Specialty Solutions Spotlight: Optimal Levels of Service in Home Health Care

How can home health be optimized to ensure the appropriate level of service is received?

Asking the right questions is key to providing effective home health services for injured employees. Factors like medical complexity, physical constraints and mental needs are crucial in determining the appropriate level of service, impacting both recovery and financial outcomes.

To assess the level and type of service needed, work with the treating physician to evaluate your options:

LPNs for Skilled Home Nursing Instead of RNs

The state-determined scope of practice differs between registered nurses (RNs) and licensed practical nurses (LPNs). While RNs typically have expanded duties, both RNs and LPNs share similar roles like checking vital signs, completing medical treatments and medication administration. Notably, the cost associated with an LPN is usually significantly lower than care provided by an RN.

Home Health Aide Care Instead of Nurses

Home health aides assist with daily tasks such as getting out of bed, eating, bathing and dressing. When non-medical services are needed, a home health aide can offer cost-effective care without compromising the quality of service provided to the injured employee.

Companions and Homemakers Instead of Medical Staff

If an injured employee’s needs are primarily supervision or assistance with household chores, a companion or homemaker might offer the required level of service to ensure the injured employee’s comfort and safety. Without the necessity for medical or physical care, companions and homemakers can provide essential assistance at a more cost-effective rate than nurses or home health aides.

DME to Decrease Reliance on Home Health Care Providers

Employing durable medical equipment (DME) can notably decrease the need for home health services. Specialty rehabilitation equipment like lift systems and chairs, traction equipment, specialty beds and motorized wheelchairs can assist injured employees thereby minimizing the need for multiple care providers in the home.

Evaluation of Services

It’s common for various home health services to be ordered upon hospital discharge, but over time, the specialty service provider may consult with the treating physician and case manager to see whether the number of care providers or the caregiver skill level can be reduced which can help save significant costs.

Determining the appropriate level of care can be complicated, but Apricus Care Coordinators can simplify the process by providing clinical oversight and cost-saving recommendations to the physician’s order. Our knowledgeable care coordinators are available 24/7 to accept referrals and work collaboratively with examiners, case managers and discharge planners to develop a customized assessment and individualized action plan for optimum injured employee care. Claims stakeholders receive ongoing communication and actionable information regarding ongoing treatment.

This information is meant to serve as a general overview, and any specific questions should be fully reviewed with a health care professional or specialty service provider.

To make a referral for home health, durable medical equipment, hospital discharge planning or another specialty solution, call us today at 877.203.9899 or send an email to referrals@apricusinc.com.

Resources:

https://www.hopkinsmedicine.org/health/caregiving/types-of-home-health-care-services

https://www.als.org/navigating-als/resources/fyi-different-types-home-care-workers

https://www.medicare.gov/what-medicare-covers/whats-home-health-care