Please use the toggles below:
No. There are essentially five types of agencies that provide in-home service:
- Private-duty home health non-skilled
- Private-duty home health skilled
- Medicare-certified home health
- Nurse registry
Homemaking and companion services cannot touch the client and bills the client directly for services. Home health can touch the client to assist with activities of daily living (ADLs), and skilled services are provided by a nurse under doctor’s order. If the agency bills the client for services, it is considered a licensed “private-duty agency;” if the agency bills Medicare for the services, it is Medicare-certified; if the agency bills Medicare or private insurance and works under a doctor’s order it is considered skilled care.
The type of care the client needs can also determine the type of agency best suited to provide services. Post-acute care addressing an immediate need with the expectation of improvement is usually best met by skilled care. These services are usually paid, at least in part, by insurance or Medicare.
If the needs are long term, such as assistance requiring help with activities of daily living (ADLs) such as transferring, bathing, continence care, eating or dressing, the services are typically provided by private-duty home health agencies. These services are paid for in part or in whole by long-term care insurance or by the client.
Homemaker/companion agencies are not technically licensed or accredited but do receive a certificate of registration by Florida’s Agency for Health Care Administration (ACHA). Workers are employed by the agency, and it is not required to have liability insurance. However, these employees may not “touch” the client and cannot provide assistance with activities of daily living or personal care.
Private-duty home health agencies are licensed by AHCA. Caregivers can do everything the homemaker/companions do as well as offer skilled and non-skilled services. Some agencies only offer non-skilled services provided by a home health aide (HHA) or a certified nursing assistant (CNA). Other agencies extend the services to include those that only a registered nurse or licensed nurse practitioner can provide under the direction of a physician. Caregivers are paid employees, and the agency is required to have liability insurance.
Medicare-certified home health agencies are licensed by AHCA, provide skilled services under doctor’s orders and bill Medicare and private insurance. If medically necessary, assistance with activities of daily living may be provided by a HHA or CNA, but only if clients are concurrently receiving skilled services.
Certified agencies typically do not provide long-term care services like a private-duty agency. Their personnel are pair employees, and the agency is required to have liability insurance.
Nurse registries can provide all the services listed above; however, the staff is composed of contractors, not employees. The business relationship exists within the agency, and the aide or nurse that the client chooses. Nurse registries are not required to carry workers comp insurance nor any insurance or bonding on contracted aides.
There are essentially two types of service categories: medically necessary and custodial care. Medically necessary services are typically provided by a nurse with a doctor’s prescription. If the client is eligible for medically necessary care, Medicare pays. Private health insurance may pay depending on the policy; if it includes a medically necessary home health benefit, insurance may pay all or part of the cost. Regardless, both provide a short-term benefit with intermittent visits.
Custodial care assists with activities of daily living and can include homemaking, companion services and errands. Neither Medicare nor private health insurance pays for these services. Custodial care is often considered long-term care and is provided by private-duty home health agencies at a fee-for-service arrangement. Long-term care insurance pays for custodial care and many agencies at a fee-for-service arrangement.
Services for Approved Home Health clients are billed weekly and may be covered by credit card, check or long-term care insurance. There is no Medicare or Medicaid reimbursement, but Approved does have contracts with a number of local agencies, some of which provide funding for those who qualify.
No. Approved Home Health staff is available for shifts of any length, but there may be a higher rate charged for visits of less than three hours.
Approved Home Health’s policy is that all referrals are seen by a registered nurse (RN) for an evaluation with 48 hours of the initial call. Quite often, the nurse is able to make that visit within just a few hours.
All the members of Approved Home Health’s personal care team are home health aides (HHAs) or certified nursing assistants (CNAs). All aides are bonded and undergo extensive level II background checks, which include criminal background, work history and department of motor vehicle background. They are drug screened when hired and at random times throughout their employment. Approved Home Health also believes it’s very important for staff to continue to build their expertise, so they all participate in ongoing monthly education to keep their skills current and sharp.
Frequently Asked Questions Videos