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Sunday, August 23, 2009

What About Seniors and Home Health?

Everyone is focused on the "death panels" in the Obamacare travesty and how it will impact seniors, but there is another section that will have an immediate and detrimental effect on our senior citizens now and in the future.

The proposed cuts to Medicare will all but eliminate the availability of home health care. For those that don't know, Medicare patients count for almost 90% of home health care clients. Home Health not only focuses on immediate needs, like wound care, IV medication or post op care, but primarily functions as a "preventative" service. Nurses and therapists work with the patients and their caregivers in their own home to teach, train and monitor their various medical conditions.

Take for instance a patient with one of the highest diagnosis related to re-hospitalization... CHF or Congestive Heart Failure. A nurse can go to the patient's residence and assess the patient's overall status. She/He can teach the patient the vital self-care tools in order to prevent re-hospitalization. The therapist can teach the patient energy conservation techniques and work to increase patient's overall strength and endurance. A seemingly minor weight gain of 3 pounds in a couple of days can indicate the start of an exacerbation of the CHF. Having a nurse monitor the patient's status and a patient/caregiver that is well informed of early signs of exacerbation can trigger a call to the MD for medication changes that can prevent a costly re-hospitalization. Early detection, prevention and treatment is the key with home health care.

You can use any other frequently diagnosed condition in the same scenario - diabetes, COPD, hypertension - the list is endless. Home health care is a bridge between the hospital and the home. Patients are cared for in their home where it is proven that recovery is enhanced in their "known" environment. Home health care is not just a "babysitter" service - patient's with continuous intravenous infusions and even patients requiring a ventilator to breath can be cared for in the home. Figure the cost of a hospital stay for a patient to receive IV antibiotics for 14 days in the hospital and compare it to the cost for home care for the same 14 day period. The difference is beyond mind-boggling.

Over the years, home health care has taken it on the chin from Medicare. The amount of paperwork and the number of hoops that one must jump through in order to receive reimbursement for Medicare claims is enormous. The documentation required to meet Medicare's regulatory requirements has driven many professionals from this field of care. Obamacare will simply be the proverbial nail in the coffin for home health care.

Without home health care availability, patients will be forced into longer hospital stays or transfers to nursing homes. The mortality rate will skyrocket due to the lack of followup for so many "at risk" patients. Costs will go up - not down - due to frequency of rehospitalizations. In short, it will be a disaster for patients that could have easily been cared for and lived productive lives while under home care services.

I have worked in the home health care field for 15 years - over half of my nursing career. I have witnessed the transformation of patients from the hospital to the home. I have argued non payment of Medicare claims in front of an Administrative Law Judge when someone sitting at a desk said teaching a patient to perform their own grooming was not a necessary skill for the patient to learn. I have been right in the middle of all the regulatory changes imposed by Medicare. But no matter what, I have never worked in a position that has left me with a feeling of utter fullfilment.

Please take a minute to watch the video at this website - Help Us Choose Home - then sign the petition asking Congress to vote "NO" to Medicare cuts. While the petition does not denounce the entire plan, I believe that a loud NO to Medicare cuts can work to defeat the disaster known as Obamacare in total.

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