Home Health Care FAQs

Ensuring Quality Home & Hospice Care
With so many patients receiving home care and hospice services, ensuring quality of care is vitally important. Fortunately, a number of measures of quality are available to consumers. Both the state and federal governments regulate organized home care and hospice programs. Licensed home health agencies undergo annual licensure surveys through the Oregon Department of Human Services’, Oregon Health Division.  Medicare-certified programs are surveyed annually against the Medicare Conditions of Participation. 

In addition, the Federal Food and Drug Administration regulate home medical equipment companies that provide oxygen. Non-skilled home care provided through private and home care aide organizations are now separately licensed to provide non-skilled services in Oregon (effective 2-1-03). Licensure for all "in-home care agencies" is the result of legislation passed in 1999 by the Oregon Legislative Assembly. Regulations for in-home care agency can be found here.  

Licensure for Oregon's hospices is also regulated by the state. State laws and regulations for hospices can be found here. 

Many providers seek voluntary accreditation through organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO); and Community Homecare Accreditation Program (CHAP). As employers, home care organizations also comply with federal and state OSHA requirements, as well as other applicable laws and regulations. 

Defining Home & Hospice Care
What is Home Care?
Home care has a long history of providing quality care to individuals in their homes. Full spectrums of cost-effective services, ranging from high-tech nursing to non-medical assistance with the activities of daily living, are available. Home care services are provided by trained caregivers and include skilled nursing, rehabilitation, and personal care services. Considered to be the model for quality, compassionate care for people facing a life-limiting illness or injury, hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person's needs and wishes. Support is provided to the person's loved ones as well. Home care continues to be an increasingly important sector of the health care system.  Oregon rates as one of the most efficient providers of Medicare home care services.  As the population of Oregon continues to increase (in terms of the number of persons over the age of 65) home care will continue to be an essential component of the health care system.

Who Uses Home Care? 
Most people prefer to stay at home rather than go to a hospital or nursing home when they can no longer manage their own care.  Home care is not just an alternative to institutional care – home care services can allow many individuals to avoid institutional care altogether.

Home & Hospice Care's Role in the Health Care System
Home care has a unique position within the health care system because:

  • Home care providers’ presence in the home allows insight into the actual needs, strengths and weaknesses of patients and their support systems;
  • Emphasis is placed on providing care, encouraging patient and family involvement, and fostering independence;
  • When an acute episode of care requires hospitalization, home care serves as the intervention before hospitalization, and the care following;
  • Hospice care allows terminally ill patients to receive needed care in the comfort of their own homes;
  • Home care commonly interfaces with other health care entities, such as outpatient services, residential care facilities, skilled nursing facilities; and
  • By nature of their commitment to home-based care, home care providers support community involvement, including referrals to supportive agencies to maintain the patients at home.

Who pays for Home Care Services?

  • Medicare
  • Medicaid / Oregon Medical Assistance Plan
  • Managed Care Organizations
  • Private Insurance
  • Private Payers

Home Care Services Can Be Offered by Many Individuals, including:
Physicians, Registered Nurses, Licensed Practicing Nurses, Psychiatric Nurses, Physical Therapists, Occupational Therapists, Respiratory Therapists, Enterostomal Therapists, Speech / Language Pathologists, Medical Social Workers, Registered Dietitians, Certified Home Health Aides, Certified Nursing Assistants and Homemaker / Companions.

Home Care Equipment/Supplies Can Include:
Oxygen-respiratory equipment; Infusion therapy equipment; Monitoring devices; Assistive devices; Emergency response devices; Home medical equipment, such as wheelchairs and walkers; Rehabilitation equipment and various other Medical supplies.

Checklist for Choosing a Home Health Agency
There are many considerations one should make when selecting a home health care agency. Here are some questions to consider:

  • A home care agency should be selected to meet your individual care needs. The Oregon Association for Home Care (OAHC) can provide you with a list of member agencies which serve your area. The following are a few factors you may want to consider in making a selection. These points are meant to be a guide only. Some points may be more important to you than others.

  • Is the agency certified by Medicare? Medicare certification means the agency has met federal requirements. Because an agency does not participate in the Medicare program does not mean the agency provides less quality care.
  • Is the agency accredited? Accreditation is a voluntary process conducted by nonprofit professional organizations stating the agency has met established standards.
  • Does the agency provide written statements describing services, eligibility requirements, fees and funding sources?
  • What are the financial arrangements? Can you get them in writing, including visit costs, minimum hour or day requirements the agency may have and any extra charges such as supplies?
  • How long has the agency been serving the community?
  • How does the agency select and train its employees, especially nonlicensed caregivers?
  • Who owns and manages the agency? What type of "governing body" oversees the agency?
  • Is a professional agency staff member available for phone consultation on a 24-hour, seven-day-a-week basis?
  • How is the plan of care developed? Does it provide you with a copy of your Rights and Responsibilities?
  • Does the agency provide supervisory visits to the patient's home and evaluate the quality of care delivered regularly? How is the quality of care evaluated?
  • What arrangements are made to ensure patient confidentiality?
  • Does the agency belong to OAHC? OAHC keeps its members up-to-date on industry policies and regulations and provides educational opportunities for all types of caregivers.
  • Has the agency adopted the OAHC Code of Ethics?

Medicare & Home Health Care
Learn what Medicare covers under the Home Health Part A benefit ~ Click Here

Medicare & Hospice Care
Learn what Medicare covers under the Hospice Part A benefit ~ Click Here

How Home Care Started
Starting in the 1880s, public health nurses traveled to patients' homes, caring for the sick, teaching family members how to provide care in their absence, suggesting ways to improve health, and comforting the dying.  As the nurse's role in saving lives became more apparent, insurance companies started to offer visiting nurse services to their working- and middle-class policyholders faced with illness.  By 1916 these services were available to more than 10 million policyholders in the United States, creating the first nationwide system of insurance payment for home-based care.