Home Health Agencies: Use of in RCFEs

Use:    Third party caregivers or skilled medical professionals hired through Home Healthcare (HHC) agencies can be used in an RCFE.  These individuals can be hired either a) by the RCFE to provide the skilled medical professional services necessary to meet the resident’s incidental medical needs, or b) by the resident’s family or responsible party to augment care and services being provided by the facility. 

Medicare Certification:  Home health care (HHC) agencies offer a variety of skilled medical services, and most are not required by the state to be licensed.  However if use of HHC individuals is expected to be paid by Medicare, it is important to select a Medicare-certified HHC agency, as services rendered by a non-Medicare certified agency will not be reimbursed.  

Facility-Provided Home Health Services:    Typically, the resident’s care plan prepared by the Licensee will stipulate the requirement for use of a home health aide to provide injections, wound care, or other specialized care that the Licensee is unable by regulation to provide. 

Resident-Provided Home Health Services:  There are times when family members (or responsible parties) of the resident elect to have additional care, assistance and supervision provided for their residents.  The resident may receive Home Healthcare services directly, and apart from any care and supervision provided by the facility. 

In these instances, the family or other responsible party would independently arrange for the service, interview the caregiver, arrange for payment, and would be responsible for coordinating with the Licensee, this 3rd party’s presence in the facility, including Criminal Background Checks (see below).

Criminal Background Checks:   Title 22, Section 87411 exempts “licensed or certified medical professionals from criminal background check requirements.  Thus a privately paid personal assistant who is also a licensed medical professional is exempt.  In addition, a privately paid personal assistant who has a current certification as a Certified Nursing Assistant and/or a Certified Home Health Aide is exempt.”  The operative word here is “certified.”    

What You Should Know: 

 

Consumers should ask to see evidence of a home health aide’s certification if the agency or the individual represents they are “certified.”  The licensee must keep a copy of the  person’s current license or certification on file in the facility.

Some RCFEs may have Home Health Agencies that they regularly use.  The Licensee or Administrator may tell you that you have to use ‘their’ home health agency.  That is not true.  You and your resident have the choice of which home health agency you use. 

Notes in italics represent the views and/or experience of CARR regarding this topic and/or regulation..