Skilled Care at Home
Skilled care is a service to address a medical need. At home it is provided by a Certified Home Health Care Agency (CHHA) or a hospiceprogram. Skilled care with a CHHA includes the services of a:
- Registered Nurse (RN)
- Physical Therapist, Occupational Therapist, or Speech Therapist
- Home Health Aid (HHA)
When a CHHA provides skilled care services, the purpose is to restore and maintain an individual’s optimal level of function and health. These services are provided instead of hospitalization, admission to a care facility, or going to an outpatient office.
Commonly, skilled care is provided for six to eight weeks and includes items such as wound care, injections, or therapy (physical, occupational, speech)directed at restoring or improving function. It may include medical equipment, such as an electric bed, specialty mattress, or respiratory support like oxygen and other devices.
During the time that the CHHA is providing services, the agency may be able to offer a Home Health Aide (HHA) to assist with Activities of Daily Living (ADL), such as dressing, bathing and feeding, for a few hours a week. However, this is not the primary purpose of skilled care. When the CHHA’s skilled care services are finished, any added services end except for medical equipment which will be provided for as long as you need it based on your medical situation and qualifications.
Medicare and private insurance usually pay for skilled care, although the insurance plan (Medicare and commercial insurance) determines the extent and level of care that is covered. Many people are surprised when they are not eligible for CHHA services, even when there are high levels of frailty or advanced stage of illness.
If you are on Medicare, learn more about your service needs and if Medicare will pay for them. If you have private insurance, you can contact your insurance company to learn what services are eligible. It is usually a good idea to ask for a case manager to be assigned to your case. The case manager will get to know you over time and can help advocate for your needs.
If you are at home and would like to receive services from a CHHA you have two options:
- Call the CHHA directly; or
- Call your doctor’s office and request that services be ordered. Be prepared to specify what your needs are (for example, changing wound dressings, shots, IV medication, or occupational therapy).