Skilled Nursing Visits

Description of Service:

RNs and LPNs provide professional nursing services to patients in the privacy of their own homes under direct orders from the private physician. Care provided is determined by individual patient need. Services include, though are not limited to, the following: 

1.     ASSESSMENT ~ An initial assessment visit will form the basis for the care to be provided to you. Changes in your plan will be made constantly as your condition warrants. Each visit, the nurse will assess your current status, progress made and any new problems, which may have developed. 

5.     COMMUNICATE changes in your health care needs to your doctor. This will include regular progress reports and updates to your plan of care. You will be informed of any communication and changes in orders received from your doctor regarding your care.

6.     RESTORE you to your maximum level of independence in the least amount of time possible.  The ultimate goal of the nurse is to return the patient to independence with the greatest degree of good health in the shortest span of time possible. We know you have better things to do than be sick. 

Eligibility Requirements:

SKILLED SERVICES can be provided only under the direction of a licensed doctor. Each payment source has it's own eligibility guidelines. In most cases, the patient must be "homebound". This means leaving home to obtain medical care is difficult or causes a hardship and the patient rarely leaves home except with help for very short periods of time. In some cases, the physician prescribes that the patient remain home until treatment is completed to avoid prolonging the recovery period or risking exposure to additional health threats while the patient's resistance is low.

Additional Notes:

HOME HEALTH SKILLED NURSING visits are designed to meet the needs of the person recovering from an acute illness or a setback in a chronic illness. Recurrent hospitalizations and multiple trips to the emergency department are "red flags" signaling the need for home care.

Physical Therapy

Description of Service:

A licensed therapist will assess the patient's current physical abilities focusing primarily on lower body strength, coordination, and tolerance to activity. Therapy will be provided to improve mobility, strengthen muscle coordination, improve endurance, promote safety and teach correct use of equipment such as prosthetic devices, walkers, canes, crutches and lifts. Therapy is designed to promote patient independence in performance of daily living activities. The patient will be taught a series of exercises to perform between therapy visits to speed recovery. Prior to discharge from service, the patient will have received the needed training to continue steady improvement or to maintain progress made.

Eligibility Requirements:

PAYOR SOURCE ELIGIBILITY REQUIREMENTS vary and must be met before that source will pay for services. All require that the patient have need of skilled care and that there be a reasonable expectation of improvement in the patient's current health status.

Additional Notes:

PHYSICAL THERAPY ASSISTANTS may provide treatments under the direction of a Physical Therapist once a plan of care has been developed. HOME HEALTH AIDES may be instructed by the Physical Therapist to perform range-of-motion exercises and ambulation exercises in conjunction with bathing and dressing as an extra period of physical therapy between the therapist's visits.

Speech Therapy

Description of Service:

A licensed therapist will assess the patient's current physical and mental abilities for communication and/or swallowing of foods and liquids. A program of therapeutic exercise will be developed to improve the patient's communication abilities. As an example, patients who have suffered the loss of their "voice box" (laryngectomy) may receive instruction in esophageal speech. A patient who has trouble swallowing may benefit from neck and throat exercises designed to regain the ability to take oral nourishment. The patient will be taught an exercise program to be used between the therapist's visits so as to speed recovery. This will also improve the patient's potential for recovery.

Eligibility Requirements:

PATIENT NEED for skilled treatments and payors source eligibility requirements dictate provision of therapy services.

Occupational Therapy

Description of Service:

A licensed therapist will assess the patient's current physical ability focusing primarily on upper body strength, coordination and tolerance to activity. Therapy will be provided to improve mobility, strengthen muscle coordination and improve endurance so as to promote independence in daily living activities. The patient will be taught a program of exercise to continue progressive improvement between therapy visits and following discharge from service.  VNA also offers a certified lymphedema therapy specialist to assist patients suffering from debilitating fluid retention in the arms or legs.

Eligibility Requirements:

PATIENT NEED for skilled services and payors source eligibility requirements dictate provision of therapy services.

Medical Social Service

Description of Service:

The primary concern of the social worker is provision of a safe environment for the patient. The patient receives assistance in identifying and accessing needed community services.

Fees to Participant:

Medicare, Private Insurance, Workman's Comp, Private Purchase and Charitable Contributions (when available) are used to purchase the services of a social worker for VNA Patients.

Eligibility Requirements:

PATIENT NEED for professional services and payors source eligibility requirements dictate provision of social services.

Home Health Aide

Description of Service:

Personal hygiene care, such as bathing and grooming, is provided to improve the condition of the skin, hair and nails. Simple dressings to unbroken, precariously fragile skin may be applied under the direction of the nurse. Range of motion exercises may be provided according to a plan developed by a licensed therapist. Ambulation transfer assistance is provided to promote safety. Bed linens are changed according to patient preference. The patient is encouraged to perform as much of his own care as able. The Home Health Aide's goal is to return the patient to independent self-care as soon as possible.

Payment Methods:

Medicare, Medicaid, and occasionally Private Insurance or Workman's Comp will purchase the non-skilled services of the Home Health Aide. Frequently, aide services are Privately Purchased.

Eligibility Requirements:

PATIENT NEED and the source of payment determine eligibility for service.

Additional Notes:

PERSONAL HYGIENE and grooming assistance are often cited as one of the most appreciated home care services as the increased sense of well-being is immediate. Privacy is a priority in all personal care.

Dietitian

Description of Service:

Dietary needs are assessed and the patient is instructed in foods recommended to meet those needs to promote recovery and maintain wellness. The patient's health requirements, economic status and personal food preferences are considered in developing a nutritious diet.

Payment Methods:

This service is rarely reimbursable by an insurance plan but provided by VNA because improved nutrition reduces the time needed for recovery. Also, patient awareness of their body's food and fluid needs will decrease the likelihood of a recurrence of ill health.

Eligibility Requirements:

A nursing assessment reveals the need for a dietary consult. The physician must approve and authorize the service.