What Type is Right?
The term “home care” encompasses a wide range of health and social services. These services are delivered at home to recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social or therapeutic treatment and/or assistance with activities of Daily Living (ADLs).
Home Health Care Providers
Home Health Care providers include companies and independent healthcare professionals. The types of home health care providers that are licensed or registered by the Florida Agency for Health Care Administration are detailed here:
Homemaker/Companion Agencies are licensed by the State of Florida. Services provided include light housekeeping, meals, shopping and trips outside the home. These services can also be offered by a home health agency.
A homemaker/companion service is prohibited by Florida law from providing hands-on personal care. “Personal Care” means assistance with ADLs such as bathing, eating, personal hygiene, physical transfer & ambulation and administering medications. Personal Care is to be provided by Home Health Aides (HHAs) and Certified Nursing Assistants (CNAs) working for Home Health Agencies and Nurse registries.
Caregivers of agencies are required to have a level two fingerprint background check through the Florida Agency for Healthcare Administration (ACHA)
Home Health Agencies deliver health and medical services and medical supplies through visits to an individual’s home or place of residence. Supplies are restricted to drugs and biologicals prescribed by a physician. They may provide the following:
• nursing care
• physical, speech, occupational, respiratory and IV therapies therapy
• hands on home health aide and homemaker/companion services
• home medical equipment
• nutritional guidance
• medical social services
• skilled services
Florida Law requires the following of Home Health and Nurse Registries that serve patients who need skilled services:
• If a patient is receiving skilled services, that patient’s doctor must sign and treatment order citing the services needed. A plan of care (POC) must be creates, giving details of how care will be given. A POC is not required for people receiving home health aide services without a treatment order or for those receiving only homemaker/companion services. A patient has the right to be a part of the planning of his or her care and to receive, upon request, a copy of the POC.
• For patients receiving skilled services, a health care professional licensed to perform these services must do an assessment of the patient’s condition.
• The POC must be reviewed at certain times by the patient’s doctor and the care must be coordinated and supervised by the home health care provider. These requirements vary depending on the provider offering the services, so ask the provider and your doctor what to expect.
*Note: Not all agencies provide all services.
Medical Home Health Agencies are required to be licensed and inspected by the State of Florida. Caregivers are required to have a background check either through AHCA or FDLE.
Nurse registries arrange for nurses (RNs, LPNs), Certified Nursing Assistants (CNAs), Home Health Aides (HHAs) or homemakers/companions to provide services to patients in their home or place of residence.
Each individual health care worker is contracted with the registry. Nurse registries provide nursing care or homemaker/companion services, but they are not licensed to provide physical, occupational, respiratory, speech or IV therapy or medical equipment services. They must be licensed by the State of Florida and caregivers are required to have a background check through either AHCA or FDLE.
Products range from respirators, wheelchairs, and walkers, to catheter and wound care supplies. These providers deliver, and when necessary, install these products as well as instruct patients on their proper in-home use. These providers usually do not provide physical care for patients, but there are a few exceptions. Some offer pharmacy and infusion services, where a nurse administers medication and nutritional formulas to patients and teaches them the proper techniques for self-administration. Some providers also offer respiratory therapy services to help individuals use breathing equipment. Providers that bill the Medicare program are required to meet federal minimum standards. Each provider is liable for its personnel and the services provided to patients. Providers must be licensed by the State of Florida by AHCA.
Although not administered by AHCA, an individual healthcare professional may provide health care services in the home, within the scope of his or her state license or registration and/or training. Health care professionals can include registered nurses (RNs), licensed practical nurses (LPNs), respiratory and speech therapists, certified nursing assistants (CNAs), home health aides (HHAs) and homemakers/companions. If you employ and independent health care professional you should ask who will be responsible to pay household employment, income withholding and unemployment taxes. If he or she does not pay these taxes, you may be required to pay.
Use our Home Care Questions to Ask worksheet to assist you in evaluating home care agencies you are considering.