Beebe Home Health Agency

Beebe Medical brings expert care home
June 28, 2012

pan class="Apple-style-span" style="font-size: 9px; font-family: Times; ">Plain and simple truth: after a certain point in treatment, most patients will recuperate faster in their own home, in a familiar environment and among loved ones. Most prefer to be at home where family and friends can visit at any time. For those who still need skilled nursing care, at least on an intermittent basis, there's home healthcare such as the services offered by Beebe Home Health Agency.

Owned by and affiliated with Beebe Medical Center, Beebe Home Health Agency provides care for patients after discharge from a hospital or nursing home or after an event that leaves a patient temporarily home-bound. With an order from a physician, care is provided in the patient's home for up to 60 days. Joan Thomas, special consultant to the president of Beebe Medical Center, and Cheryl-Ann Benn, director of home health, explained how the home health business works. 

The federal government provides grants for agencies providing patient visits in the home — anything from skilled nursing, physical therapy, occupational therapy, speech pathology, medical social work to home health aides who provide assistance with hygiene care. Qualifying patients include those with heart disease, congestive heart failure, diabetes, respiratory disease, recent orthopedic surgery or medical management needs. The patient also must be considered home-bound, unable to function in the community or for whom getting out for medical care is difficult, Benn said.

An assessment is required — a 35-page questionnaire that covers not only the patient's medical condition "head to toe" but how the patient functions in his or her home and community and how much the patient is able to do for himself or herself. Among the questions are what are the goals of the patient and the family. The assessment is reviewed by Medicare which then says, as Benn put it, "We'll give you this amount of money to go to the home and take care of this patient for us." Providing care for many patients at home has proven more cost effective than care in a medical facility. Home health care service might include catheter or continence care, wound care, injections or IV therapy or nutritional support. Certified home health aides can periodically provide personal assistance, including bathing, dressing and home exercise.

Thomas added that regaining independence is key. "There are patients who would not be appropriate for referral because the likelihood of achieving independence is slim. This is intermittent care. The patient needs to be able to manage his or her own (non-skilled nursing) care with family or private help. That's why we rely on the assessment. Everything must fall within the guidelines of Medicare."

Another key is reducing the likelihood of the patient requiring readmission to a hospital. Starting next year, Benn said, the federal government will not provide reimbursement for patients who are readmitted within 30 days of discharge from a hospital.  Benn noted that with 10,000 "Baby Boomers" retiring every day, the federal government is looking at ways to reduce medical costs. "Within the next 20 years there will be a big pool of people needing Medicare services, but limited funds. Home health is an alternative and is not as costly as a hospital or nursing home." With somany people needing care, Benn explained, the agency must be proactive. "We must provide the right amount of care, in the right time frame, and make sure the right amount of services are available — all with no additional revenue. We must do everything with the given amount of money. It's like having a budget and having to stay within that amount."

Each patient must receive at least five visits within the 60 days, although, depending on need, it could be as many as 40 visits. If a patient needs additional care, or if there is a change in condition, need for surgery or a medical change, care can be extended for another 60 days. Recertification for that period begins with another order from the doctor. "The physician is the manager of the patient while being seen under home health," Benn said. Thomas said, "The whole effort is a collaboration between nursing (the case manager) and the physician's office. Each patient has a physician's order for home health care that identifies specifically what must be done." If the nurse, in completing the assessment, finds something different from what the doctor found, the nurse will contact the physician to request an order for additional treatment."

The nurse case manager, Benn said, communicates with the physician, arranges follow-up care, sends a licensed social worker in for community services, who can arrange help in paying for medication, transportation or food when necessary. "No one knows what the patient is going through until the nurse goes through the front door. If there's no food in the refrigerator, no one knows." The nurse sees herself as a guest in the patient's home. Some patients are welcoming, Benn said. Others are apprehensive, afraid of being "reported" to the doctor and placed in a facility. "Our No. 1 criteria is to put the patient first. We are invited professionals, but this is their domain. We must be cautious how we act and talk."

Customer service is important because "they talk to their friends, and we get referrals from them." Beebe Home Health Agency is Medicare-certified, meaning state and federal Medicare staff have reviewed the competency of the nursing staff, looked at documentation, care plans and patient outcomes, Thomas said. Not all home health agencies are Medicare-certified; those that are not can provide care but costs are not reimbursable from Medicare. "It's very much a business. We have to look at profit margins and quality issues. Discharge planners recommend that patients and families go online to medicare.gov and see the quality of care provided. Beebe has good scores in the state and the region. We are very proud of our scores. We are in the limelight, not only in clinical care and measuring clinical outcome but also in the need to (provide that care) in a cost-effective way."

Customer satisfaction surveys, conducted by an independent agency, rate Beebe Home Health Agency above 95 percent. Referrals come not just from the hospital (40 percent) but from physicians in the community (30 percent), other hospitals (25 percent) and skilled nursing facilities (5 percent). "There is never a boring day in home health," Benn said. "We have to be able to change, because every day there's a curve ball. We must rise to the challenge and get it done. That's what makes this profession exciting. "This is nursing with a Florence Nightingale philosophy — putting a patient in the best condition possible." For more information about Beebe Home Health Agency, call (302) 854-5210.

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