Study Shows Home Health Services Are Being Underutilized

Author

Entrusted Legacy Law

For more information about the author, click to view their website: Sharek Law LLC

Posted on

Sep 18, 2023

Book/Edition

Pennsylvania - Greater Pittsburgh Area

Share This

Health Affairs estimates that 4 million older adults can only leave their homes with assistance, making accessing care challenging.

The Centers for Disease Control and Prevention reports that 1.3 million Americans receive care in nursing homes. According to A Place for Mom, more than 810,000 reside in assisted living.

Home health care presents an alternative to nursing homes and assisted living, providing care for homebound people. Those who receive home health care can remain in their residences, reducing expenses, preserving autonomy, and maintaining community ties.

Although Medicare funds some home health care services, a recent study has found that Medicare beneficiaries are underutilizing the program’s home health care options. Many older adults do not receive the home-based clinical care or home-based long-term services and supports that could benefit them.

Medicare Coverage of Home Health Services

Medicare Parts A and B cover certain home health services. Homebound individuals can receive part-time or intermittent skilled services. Part A covers home health care for people following a hospital stay or a stay in a skilled nursing facility. Part B provides home health care for homebound adults who need skilled nursing care.

A Medicare beneficiary is considered homebound in the following situations:

  • Because of an illness or injury, they have trouble leaving their home without help, such as a cane, wheelchair, walker, or crutches, special transportation, or another person’s assistance.

  • Their physician recommends staying at home.

  • Leaving their residence takes a major effort.

The program covers medically necessary part-time or intermittent skilled nursing care and health assistance, durable medical equipment, and medical supplies for use at home.

Medicaid also covers long-term services and supports (LTSS), which include medical and personal care services that aid with activities of daily living (ADLs). These are the kinds of services an assisted living facility typically provides.

Use of Home-Based Clinical Care and Long-Term Services and Supports Among Homebound Older Adults

A 2023 study published in the Journal of American Medical Directors Association looked into home-based clinical care and home-based LTSS among homebound older Medicare beneficiaries. The researchers examined the Medicare claims of 974 beneficiaries to shed light on their use of in-home services.

The study found that while homebound individuals used these services, no group received high levels of all care types.

Homebound individuals more commonly utilized LTSS services than home-based clinical care.

  • Approximately 30 percent of participants received some home-based clinical care.

  • About 80 percent of the sample received home-based LTSS.

The researchers identified three levels of home clinical care and LTSS usage among older adults:

  • Low Care and Services (46.6 percent). The largest group of participants received little home-based care. These individuals tended to be younger with fewer chronic conditions and functional impairments.

  • Home Health Only with LTSS (44.5 percent). While this group used some home health services, such as assistance with ADLs, they received little home-based clinical care.

  • High Clinical with LTSS (8.9 percent). Only a few participants had extensive home-based clinical care. In addition to tending to be older, they were more likely to have dementia and live alone.

In finding that only roughly 9 percent of participants receive high levels of clinical care and LTSS, the study points to a gap between those who could benefit from these services and the care provided. Although in-home care and support could meet the needs of older adults, many homebound older adults do not take full advantage of the services available.

Learn More About Your Options

If you or your loved one need help with medicare care of activities of daily living at home, contact Sharek Law Office at 412-347-1731 or click here to schedule a complimentary 15-Minute call to learn more about your options.

 

This article is a service of Sharek Law Office, LLC. We don’t just draft documents; we ensure you make informed and empowered decisions about life and death, for yourself and the people you love. That's why we offer a Life and Legacy Planning Session, during which you will get more financially organized than you’ve ever been before and make all the best choices for the people you love. You can begin by calling our office today to schedule a Life and Legacy Planning Session and mention this article to find out how to get this $750 session at no charge. Please note this is educational content only and is not intended to act as legal advice.

Other Articles You May Like

What are ADLs and IADLs?

When deciding on the best senior living residence for your loved one, you may have questions regarding which type of facility is most appropriate to address their current health and desired autonomy. Your physician can hep in this determination, and most assisted living and memory care centers will perform their own assessment both to determine if their facility is equipped to help the individual and to determine a probable path for ongoing care. As time goes on, your loved one will be regularly assessed to ensure that their care plan is beneficial for their evolving needs. ADLs and IADLs are the most common measurement guidelines for the required care level.The six activities of daily living (ADLs) and the eight instrumental activities of daily living (IADLs) are the standard guidelines used to assess whether senior adults can or should continue living independently, or if assistance is needed. In some cases, insurance companies may also require ADL or IADL assessment to clinically identify needs before agreeing to pay for additional care.What Are the 6 ADLs?Bathing. The individual is fully capable of bathing themselves, or may just need help with one part of the body because of injury.Dressing. The individual chooses their own clothes from a dresser or closet, get dressed, and adds appropriate outer clothing such as a sweater on cool days.Toileting. The individual goes to the bathroom without assistance, including getting on and off the toilet, taking off and putting on clothes, and cleaning themselves.Transferring. The individual can gets themselves in and out of a chair or bed on their own.Continence. The individual has complete control over urination and defecation.Feeding. The individual can feed themselves without assistance. (Food may be prepared by someone else.)Effectively Assessing ADLsIf senior adults can perform all six of these activities without any assistance or prompting, they are deemed to have full function, and can care for themselves. A score of four out of six indicates  moderate impairment and that they may need additional care, while one or two out of six indicates severe functional impairment and therefore, they need others to care for them. Many seniors lose these abilities gradually and progressively. Certain tasks may become more challenging as they ag, while others may remain their entire life.What are the 8 IADLs?Using the telephone. The individual can answer the phone, and knows how to call family and friends on their own.Shopping. The individual can purchase everything they need without assistance.Food preparation. The individuals has the capacity to plan, prepare and serve their own food.Housekeeping. The individual can perform home maintenance duties such as washing dishes or making the bed.Laundry. The individual can do their own laundry, at least in part.Mode of transportation. The individual can either drive, or understands how to arrange for their own transportation.Responsibility for own medications. The individual correctly self-administers their medication without prompting.Managing finances. The individual manages their personal finances with little (or limited) help, including paying bills and keeping track of balances.Considerations When Assessing ADLs and IADLsWhile ADLs and IADLs can be helpful in assessing autonomy, they arent a perfect tool. An individuals unique physical and cognitive abilities can change from day to day, or decline gradually over time. Because of this, ADLs and IADLs should be evaluated routinely to identify if any changes in living and care arrangements are needed.At My Care Finders, we help families to navigate the complexities of understanding all of their care options. Our knowledgeable senior care experts can help you to collect the necessary information to make an informed and appropriate decision for your loved one. Call today to learn more about our FREE services.

Foolproof your Home: Senior Safe Strategies

As our loved ones age, ensuring their safety and well-being becomes a top priority. For many seniors, the desire to age gracefully in the comfort of their own homes is strong. However, as homes age with them, they may pose various risks and challenges. In this comprehensive guide, we'll explore foolproof strategies to make your home safe for seniors, enhancing their independence and well-being.Understanding the Importance of Senior SafetyAging comes with its own set of challenges, including decreased mobility, vision impairments, and other health concerns. It's essential to create a safe living environment that addresses these challenges and minimizes the risk of accidents and injuries. By prioritizing senior safety, we can help our loved ones maintain their independence and quality of life.Introducing Aging in PlaceAging in Place is a concept that emphasizes the ability for seniors to remain in their own homes as they age, rather than moving to assisted living facilities or nursing homes. This approach allows seniors to maintain their sense of independence and familiarity with their surroundings, promoting overall well-being and happiness.Identifying Home HazardsBefore implementing safety measures, it's crucial to identify potential hazards in the home. Common hazards for seniors include slippery floors, poor lighting, cluttered walkways, and inaccessible bathrooms. By conducting a thorough home safety assessment, we can pinpoint areas that require attention and make necessary modifications to improve safety.Essential Home ModificationsOnce hazards have been identified, it's time to implement modifications to enhance senior safety. These modifications may include:Installing grab bars in bathrooms and near stairs to prevent fallsAdding non-slip flooring and mats in high-traffic areasImproving lighting throughout the home to reduce the risk of trips and fallsInstalling handrails and ramps for easier mobilityLowering countertops and cabinets to make them more accessibleUpgrading bathroom fixtures to include features such as walk-in showers and raised toiletsBy making these modifications, we can create a safer and more accessible living environment for seniors, allowing them to navigate their homes with confidence and ease.Leveraging Technology for SafetyIn addition to physical modifications, technology can also play a crucial role in enhancing senior safety. Smart home devices such as motion sensors, doorbell cameras, and medical alert systems can provide added security and peace of mind for both seniors and their caregivers. These technologies can help monitor for potential emergencies, provide assistance in case of falls or accidents, and allow for remote monitoring of the home.TruBlues Senior Safe SolutionsAt TruBlue, we understand the importance of senior safety and independence. That's why we offer a range of services specifically designed to make homes safer and more accessible for seniors. From home assessments and modifications to ongoing maintenance and support, we're here to help seniors age in place with confidence and peace of mind.Taking Action for Senior SafetyEnsuring senior safety in the home requires careful planning, assessment, and implementation of foolproof strategies. By identifying hazards, making necessary modifications, leveraging technology, and partnering with trusted experts like TruBlue, we can create a safe and supportive environment that allows seniors to age in place with dignity and independence. With the right approach and support, we can make our homes safer and more comfortable for our aging loved ones, ensuring their well-being and happiness for years to come.

Spring Cleaning Checklist: Essential Home Maintenance Tips

As spring approaches, it's the perfect time to refresh and maintain your home with a thorough spring cleaning. This guide provides essential tips to ensure your home is in top condition, covering everything from deep cleaning to checking for any necessary repairs or updates. Spring Cleaning Checklist1. Deep Clean Inside: Start with decluttering each room, followed by dusting, vacuuming, and mopping. Don't forget to clean windows, treat carpets, and organize closets.2. Check Your HVAC: Ensure your heating, ventilation, and air conditioning system is ready for the change in seasons by replacing filters and scheduling a professional inspection.3. Inspect Roof and Gutters: Winter weather can take a toll. Inspect your roof for damage and clean out gutters to prevent water damage.4. Safety Checks: Test smoke detectors, carbon monoxide detectors, and fire extinguishers. Replace batteries as needed.5. Exterior Maintenance: Power wash the exterior, check for paint touch-ups, and ensure your landscaping is in good shape.6. Plumbing and Leaks: Look for any signs of leaks under sinks, around toilets, and near appliances. Consider scheduling a plumbing inspection to catch any issues.7. Prepare Outdoor Spaces: Clean and set up outdoor furniture, check decks and patios for needed repairs, and get your garden ready for planting.  Why It's ImportantRegular maintenance not only keeps your home looking great but also prevents costly repairs down the line. Tackling these tasks can extend the life of your home's components and systems, enhance its value, and improve your living environment.  Let's Get Started!Feeling overwhelmed? TruBlues team of professionals is here to help with all your spring maintenance needs. From deep cleaning to repairs and everything in between, we've got you covered. Contact us today to schedule your spring maintenance service and enjoy peace of mind knowing your home is in expert hands.This guide is designed to be your starting point for a thorough spring refresh. By following these steps, you'll not only maintain your home's condition but also create a healthier, more enjoyable living space for you and your family. Let Us Become Your Home AllyWhen it comes to handyman services, choosing the right company can make all the difference. With TruBlue of North Pittsburgh, you can trust that your home is in capable hands. From our commitment to providing a great experience, our skilled handyman professionals, to transparent pricing, we strive to provide you with a seamless and stress-free experience from start to finish. So why settle for anything less? Experience the TruBlue difference for yourself and see why we're the trusted choice for homeowners.

Local Services By This Author

Entrusted Legacy Law

Elder Law 100 Pinewood Lane Suite #303, Warrendale, Pennsylvania, 15086

Our Firm Prepares You for Life What makes our firm different is that we were built with the needs of growing families in mind. We understand you are BUSY, you are growing, you are planning for a life of prosperity and you value ease, convenience and efficiency. You are raising children, and caring for elderly parents, while also working hard to build your own nest egg for a lifetime of support. You want to know youve made the best decisions for your family and that your plan will work when your loved ones need it most. You want to make sure your minor children would be raised by the people you choose, and never by anyone you wouldnt want, and that your teens and adult children are properly prepared to care for you and what you leave behind.  You want to feel confident that youve made the right choices, and handled everything so that you arent leaving behind a mess, when something happens. That is our focus as well. Weve developed unique systems to give you the same access to a Personal Family Lawyer as was previously only available to the super-wealthy, so you can have the guidance you need to build and maintain a life of prosperity and wealth. And, to keep your family out of court and out of conflict, which is the greatest risk to the people you love and all you have created, even if youve already worked with a traditional lawyer or created documents online. Our Team Is Here for You We encourage communication with our clients. In fact, weve thrown out the time clocks so you never have to be afraid to call with a quick question. Everything we do is billed on a flat-fee basis, agreed to in advance, so there are never any surprises. We have a whole team to serve you. When you call our office to ask your quick question, you wont have to wait hours or days for a phone call back. Youll get your question answered, right away. And, if you need to schedule a more in-depth legal or strategic call with your Personal Family Lawyer, a call will be scheduled when you're both available and ready for the call so we can make the very best use of your time and not waste your time by leaving voicemail after voicemail back and forth. And, we ensure the most important details of your planning are followed through on and your plan continues to work throughout your lifetime. We have a funding coordinator to ensure your assets are owned the right way throughout your lifetime and none of your assets will end up going through a long, expensive court process or being lost to the state because they were missed after your death. Weve created unique membership programs to keep your plan up to date year in and year out as well as give you access to our Trusted Team of Legal Experts for guidance on ANY legal or financial matter. One day you will need a lawyer. I dont know why and I dont know when, but when you do, you will be grateful you can call on us and well be here to advise you or get you out of a jam. We Help You Transfer Your Life and Legacy Lastly, we believe your financial wealth is only a small part of your overall Life and Legacy Planning which is made up of your far more valuable and most often lost upon incapacity or death intellectual, spiritual and human assets. These assets are what make you who you are, and sum up whats most important to you. And, a survey of inheritors has revealed that what they care about even more than inheriting your money, is inheriting these intangible assets.   Most estate plans only focus on the transfer of your financial wealth to the next generation. Most people have such great intentions of passing on the intangible, but very few ever get around to it. Its just not a priority, until its too late. How much do you know about your grandparents values? Their most prized personal possessions? How they felt about you? What they had learned during their lifetime? If you are like most people, you know very little. Thats why we build the capture and passage of these most valuable assets into every estate plan we create. Not only will we help you pass on your money, but also your values, your insights, your stories and your experience the truly valuable assets your loved ones care about the most.  Weve developed a tool that allows us to capture and pass on your whole family wealth, including your Intellectual, Spiritual and Human assets.  I cant go into all of the details here, but well definitely talk about it when you come in for your Life and Legacy Planning Session.