Grace-Frequently Asked Questions

Frequently Asked Questions

Q. How do I qualify for home health care and have Medicare pay for it?

A. In order to qualify for home health and have Medicare pay for it, you must be considered homebound, be under the care of a physician and require a skilled service.

Q. What does homebound mean?

A. The patient is homebound if he/she experiences a normal inability to leave home. The patient's physical condition and/or physical limitations are such that it would be a considerable and taxing effort for that patient to leave home.

Determination of homebound status depends on the illness or limitations of the patient. The need for supportive devices or assistance alone does not necessarily render the patient homebound.

Homebound status is not affected by frequent absences from the home when the reason to leave is to receive medical treatment.

The patient is allowed brief and infrequent absences from the home for non-medical reasons, such as barber/beauty shop, to attend church, etc. However, these absences should be infrequent and of short duration.

Q. The only time I ever drive my car is to go to the doctor or to buy groceries. Will Medicare pay for home health?

A. No. According to Medicare guidelines, if you are able to drive yourself to the doctor or to buy groceries, then you are not homebound. Homebound would be someone who has a normal inability to leave home. The patient’s physical condition and/or physical limitations are such that it would be a considerable and taxing effort for that patient to leave home. If you have these limitations, you should not be able to drive a vehicle.

Q. Can I go to church on Sunday and still be considered homebound?

A. Yes. Medicare recently changed the definition of homebound to allow patients to go to church on Sunday. However, you would still need to meet the above requirements for homebound status.

Q. Do I have to pay anything if I have Medicare?

A. If you qualify for home health through Medicare, you will not have to pay anything. Medicare pays for the care. There is no deductible or out of pocket expense.

Q. If I don’t qualify for Medicare to pay for home health, can I still have it?

A. Yes. If your physician orders home health and you do not qualify under Medicare guidelines, you may pay for the services yourself. Call us for a fee schedule.

Q. How often will you come see me?

A. At the time of admission to the service, an RN will assess your condition and needs and will set up a plan of care with you. The RN will discuss the frequency of visits with you and will also discuss expectations at that time.

Q. What does a home health aide do?

A. The primary function of a home health aide is to perform personal care, such as bathing, dressing, grooming, caring for hair, nails, and oral hygiene. The aide spends anywhere from 45 minutes to 1 hour in the home. Once the personal care is complete, the aide may also perform other duties for the patient.

The aide may straighten the bedroom, clean the bathroom, change the bed linens, or fix a snack for the patient. The aide does not perform spring-cleaning, sweep and mop floors, vacuum, etc. These duties are the duties of a provider, not an aide.

Q. I just want someone to help me with a bath. Will Medicare pay for that?

A. No. According to Medicare guidelines, a patient must have a need for skilled nursing, physical therapy or speech therapy before they qualify for a home health aide. Our agency does offer these services to patients on a private pay basis. There are also some state programs that assist with this type of care.

Q. What programs are you talking about?

A. Provider programs. The Texas Department of Human Services has several programs that will put a provider in your home to assist you with personal care and housekeeping chores, such as cooking, cleaning, shopping, etc. There are specific qualifications that the patient must meet. For more information, please click on our DHS/Community Care Programs link.

Q. Will Medicare or insurance pay for in home nursing or my equipment?

A. We will contact your insurance or Medicare to check for you. Your coverage may depend on your physician's orders and your condition.

Q. How can I get a nurse?

A. Call us and we will talk with your physician about your in-home nursing needs or have you physician or hospital social worker call us. Our registered health care professionals will work with your physician to care for your needs.

Q. What can a nurse do for me at home ?

A. Professional nurses can provide skilled care under your physician's direction in your home. Among other skilled care, nurses can provide IV therapy, take blood for laboratory testing, give injections, tend wounds, change feeding tubes, provide and change catheters and teach you about special diets or medication.

Q. Can someone help with my bath and dressing ?

A. Yes. Under the supervision of a registered nurse or registered therapist, certified home health aides can provide baths, oral hygiene care, nail and skin care, and other personal hygiene care. Aides can also help with other services like changing your linens while at your home.

Q. What if I have a problem at night ?

A. You are encouraged to call us whenever you have a question about your care. You can call us 24 hours a day. A nurse is on call to answer any questions you may have or assist you in an emergency situation.

Q. If I were injured in a car wreck or suffered a sports related injury, could a nurse or physical therapist visit my home?

A. Yes. A nurse or registered therapist, under your physician's orders, can treat you in your home for injuries received in a car wreck, job-related injury or sports-related accident.

Q. My mother has been hospitalized for a long time and wants to come home. How can you provide care for a bedfast patient ?

A. Most anything administered in the hospital can be administered by a professional nurse comfortably in the home such as fluid replacements, bladder catheterizations and feeding tubes, among other types of skilled care.

Q. I just learned that I have a diabetic condition. I can't get to the doctor's office without calling an ambulance. What can a nurse do to help me ?

A. In addition to other types of in home care, the nurses will teach you how to manage your diabetic diet and help you understand your condition. You'll also learn how to give an insulin injection, if needed, and how to use blood sugar monitor (the glucometer) for in home blood sugar testing.

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