Home care provides medical and health-related services and assistance with day-to-day activities to people in their homes. Home care can also be used to provide short-term care for people moving from a hospital or nursing home back to their home and can also be used to provide continuing care to people with ongoing needs. Home care services may be provided outside a person’s home when normal life activities take the individual away from home.
Home care services provided to MA enrollees must be:
- medically necessary;
- ordered by a licensed physician;
- documented in a written service plan;
- provided at a recipient’s residence (not a hospital or long-term care facility); and
- provided by a Medicare-certified agency.
A registered nurse from a Medicare-certified home health agency completes an assessment to determine the need for service. The assessment identifies the needs of the person, determines the outcomes for a visit, is documented, and includes a plan. Most home care services must be prior authorized. The maximum benefit level is one visit per day for home health aide services, one visit per discipline per day for therapies (except respiratory therapy), and two visits per day for skilled nurse visits.
Home care services include the following:
- Intermittent home health aide visits provided by a certified home health aide
- Medically oriented tasks to maintain health or to facilitate treatment of an illness or injury provided in a person’s place of residence
- Personal care assistant (PCA) services
- Home care nursing
- Therapies (occupational, physical, respiratory, speech)
- Intermittent skilled nurse visits provided by a licensed nurse
- Equipment and supplies
About 65 percent of PCA and home health agency service recipients over the age of 65 are also on the EW. This does not include people on other waivers.
Home health agency program statistics (does not include managed care enrollees) for fiscal year 2016:
- Total MA expenditures: $16.5 million
- Monthly average recipients: 3,204
- Average monthly cost per recipient: $430
Home care nursing statistics for fiscal year 2016:
- Total MA expenditures: $121.3 million
- Monthly average recipients: 765
- Average monthly cost per recipient: $13,218
The content of this and any related posts has been copied or adopted from the Minnesota House of Representatives Research Department’s Information Brief, Long-Term Care Services for the Elderly, written by legislative analyst Danyell Punelli.