You’ve been informed by the hospital staff that your mom will need some home health care after she is discharged from the hospital. You are further told that Medicare will pay for it. Great! You will have a nurse and therapists and an aide watching over Mom….you think.
Not so fast!
Medicare only pays for skilled home care services not custodial services. So what’s the difference?
Skilled care services include:
1.Physical therapy to strengthen lower extremity muscle groups that may have been weakened by a stroke, knee or hip surgery, de-conditioning from a lengthy hospital or rehab stay, or a history of frequent falls.
2. Occupational therapy to strengthen upper body muscle groups and to retrain patients in ADLs (activities of daily living) or train caregivers in how to assist the patient.
3. Skilled nursing for wound care; IV therapy; education of new disease management, new or changed medications, or treatments; observation for the effects that treatment and medication is having to resolve acute problems in order to report to the physician so treatment plans can be modified if needed.
If someone qualifies for skilled home care, they may also have an aide once or twice a week to assist with bathing. Once someone is safe enough to bathe without assistance or there is a competent caregiver to assist with bathing, or there is no longer a skilled need, then the aide will not come any more.
Custodial care is for patients that have a poor prognosis and need a much higher level of assistance. These are patients who may be incontinent and need frequent cleansing, bed bound or chair bound and need frequent repositioning or turning, unable to prepare meals or feed themselves, unable to take correct medications at the correct times, or have severe cognitive problems and need twenty four hour supervision.
So if you think home care is going to do everything for Mom, you had better think again. Know the difference between skilled and custodial care and read my previous article on When You Want to Bring Mom or Dad Home to Live With You: What you Need to Know.