medication management
- May result in better health outcomes and improved management of chronic conditions
- Can be more cost-effective than hospital or nursing home care, particularly for individuals with lower acuity needs
- Can provide valuable support and education for family or other caregivers May reduce the risk of infection or other complications that can occur in a hospital or institutional setting.
Many different individuals may benefit from home health services, including:
- Individuals who have recently been discharged from a hospital or rehabilitation center and require ongoing care
- Individuals with chronic medical conditions, such as diabetes, heart disease, or COPD, who require ongoing medical management and monitoring
- Individuals who have experienced an injury or illness that limits their ability to leave the home
- Elderly individuals who require assistance with activities of daily living, such as bathing, dressing, or meal preparation
- Individuals with disabilities who require ongoing medical or personal care
- Caregivers who require education, support, or respite care to help manage the care of a loved one at home.
Home health services can be tailored to meet the specific needs of each individual, and can include a range of services such as skilled nursing care, physical or occupational therapy, medication management, wound care, and more. Ultimately, anyone who requires skilled medical care or assistance with activities of daily living may benefit from home health services.
During the first home health care visit, you can expect a healthcare professional, such as a nurse or therapist, to come to your home to evaluate your health status and develop a care plan tailored to your individual needs. Here are some things you can expect during the first home health care visit:
- Assessment: The healthcare professional will perform a comprehensive assessment of your medical condition, including your vital signs, medication list, medical history, and any other relevant information. They may also perform a physical examination to identify any specific needs or areas of concern.
- Care planning: Based on the assessment, the healthcare professional will work with you and your family to develop a personalized care plan that addresses your specific needs and goals. The care plan may include recommendations for medications, therapy services, wound care, or other treatments.
- Education: The healthcare professional may provide education and training to you and your family on how to manage your condition at home, including how to properly use any medical equipment or devices, how to monitor your symptoms, and how to recognize and respond to any changes in your health status.
- Coordination: The healthcare professional may coordinate with your healthcare providers, including your primary care physician and any specialists, to ensure that you are receiving the appropriate care and treatment.
Overall, the first home health care visit is an important step in developing a plan of care that meets your unique needs and supports your recovery and wellbeing at home.
The frequency of home health care visits will depend on your individual medical needs and the care plan developed by your healthcare provider. The frequency of visits may change over time as your medical condition improves or worsens. Here are some general guidelines for the frequency of home health care visits:
- Skilled nursing visits: If you require skilled nursing care, such as wound care, medication management, or intravenous therapy, you may receive visits from a nurse once or twice a week, or more frequently if needed.
- Therapy visits: If you require physical therapy, occupational therapy, or speech therapy, the frequency of visits will depend on your individual treatment plan and goals. Typically, therapy visits occur once or twice a week, and may be adjusted based on your progress.
- Home health aide visits: If you require assistance with activities of daily living, such as bathing, dressing, or meal preparation, you may receive visits from a home health aide several times a week, or daily if needed.
It is important to note that the frequency of home health care visits may be adjusted based on changes in your medical condition or treatment plan. Your healthcare provider will work with you to determine the appropriate frequency of visits to support your recovery and wellbeing at home.
Yes, you have the right to choose your own home health provider. Medicare beneficiaries, for example, have the right to choose any Medicare-certified home health agency that serves their area. Private insurance plans may also allow you to choose your own home health provider, although specific requirements may vary depending on the plan.
We’d be honored to care for you or your loved one.
Our patient advocate will contact you by phone to schedule the first visit. If you’re coming from a hospital or nursing facility, the initial visit will usually happen within 24 hours after you’re discharged to make the transition easier.
The payment for home health care services may vary depending on several factors, including your insurance coverage, the type of services you require, and your eligibility for government-funded programs. Here are some of the most common payment sources for home health care services:
- Medicare: If you are a Medicare beneficiary, Medicare may cover the cost of your home health care services, including skilled nursing care, therapy services, and home health aide services.
- Medicaid: If you are eligible for Medicaid, your state Medicaid program may cover the cost of your home health care services. Medicaid coverage may vary by state, so it is important to check with your state Medicaid agency for more information.
- Private insurance: If you have private health insurance, your insurance plan may cover some or all of the cost of your home health care services. Coverage and out-of-pocket costs may vary depending on your plan.
- Out-of-pocket: If you do not have insurance coverage or if your insurance does not cover home health care services, you may be responsible for paying for the cost of services out-of-pocket.
It is important to note that coverage and payment sources for home health care services may vary depending on your individual situation and the services you require. If you have questions or concerns about payment for home health care services, you should speak with your healthcare provider or CALL US for more information.
Yes. All of our home health care services are Medicare-certified. This is a requirement for Medicare to cover the cost of home health services.
When home health care is being considered, a “home” typically refers to a place of residence where an individual lives, such as a private home, apartment, or assisted living facility.
It is important to note that the home must be a safe and appropriate environment for the individual to receive care. This means that the home should be equipped with necessary medical equipment and supplies, as well as a safe and accessible living space for the individual to move around.
Additionally, the home health care provider may need to conduct a home assessment to determine if the home is suitable for providing the necessary care. The assessment may evaluate factors such as accessibility, safety hazards, and the availability of necessary medical equipment and supplies.
Overall, a “home” for the purpose of home health care is any place of residence where an individual lives, as long as it is deemed safe and appropriate for providing the necessary care.
The length of time that you will receive home health care depends on your individual medical needs and the care plan developed by your healthcare provider. In general, home health care is intended to be a short-term solution for individuals who need medical care at home following an illness, injury, or hospitalization.
Medicare and other insurance plans typically cover home health care for a limited time period, which is typically 60 days at a time. If you require continued care beyond this initial period, you and your healthcare provider can work with your insurance provider to request an extension of your home health care services.
The length of time that you receive home health care may also depend on your progress in achieving your medical goals and the effectiveness of the care plan. Your healthcare provider will regularly evaluate your condition and adjust the care plan as necessary to ensure that you receive the appropriate level of care.
It is important to communicate with your healthcare provider and home health provider throughout the care process to ensure that you are receiving the highest quality of care possible and that your care plan is meeting your needs. If you have any questions or concerns about the length of time that you will receive home health care, you should speak with your healthcare provider or home health provider for more information.
Choosing and training home health staff is an important process for any home health care company.
- We screen applicants carefully: Conduct thorough background checks, reference checks, and interviews to screen potential home health staff. This helps us identify candidates who are reliable, trustworthy, and have the necessary skills and experience to provide high-quality care.
- We have developed a comprehensive training program that covers all aspects of the job, including medical procedures, safety protocols, communication skills, and cultural competency. Our training is tailored to the specific needs of each staff member and is ongoing to ensure that staff remain up-to-date on the latest medical advances and best practices.
- We require continuing education to promote professional development for all our home health staff. This can include attending conferences, workshops, and seminars, as well as pursuing advanced degrees or certifications.
- We believe in promoting a positive work environment that values and supports home health staff.
By implementing these best practices, we ensure that we are selecting and training the most qualified and dedicated staff to provide high-quality care to our patients.
In the context of home health care, “homebound” refers to an individual who has a condition or illness that makes it difficult for them to leave their home without assistance or great effort. This condition can be temporary or permanent.
To qualify as “homebound” for the purpose of Medicare home health care benefits, an individual must meet certain criteria, including:
- A doctor has ordered home health care for the individual.
- The individual has a condition that makes leaving the home difficult.
- Leaving the home requires a significant and taxing effort.
- Leaving the home is not recommended due to the individual’s condition.
- The individual is confined to their home or the immediate area surrounding their home.
It is important to note that being homebound does not mean that an individual cannot leave their home at all, but rather that they require significant effort or assistance to do so. This may include using a wheelchair, walker, or other mobility aid, or relying on assistance from a caregiver.
Overall, the term “homebound” refers to an individual who has a condition that makes it difficult to leave their home, and who requires assistance or significant effort to do so. This term is used to determine eligibility for home health care benefits under Medicare and other insurance plans.
Home health care, hospice care, and personal care are all types of in-home care, but they differ in their scope and purpose.
Home health care is a type of skilled medical care provided in the home by licensed healthcare professionals, such as nurses, physical therapists, and occupational therapists. Home health care services are typically prescribed by a doctor and may include wound care, medication management, rehabilitation, and other medical treatments. The goal of home health care is to help individuals recover from illness or injury and improve their overall health.
Hospice care, on the other hand, is a specialized type of care provided to individuals who are terminally ill and have a life expectancy of six months or less. Hospice care focuses on providing comfort and improving the quality of life for the individual and their family members. Hospice care services may include pain management, emotional and spiritual support, and assistance with end-of-life decision-making.
Personal care, also known as non-medical home care, is focused on providing assistance with activities of daily living (ADLs), such as bathing, dressing, and meal preparation. Personal care aides may also provide companionship and assistance with transportation and errands. Personal care is typically provided by non-medical professionals, such as home health aides or personal care assistants.
In summary, home health care is skilled medical care provided in the home by licensed healthcare professionals, hospice care is specialized care for individuals with a terminal illness, and personal care is non-medical assistance with activities of daily living. Each type of care has its own purpose and scope, and the specific services provided will vary based on the individual’s needs and goals.
No, hospitalization is not always a requirement to receive home health care. However, to qualify for home health care services under Medicare, a person must have a doctor’s order and meet certain criteria, including:
- The person must be homebound, meaning it is difficult for them to leave the home without assistance.
- The person must require skilled nursing care or therapy services.
- The services must be reasonable and necessary for the treatment of the person’s illness or injury.
- The services must be provided by a Medicare-certified home health agency.
Hospitalization is not necessarily a requirement for someone to receive home health care services, but the person must have a need for skilled nursing care or therapy services that can be provided in the home. This can include services such as wound care, medication management, rehabilitation therapy, and other medical treatments. The goal of home health care is to help individuals recover from illness or injury and improve their overall health, and it can be provided either as a step-down from hospitalization or as an alternative to hospitalization.
Hospice care is a specialized type of care for individuals who are terminally ill and have a life expectancy of six months or less. The focus of hospice care is on providing comfort and improving the quality of life for the individual and their family members. Hospice care is typically provided in the individual’s home or in a hospice facility, and may also be provided in hospitals or long-term care facilities.
Hospice care services are provided by a team of healthcare professionals, including doctors, nurses, social workers, chaplains, and volunteers. The team works together to provide physical, emotional, and spiritual support to the individual and their family members. Hospice care services may include pain and symptom management, emotional and spiritual support, assistance with end-of-life decision-making, and bereavement support for family members.
Hospice care is not intended to cure the individual’s illness or prolong life, but rather to provide comfort and support during the end-of-life process.
To be eligible for hospice care, an individual must have a life-limiting illness or condition and a prognosis of six months or less. Some of the common illnesses that may qualify for hospice care include cancer, heart disease, lung disease, dementia, and liver disease.
In addition to the medical eligibility criteria, the individual must also elect to receive hospice care and agree to forgo curative treatment for their terminal illness. The individual or their representative must sign a statement indicating their decision to receive hospice care, and the statement must be witnessed by a hospice representative.
If you or a loved one is considering hospice care, it is important to speak with your healthcare provider or a hospice representative to determine eligibility and discuss available services.
The decision to start hospice care is a personal one that should be made in consultation with your healthcare provider and family members. Generally, hospice care is appropriate when an individual has a life-limiting illness or condition and has a prognosis of six months or less. However, hospice care can be initiated earlier in the illness trajectory to provide comfort and symptom management, and may be provided for longer than six months if the individual’s condition does not improve or stabilizes.
Some signs that may indicate that it is time to consider hospice care include:
- Continued decline in physical function or ability to perform daily activities.
- Increased pain or other symptoms that are difficult to manage.
- Recurrent hospitalizations or emergency room visits.
- Decline in cognitive function or ability to communicate.
- Loss of appetite or significant weight loss.
- Withdrawal from social activities and interests.
If you or a loved one is experiencing these or other signs of decline, it may be appropriate to speak with your healthcare provider about hospice care. Hospice care can provide comfort, support, and dignity during the end-of-life process for both the individual and their family members.
Hospice care provides a range of services designed to support the physical, emotional, and spiritual needs of individuals with life-limiting illnesses and their families. Some of the common services provided by hospice care include:
- Pain and symptom management: Hospice care focuses on managing pain and other symptoms associated with the individual’s illness to improve their comfort and quality of life.
- Nursing care: Registered nurses and licensed practical nurses provide skilled nursing care to manage the individual’s symptoms, monitor their condition, and coordinate care with the healthcare team.
- Personal care: Hospice aides provide assistance with activities of daily living, such as bathing, dressing, and grooming.
- Counseling and emotional support: Hospice care provides counseling and emotional support to individuals and their families to help them cope with the challenges of end-of-life care.
- Spiritual care: Chaplains and spiritual counselors provide support to individuals and families based on their spiritual and religious beliefs.
- Volunteer services: Trained hospice volunteers provide companionship, respite care, and other supportive services to individuals and their families.
- Bereavement support: Hospice care provides bereavement support to family members after the individual’s death to help them cope with grief and loss.
Hospice care is designed to provide comfort and support to individuals and their families during the end-of-life process, and services are tailored to meet the unique needs of each individual and family.
Hospice care can take place in various settings, depending on the individual’s needs and preferences. The most common settings for hospice care include:
- Home: Hospice care can be provided in the individual’s own home, which may be a private residence, nursing home, or assisted living facility. This is often the preferred choice for individuals who want to remain in their familiar surroundings.
- Hospice facility: Some hospice organizations have inpatient facilities where individuals can receive care when their symptoms cannot be managed at home. These facilities provide a homelike environment and around-the-clock nursing care.
- Hospital: Hospice care can also be provided in a hospital setting, typically in a hospice unit or in the individual’s own hospital room. This may be necessary if the individual requires more intensive medical care or if their symptoms cannot be managed at home.
- Long-term care facility: Hospice care can be provided in long-term care facilities, such as nursing homes or assisted living facilities. In these settings, hospice care is often integrated with the individual’s ongoing care.
The choice of setting for hospice care is based on the individual’s needs and preferences, as well as the level of support available from family members and caregivers. Hospice care can be provided wherever the individual feels most comfortable and supported.
Yes, including hospice care in your advanced care planning is an important step in ensuring that your end-of-life wishes are respected and that you receive the care that you desire. Hospice care is a specialized form of end-of-life care that focuses on managing symptoms, improving comfort, and providing emotional and spiritual support to individuals and their families. By including hospice care in your advanced care planning, you can ensure that you receive the care you want and avoid receiving care that you do not want.
When including hospice care in your advanced care planning, it is important to discuss your wishes with your healthcare providers, family members, and other loved ones. You should also consider appointing a healthcare proxy or durable power of attorney for healthcare to make decisions on your behalf if you become unable to make decisions for yourself.
By including hospice care in your advanced care planning, you can ensure that your end-of-life wishes are respected, and that you receive the care that is aligned with your values and preferences.
When you begin hospice care, medication and other treatments to cure or control your serious illness will stop. For example, if you are receiving chemotherapy that is meant to treat or cure your cancer, that must end before you can enter hospice care.
No, you do not have to stop other medication if you are in hospice. In fact, it is important to continue taking any medication that helps manage your symptoms or treat other health conditions. Hospice care is designed to improve comfort and quality of life for individuals with life-limiting illnesses, and medication is an important part of managing symptoms and improving comfort.
However, your hospice team may review your medication regimen and make adjustments as needed to ensure that your medication is effectively managing your symptoms and is in line with your goals of care. They may also make recommendations regarding medication that is no longer necessary or that may be causing unwanted side effects.
It is important to discuss any questions or concerns about medication with your hospice team, including questions about potential interactions between medications, potential side effects, and whether certain medications are still necessary or appropriate. Your hospice team can work with you to develop a medication plan that is tailored to your specific needs and preferences.
Most insurance plans, including Medicare, Medicaid, and many private insurance plans, cover hospice care. In fact, hospice care is a benefit under Medicare Part A, which means that if you are enrolled in Medicare and meet certain eligibility criteria, you will be able to receive hospice care without incurring any out-of-pocket costs.
To be eligible for hospice care under Medicare, you must have a life-limiting illness and have a prognosis of six months or less if the illness runs its normal course. You must also agree to receive palliative (comfort-oriented) care instead of curative treatment for your illness. Other insurance plans may have different eligibility criteria, so it is important to check with your insurance provider to understand what is covered under your plan.
If you are concerned about the cost of hospice care, it is important to speak with your hospice provider and your insurance company to understand your coverage and any out-of-pocket costs that you may be responsible for. Your hospice team can also work with you to explore options for financial assistance or other resources that may be available to help offset the cost of care.
Hospice care typically does not include 24/7 care in the home, as it is designed to provide support and care to patients and their families during regular business hours. However, hospice providers typically have nurses available around-the-clock to answer questions and provide guidance over the phone, and they may also provide in-person visits during off-hours if needed.
In addition, if a patient’s symptoms or needs require around-the-clock care, a hospice provider may recommend transferring the patient to a hospice inpatient facility, hospital, or nursing home where they can receive more intensive care.
It is important to note that hospice care is primarily focused on providing comfort and improving quality of life for patients with life-limiting illnesses, rather than providing curative treatment or interventions. The hospice team works closely with patients and their families to develop a care plan that meets their needs and preferences, and they are available to provide support and guidance throughout the end-of-life process.
Hospice can provide significant benefits to people with advanced dementia and their families. Advanced dementia is a progressive disease that can cause a range of physical, emotional, and behavioral symptoms, and hospice care is designed to provide comfort and support to patients and their families during this difficult time.
Some of the ways that hospice can benefit people with advanced dementia include:
- Pain and symptom management: Hospice providers can help manage the physical symptoms associated with advanced dementia, such as pain, breathing difficulties, and infections. They can also help manage behavioral symptoms such as agitation, aggression, and anxiety.
- Emotional and spiritual support: Hospice providers can provide emotional and spiritual support to patients and their families, helping to reduce stress, anxiety, and depression. They can also provide counseling and support for families who may be struggling to cope with the challenges of caring for a loved one with dementia.
- Caregiver support: Hospice providers can provide support and respite care for caregivers, helping to reduce the burden of caring for a loved one with dementia. They can also provide education and training to help caregivers manage the physical and emotional needs of their loved one.
- Comfort and dignity: Hospice providers can help ensure that patients with advanced dementia are comfortable and treated with dignity and respect during their final days. They can also help families navigate end-of-life decisions and provide support during the grieving process.
Overall, hospice care can provide significant benefits to people with advanced dementia and their families, helping to improve quality of life and provide comfort and support during this difficult time.
Hospice care provides a range of benefits to patients and their families during the end-of-life stage. Some of the benefits of using hospice care include:
- Comfort and pain management: Hospice care is focused on providing comfort and pain management to patients, helping to alleviate physical discomfort and improve quality of life during the end-of-life stage.
- Emotional and spiritual support: Hospice care providers offer emotional and spiritual support to patients and their families, helping them cope with the challenges of end-of-life care and providing guidance and counseling as needed.
- Personalized care: Hospice care is personalized to meet the unique needs and preferences of each patient, with a focus on maintaining dignity, respect, and quality of life.
- Caregiver support: Hospice care providers offer support to caregivers, helping to alleviate the burden of caregiving and providing education, resources, and respite care as needed.
- Bereavement support: Hospice care providers offer bereavement support to families after the death of a loved one, helping them cope with grief and loss and providing resources and counseling as needed.
- Cost savings: Hospice care is often less expensive than hospital-based care, and can help reduce healthcare costs by avoiding unnecessary hospitalizations and treatments.
Overall, hospice care can provide significant benefits to patients and their families during the end-of-life stage, helping to improve quality of life, manage symptoms, and provide emotional and spiritual support during this difficult time.
FAQ Home Care
Because of the personalized nature of home care, there is not always a single answer for every question. Below are some general responses to some of the most commonly asked questions about home care, but to get answers that apply to your specific situation, please give us a call at 573-686-5510
The duration of home care services can vary depending on the individual’s needs and circumstances. Some individuals may only require home care services for a short period of time, such as a few weeks or months, while others may require ongoing care for an extended period of time.
The length of time that home care services are needed will depend on several factors, including the individual’s health condition, the level of support they require, and their ability to manage their care independently.
In some cases, home care services may be provided as a short-term solution to help individuals recover from an illness, injury, or surgery. In these cases, home care services may last until the individual has regained their independence and is able to manage their care without assistance.
In other cases, home care services may be provided on an ongoing basis to help individuals manage chronic health conditions or disabilities. In these cases, home care services may be needed for an extended period of time, ranging from months to years or even indefinitely.
The duration of home care services will be determined by the individual’s needs and goals for care, as well as their healthcare provider’s recommendations. It’s important to discuss your options with your healthcare provider and to work together to develop a plan of care that meets your needs and goals.
No, home care can be provided in a variety of settings, including private residences, assisted living facilities, and other community-based settings. The goal of home care is to provide individuals with the support and care they need in the comfort of their own environment, whether that be in their own home or in another community-based setting.
In some cases, home care services may be provided in an assisted living facility or other residential setting where the individual is receiving care. This can be particularly beneficial for individuals who need additional support or supervision but do not require round-the-clock medical care.
Regardless of the setting, home care services are designed to meet the unique needs and preferences of the individual receiving care. Services may include assistance with activities of daily living, medication management, wound care, physical therapy, and other types of support to help individuals maintain their independence and quality of life.
Home care services can be paid for through a variety of sources, including:
- Private pay: Individuals can pay for home care services out of pocket, either through personal savings or other financial resources.
- Health insurance: Some health insurance plans, such as Medicare, Medicaid, and private health insurance, may cover some or all of the costs of home care services, depending on the individual’s eligibility and the specific services needed.
- Veterans benefits: Veterans may be eligible for home care services through the Department of Veterans Affairs (VA), which provides a range of home-based care services to eligible veterans.
- Long-term care insurance: Some individuals may have long-term care insurance policies that cover the costs of home care services.
- State and local programs: Some states and local communities offer programs that provide funding or support for home care services for eligible individuals.
The availability and extent of coverage for home care services will vary depending on the individual’s circumstances, the type of care needed, and the specific programs and resources available in their area. It’s important to research the options available and to speak with healthcare providers and insurance companies to determine the best way to pay for home care services.
When you are looking for home care services, you may come across the term “Medicare-certified.” This means that the home care agency has met the standards set by the Centers for Medicare & Medicaid Services (CMS) and has been approved to provide services that are covered by Medicare.
To be Medicare-certified, a home care agency must meet certain requirements related to the quality of care provided, the qualifications of staff members, and other factors. These requirements are designed to ensure that individuals receiving home care services are receiving high-quality care that meets their needs and supports their overall health and wellbeing.
If a home care agency is Medicare-certified, it means that the agency is authorized to provide certain types of care and services that are covered by Medicare. This may include skilled nursing care, physical therapy, occupational therapy, and other types of care that are provided by licensed healthcare professionals.
If you are looking for home care services and need coverage from Medicare, it’s important to look for a home care agency that is Medicare-certified. This will ensure that the services you receive are covered by Medicare and that the agency has met the standards for quality care set by CMS.
The specific healthcare professionals who come into your home to provide home care services will depend on the type of care you need and the healthcare provider or agency you are working with.
Typically, home care services are provided by licensed healthcare professionals, such as registered nurses (RNs), licensed practical nurses (LPNs), certified nursing assistants (CNAs), physical therapists (PTs), occupational therapists (OTs), speech therapists, and other trained professionals.
In addition to these healthcare professionals, home care services may also be provided by trained caregivers, who may be employed by a home care agency or may be hired privately by the individual receiving care. These caregivers may provide assistance with activities of daily living, such as bathing, dressing, and meal preparation, as well as companionship and other forms of support.
When you are working with a home care agency or healthcare provider, they will work with you to determine the specific type of care you need and the healthcare professionals who are best suited to provide that care. They will also provide you with information about the qualifications and credentials of the healthcare professionals who will be coming into your home to provide care, and will work with you to develop a plan of care that meets your needs and preferences.
Home care enables a person to live as independently as possible without having to give up the comforts of their own home. It allows them to be in a familiar environment, sleep in their own bed at night, and stay close to loved ones like family, friends, and pets. It also brings peace of mind to know they have access to skilled, consistent, reliable care when it’s needed, even if those needs change.
When compared to other alternatives of care, home care can be significantly more cost effective. According to the Centers for Medicare and Medicaid Services (CMS), at-home care is usually less expensive, more convenient, and effective.
FAQ Physical Therapy
The main difference between inpatient rehabilitation and outpatient therapy is the level of intensity and duration of treatment.
Inpatient rehabilitation, also known as residential rehabilitation, refers to a program in which a patient resides at a rehabilitation facility and receives intensive therapy for several hours each day, typically for a period of several weeks. Inpatient rehabilitation is usually recommended for patients who require a high level of care and supervision due to the severity of their condition or because they have undergone major surgery or suffered a significant injury.
Outpatient therapy, on the other hand, refers to a program in which a patient receives therapy on an outpatient basis, typically visiting a clinic or rehabilitation center for several hours each week. Outpatient therapy is often recommended for patients who have a less severe condition or injury, and who are able to manage their daily activities and responsibilities while undergoing treatment.
In summary, the main differences between inpatient rehabilitation and outpatient therapy are:
- Inpatient rehabilitation is more intensive and requires the patient to reside at a facility, while outpatient therapy is less intensive and allows the patient to return home after each session.
- Inpatient rehabilitation is typically recommended for more severe conditions or injuries, while outpatient therapy is often recommended for less severe conditions or injuries.
- Inpatient rehabilitation typically lasts for several weeks, while outpatient therapy can last for several months or longer depending on the patient’s needs and progress.
Outpatient physical therapy is a type of healthcare service that is designed to help individuals recover from injuries or illnesses that affect their ability to move and perform everyday activities. Here’s how outpatient physical therapy typically works:
- Referral: Outpatient physical therapy often begins with a referral from a primary care physician, surgeon, or specialist. The referral may be for a specific injury or condition, or it may be a general referral for physical therapy to address issues such as pain or difficulty with movement.
- Initial Evaluation: Once a referral is received, the physical therapist will conduct an initial evaluation to assess the patient’s condition, functional abilities, and limitations. This evaluation may include a physical examination, medical history review, and other tests and measurements to identify areas of weakness or dysfunction.
- Treatment Plan: Based on the evaluation results, the physical therapist will develop a personalized treatment plan that outlines specific goals, treatment techniques, and a timeline for achieving those goals.
- Treatment Sessions: Outpatient physical therapy typically involves regular treatment sessions that take place in a physical therapy clinic or outpatient facility. The frequency and duration of treatment sessions will depend on the patient’s condition and treatment plan. During treatment sessions, the physical therapist will use a variety of techniques and exercises to help the patient improve their strength, flexibility, range of motion, balance, and coordination.
- Modalities: In addition to exercise and movement-based therapies, outpatient physical therapy may also involve the use of various modalities such as heat, cold, electrical stimulation, ultrasound, or manual therapy techniques.
- Progress Evaluation: Throughout the course of outpatient physical therapy, the physical therapist will evaluate the patient’s progress and adjust the treatment plan as needed to ensure that the patient is making progress towards their goals.
- Discharge: Once the patient has achieved their treatment goals or has reached a plateau in their progress, they will be discharged from outpatient physical therapy. At this point, the physical therapist may provide the patient with a home exercise program or other recommendations for maintaining their progress.
Overall, outpatient physical therapy is designed to help individuals recover from injuries or illnesses that affect their ability to move and perform everyday activities. With the help of a skilled physical therapist and a personalized treatment plan, many patients are able to improve their physical function and quality of life.
The frequency and duration of physical therapy treatment can vary depending on several factors, including the type and severity of your condition, your overall health, and your treatment goals. Your physical therapist will work with you to create a personalized treatment plan that outlines the recommended frequency and duration of treatment.
In general, outpatient physical therapy treatment may involve sessions that take place 1-2 times per week, with each session lasting 30-60 minutes. The total duration of treatment may vary based on the specific goals of treatment and the progress that is made over time. For example, some patients may achieve their treatment goals after just a few weeks of treatment, while others may require several months of ongoing therapy.
It’s important to note that physical therapy treatment is often most effective when it is consistent and ongoing. This means that it’s important to attend all scheduled therapy sessions and to follow through with any recommended home exercise programs or other self-care activities that your physical therapist may recommend.
Ultimately, the frequency and duration of physical therapy treatment will depend on your individual needs and goals. Your physical therapist will work with you to create a treatment plan that is tailored to your specific needs and that takes into account your overall health and lifestyle.
The top 3 types of rehabilitation therapy are:
- Physical therapy: Physical therapy is a type of rehabilitation therapy that is focused on helping individuals recover from injuries or illnesses that affect their ability to move and perform everyday activities. Physical therapists use a variety of techniques and exercises to help patients improve their strength, flexibility, range of motion, balance, and coordination.
- Occupational therapy: Occupational therapy is a type of rehabilitation therapy that is focused on helping individuals regain independence and functionality in their daily lives. Occupational therapists help patients develop the skills and abilities needed to perform everyday tasks such as dressing, grooming, cooking, and driving.
- Speech therapy: Speech therapy is a type of rehabilitation therapy that is focused on helping individuals improve their ability to communicate and swallow. Speech therapists work with patients to address issues such as speech and language disorders, cognitive-communication disorders, and swallowing disorders.
These three types of rehabilitation therapy are often used in combination to provide comprehensive care for individuals who are recovering from injuries, illnesses, or surgeries. The specific type of therapy that is recommended will depend on the individual’s needs and goals for treatment.
Whether or not outpatient therapy is right for you depends on several factors, including the type and severity of your condition, your treatment goals, and your personal preferences.
Outpatient therapy may be a good option for you if:
- You have a condition that can be effectively treated on an outpatient basis, such as a musculoskeletal injury, a mental health condition, or a neurological disorder.
- You prefer to receive care in a more flexible and convenient setting, such as a clinic or an office, rather than in a hospital or residential facility.
- You have a support system in place that can help you manage your condition outside of a hospital or residential facility.
- You are able to travel to and from therapy appointments without significant difficulty.
On the other hand, outpatient therapy may not be the best option for you if:
- You have a condition that requires intensive, round-the-clock medical care, such as a severe injury or illness.
- You do not have reliable transportation or access to a therapy facility.
- You do not have a support system in place to help you manage your condition outside of a hospital or residential facility.
- You have difficulty complying with treatment plans and need more structured or intensive care.
Ultimately, the decision to pursue outpatient therapy will depend on your individual needs, goals, and preferences. It’s important to discuss your options with your healthcare provider and to work together to develop a treatment plan that is right for you.
Yes, we work with your physician and insurance company to recertify needed name brand drugs.
Yes, our pharmacy offers delivery programs to those in need in our geographic region. Call us to inquire if we service your area.
Typically we can do same day fills within a short amount of time, some specialty needs will be next day
Typically we can do same day fills within a short amount of time, some specialty needs will be next day
Yes, we do recur script fill.
Ambulatory Infusion FAQs
“Infusion” or “infusion therapy” refers to the delivery of medications directly into the veins of a patient, also known as intravenous or IV administration. Sometimes infusion medications are referred to as “injectables” and are lumped into the category that includes provider-supervised intramuscular (IM) and subcutaneous injections (Sub-Q/SQ). “Provider-Supervised” means that they are not typically self-administered by the patient without a medical provider physically present. We often refer to both intravenous (IV) and injectable (IM,SQ) medications in our discussions if they are provider-supervised. A medication that is provider-supervised will likely be administered in an office-based setting (Infusion Center). Intravenous/Infusion or injectable methods of drug delivery are typically used when oral/pill medications are insufficient , inappropriate, or unavailable. Many of the newest medications are Biologic (made or derived from living cells) and cannot be taken orally like a pill because they will not remain effective after exposure to the digestive system.
Many infusion medications are prepared at the time of treatment by a medical professional, commonly a registered nurse. If the medication is intravenous (IV) it will likely be prepared and added to an appropriately sized bag of sterile solution (IV Fluids) which is then administered intravenously through an IV catheter placed by the registered nurse. Some IV and injectable medications come in pre-prepared forms that may not require as much advanced preparation.
A wide variety of conditions are treated with infusion (IV) and injectable therapy. Many of the newest infusible and injectable medications are used to treat autoimmune conditions – diseases in which the body’s immune system attacks healthy cells. Infusion therapy is also used to treat a number of other conditions including: infections that are unresponsive to oral antibiotics, cancer and pain associated with cancer, migraines, osteoporosis, osteoarthritis, congestive heart failure, hemophilia, and many more.
Examples of autoimmune conditions treated with IV or injectable biologics include:
- Inflammatory Bowel Diseases, including Crohn’s Disease and Ulcerative Colitis
- Rheumatoid Arthritis
- Multiple Sclerosis
- Psoriatic Arthritis
- And many others…
An Infusion Center is any physical location where infusion/injectable medications are routinely administered under the supervision of a healthcare provider (Medical Doctor, Nurse Practitioner, etc). Usually, this means that the location will have some form of part-time or full-time dedicated space where medications are prepared and administered. Infusion Centers do not include offices who only inject medication as a normal part of their patient procedures in exam rooms. (Example: a Family Practice physician who administers vaccines, steroids, and other agents to patients as a normal part of their practice would not be considered to have an Infusion Center.) Infusion Centers are more commonly found in the specialties of Oncology, Hematology, Infectious Disease, Gastroenterology, Rheumatology and others where there are multiple infusible medications for diagnosis in their fields of specialty.
- Office-Based Infusion Centers
- Hospital-Based Infusion Centers
- Pharmacy-Based Infusion Centers
- Stand-alone Infusion Centers
Office-Based Infusion Centers:
These are locations where a physician or physician group is providing/administering infusion/injectable medications as a distinct part of their practice. There is typically dedicated space and some dedicated staff for the Infusion Center. Larger offices may have multiple Infusion Center locations to better accommodate their patients in different parts of town. Some offices may only treat their own internal patients while others may accept and treat patients referred by other healthcare providers in their communities. For fee-for-service billing, these office-based locations typically fall into the “place of service” 11 code. NICA believes that the Office-Based Infusion Center is currently the most cost-effective site of care for patients needing infusion/injectable therapy.
Hospital-Based Infusion Centers:
These are locations that are owned or operated by Hospitals or Institutional organizations. They are almost always located directly within or on the campus of a Hospital facility. Hospital Outpatient Infusion Centers are sometimes referred to by industry as HOPD’s. All hospitals administer IV/injectable medications as part of their emergency department and inpatient services, however, if they do not have a dedicated facility/department for outpatient infusion services, then we do not consider them to have an Infusion Center. Hospital Infusion Centers may administer a wide variety of therapies including antibiotics, whole blood, blood products, chemotherapy, biologics, and many others. For fee-for-service billing, these hospital outpatient Infusion Centers currently fall into the “place of service” 22 code.
Pharmacy-Based Infusion Centers:
Less common than the previous two are the Pharmacy-Based or Pharmacy-owned Infusion Centers. Typically these locations are part of a company that has a home infusion pharmacy and a focus on providing infusion treatments inside a patient’s home. The Infusion Center will be a space, typically within the offices of the pharmacy, where a patient can receive treatment on-site with a registered nurse. Sometimes, these locations are used so that a patient can receive their first infusion treatment and at the same visit, be trained to self-administer the remainder of their treatments at home without the supervision of a nurse.
Pharmacy Infusion Centers are distinct in that they do not commonly have a medical doctor or nurse practitioner on site directly supervising the infusions/injections. For this reason, under current government regulations, most of the Pharmacy Infusion Centers will not be able to receive payment from Medicare for infusion therapy.
Stand-Alone Infusion Centers:
These are the most difficult sites of care to identify. Stand alone infusion centers, sometimes referred to by industry as SOICs or AICs (Ambulatory Infusion Centers), are locations that are not obviously attached to or located on the premises of a Hospital, doctor’s office, or pharmacy. They may be located in retail shopping areas or other local business offices suite in non-medical areas of town.
There are some cases we are aware of where these locations can exist and service patients with private insurance. It is rare that Medicare patients are treated at this site of care because these locations do not typically have medical doctors or nurse practitioners physically present at any given time. Sometimes these locations are actually one of the other three types listed above, but are organized and marketed in a way that is not obvious to an observer.
New Infusion Center Models:
There are new innovative delivery models that combine traits of both the office-based model and the stand-alone model by the use of nurse practitioners (NP’s). These locations look and feel like a stand-alone operation but are commonly regulated and paid like a doctor’s office. In most US states, nurse practitioners can operate practices independent of a medical doctor’s office or direct ownership/supervision. For billing, these locations use the same classification as a medical provider’s office, place of service 11.
For these locations the nurse practitioner serves not only as the supervising provider, but may administer the infusions/injections as well. Under most current private payer and Medicare guidelines, additional RN staff may work “incident-to” the nurse practitioner so that the NP does not have to directly administer every medication to every patient in order to bill claims for the medication and service.
Infusion Center Management Companies:
Due to the rising complexity and cost of managing an outpatient Infusion Center, many physicians have turned to infusion management companies for assistance. Infusion management companies provide services to physicians and some HOPDs so that many of the challenges of operating an Infusion Center can be outsourced. Staffing, inventory management, facility setup and maintenance, technology systems, billing, etc. can be managed independently allowing the physician and office staff to focus on the medical practice itself and not the Infusion Center.
An infusion management company will have more expertise in dealing with complexities and common issues faced when running a safe and efficient Infusion Center. Independent Infusion Center management services are typically charged as a fee based on the volume of the location and the array of services being performed.
Office-based Infusion Centers are critical parts of our healthcare system:
They are generally more accessible geographically than hospital sites of care
They are more affordable and efficient than hospitals and many other alternative sites of care
They have a more controlled environment and are often more patient friendly due to their focus on infusion medication administration
Hospitals commonly have long wait-times and a confusing navigation process that is not patient friendly. Hospitals are typically located in major metropolitan areas and are not widely dispersed and accessible for rural and suburban communities of patients. Receiving an infusion in the hospital will typically take longer than the same infusion in an office-based Infusion Center. As a result, many patients find it difficult to get their infusions in the hospital and value the accessibility of their local office-based Infusion Center.
Receiving IV medication in a hospital is typically and exponentially more expensive than receiving the same medication in an office-based Infusion Center. Hospitals and many other institutional environments have the ability to charge much higher fees for their services even if they are offering the same or lower level of care for infusion patients.
Safety and Patient Experience:
Hospitals are big places with lots of staff moving from room to room and patient to patient. Many infusion patients are diagnosed with autoimmune disorders that commonly make them more susceptible to infections than the general population. We believe that the office-based Infusion Center is a more controlled environment that does not expose patients to the kinds of infectious disease that are present in hospitals and larger facility-based locations.
At a hospital, a patient may have a different nurse for each infusion treatment. Alternatively, office-based Infusion Centers commonly have a smaller more focused staff. Patients have reported developing deep relationships with the staff at their Infusion Centers and a more compassionate patient experience as a result.
The typical episode of care will include an intake visit to establish care with the office based infusion center. The purpose of this visit is to review your medical & Surgical history, receive education regarding the infusion you will be receiving and to review current or needed labs and imaging results.
Our infusion center keeps snacks and drinks on hand as well as blankets for the most comfortable experience. You are allowed to bring outside drinks and food if you would like.
In most cases your loved one will be able to sit there beside you in our comfortable reclining medical chairs while enjoying a quiet environment. iPad and television are provided for those interested in entertainment.
FAQ Durable Medical Equipment
Medicare may cover certain durable medical equipment (DME) for eligible beneficiaries who require the equipment for medical reasons. Some of the DME services that may be covered by Medicare include:
Included but not limited to:
- Oxygen equipment and supplies, including oxygen tanks, concentrators, and related accessories
- Mobility aids, such as wheelchairs, walkers, scooters, crutches and canes
- Hospital beds and related accessories
- Commode chairs
- Continuous positive airway pressure (CPAP) devices and accessories
- Blood glucose monitors and test strips
- Enteral nutrition supplies, such as feeding pumps and formula
- Prosthetic devices, including artificial limbs and breast prostheses following a mastectomy
- Negative pressure wound therapy (NPWT) pumps and related supplies.
- Continuous passive motion devices
- Home infusion services
- Infusion pumps & supplies
- Lancet devices & lancets
- Nebulizers & nebulizer medications
- Patient lifts
- Suction pumps
- Traction equipment
It is important to note that coverage for DME may vary depending on the specific item and the individual’s medical condition. Eligibility requirements and coverage details should be discussed with the healthcare provider and insurance provider for specific information. Additionally, beneficiaries must meet certain criteria and follow specific rules in order to qualify for DME coverage under Medicare.
Yes. You can buy a light box without a prescription, but it’s best to use it under the guidance of a health care provider and follow the manufacturer’s guidelines. Your health care provider may recommend a specific light box.
Yes. We sell diabetic shoes. We need an order from your primary care physician and we can start this process. If you need help obtaining an order we also can help facilitate this request. Once we obtain it we contact you to schedule an appointment for your fitting and selection of shoes.
Yes. We carry a full range of CPAP supplies and brands.
FAQ Primary Care
Yes we are able to accommodate s.ame day appointments
Yes, for uninsured we are able to provide private pay rates.
Yes, our clinic services patients across the life span.
Yes, we are accepting new patients.
We are contracted with most insurances. Call our care coordinator to verify your insurance coverage.
FAQ Behavioral Health
In order to be assessed for an ISL program you would need to reach out to Department of Mental Health, Division of Developmental Disabilities.
Our Day habilitation program is licensed thru the Department of Mental Health and DHHS. We can review your eligibility by calling our patient care coordinator. We also accept private pay.
We are contracted with several insurances and our patient care coordinator would be happy to review your insurance for services.
Yes, all active members have 24 access.
Indoor track, group-x classes, aquatic classes, tanning, sauna, indoor heated pool, protein shake & smoothie bar, personal training, cardio equipment, free weights and selectorized equipment.
Tanning, Personal Training, Specialty Group Classes & Stretch-Fit program.
Varies from personal goals but several opportunities to meet your financial needs.
Through our Ozark Wellness app, via phone or in person at the front desk.
You may join online or in person at the front desk at Ozark Wellness.
Ozark Wellness is more than just a fitness center, Health & Wellness is a true passion to share with all members and our community.
We keep up with the new & cutting-edge equipment pieces every year. New equipment is added and updated on a yearly basis!
Yes, we offer group classes for both water and land.
Stretch-Fit is a stretch program to help you achieve greater flexibility & comfort in your daily life. PNF stretching that is performed by one our flex ologist.
Absolutely, our staff can show you the entire facility at any time!
Yes we do autopay.
We provide convenient curbside service, pull in and call the number and it will be run out to you.