Office
1160 Lake Plaza Drive, Suite 255

Colorado Springs, CO 80906

Phone: 719-533-0084
Fax: 719-533-0466

Email Us at:

"Specializing in Geriatric Home Care"

 
 

services

(Frequently Asked Questions)

Q.   Is Summit in compliance with the national Health Insurance Portability and Accountability Act (HIPAA)?

A.   Summit Home Health Care is HIPAA compliant.

Q.   Why Should I Consider Home Health Care?

A.    Although Medicare did not consider home health care a covered service until 1966, people have received nursing care at home throughout history. It wasn't until the 1900's that home health care became formalized. It has been in the last decade, however, that the use of home health care services has increased dramatically. There are a variety of reasons for the rise in utilization of this important health care component, some of which are listed below:

  • Home care improves the quality of life.
  • Home care helps maintain independence.
  • Home care promotes healing in a familiar environment & involves teaching the patient and family members how to continue caring for his/her needs when home care is no longer required.
  • Home care is less stressful and postpones or eliminates the need for
    institutionalization.
  • Home care is safer in terms of less infection and fewer complications than are incurred at a hospital.
  • Home care is more efficient and less expensive than other types of care.
  • Home care prevents or postpones advanced levels of care (i.e., assisted
    Living/skilled nursing in a facility).

Q.      Who is Eligible for Home Health Care Services?

A.  A home health care patient must be homebound (the exception is Medicare Part B Outpatient Therapy; the patient may choose to participate in outpatient therapy within their home setting). Homebound is defined as being restricted in his/her ability to leave home without assistance, due to illness or injury. The patient does not have to be bed bound, nor does the patient require a hospital stay prior to utilizing home health care services.

  • A Medicare patient must also need care on a part-time or intermittent basis. Patients requiring 24-hour care are not covered under Medicare home health care benefits. A patient may opt to pay privately for services not covered by Medicare.
  • A written physician's order is required to initiate home health care. If the physician writing the order is not the primary care physician, it will be necessary for the patient to be under the care of a physician that will oversee the patient's general medical care, including home health care. In other words, if an emergency room physician orders home care, it will be necessary for Summit to confirm that order with the primary care physician who will be ultimately responsible for reviewing home health care orders, etc.

Q.     How Do I Choose a Home Health Care Agency?

A.      It is important to understand that, unless your insurance company contracts exclusively with one particular agency, you have a choice in which home health care agency you select. As the consumer, you are encouraged to research home health care agencies and choose one that best meets your needs. It is important to understand that simply comparing prices may not be the best way to determine an appropriate agency. For instance, some agencies may quote a "per hour" fee, while others may quote a "per visit" fee." Additionally, sometimes family members indicate a need for a home health aide, when the patient actually requires someone with more advanced skills. Summit is always happy to meet with the patient and/or family prior to engaging in services, in order to determine exactly what the needs are and how best to meet them. Here are some questions to ask when exploring home health care options:

  • How long has the provider been serving the community?
  • Does the agency provide literature explaining services, eligibility requirements, and "Patient Bill of Rights?"
  • Are nurses or therapists required to evaluate the patient's home care needs?
  • Does the provider include patient and family members in developing the plan of care?
  • Does the provider assign supervisors to oversee the patient's quality of care?
  • Does the provider furnish written statements explaining costs and payment plan options?
  • Is the staff courteous and helpful when making a telephone inquiry?
  • Is the provider HIPAA compliant and does the provider present the patient with information about how patient privacy and confidentiality are handled?

Q.     Do I Have to Accept the Agency the Hospital Recommends?

A.     Again, unless the patient is limited by insurance restrictions, the patient and family have every right to choose the home health care agency they feel will best meet their needs. It is the obligation of every hospital to provide its patients with a list of local home health care agencies for the purpose of patient choice. As health care restrictions become more limited with managed care, government regulations, etc., it is important for patients to exercise their right of choice in every circumstance that allows. You may ultimately select the hospital's home health care agency, but know that you have a right to accept or reject any agency based on your own discretion.

Q.     Do Home Health Care Agencies Have a Medical Director?

A.      Yes, home health care agencies do have medical directors who provide medical direction and oversight as requested.

The Medical Director of Summit Home Health Care is Jeffrey T. Kulp, M.D., a licensed physician who provides advice/consultation to the agency pertaining to planning/evaluation of clinical and administrative policies, and promotion of activities/services by the agency.
Dr. Kulp serves as a member of the Advisory Committee, reviews medical records should problems or question arise, assists the agency in the coordination of patient care between clinical staff and patients' physicians; and provides assistance to effectively implement state-of-the-art home health services.

Dr. Kulp is an internist and geriatrician who received his B.A. from Wesleyan University in Middletown, CT and his M.D. from Pennsylvania State University College of Medicine in Hershey. He has practiced in Colorado Springs since 1990.

Q.     Is There an Outside Source that Compares Home Health Care Agencies?

A.     Yes, Medicare operates a website, www.medicare.gov/HHCompare/Home.asp that rates Medicare-certified home health care agencies, based on data collected.


 

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