What To Do If Your Home Health Care Agency Ditches You

Craig Holly was determined to fight when the home health agency caring for his wife decided to cut off services Jan. 18.

But even that little bit helped. Holly, 71, has a bad back and is responsible for his wife’s needs 24/7. Her urologist didn’t have a lift system in his office and had told the couple it was safer to have Effie’s catheter changed regularly at home. The reason he was given by an agency nurse? His wife was disabled but stable, and Medicare was changing its payment system for home health.

Holly wasn’t sure what to do. Call his congressman and lodge a complaint? Write a letter to the director of the home health agency owned and operated by Hartford HealthCare Corp., one of the largest health care systems in Connecticut? Under PDGM, agencies are paid higher rates for patients who need complex nursing care and less for people with long-term chronic conditions who need physical, occupational or speech therapy.

But therapists, home health agencies and association leaders say that patients across the country are being told they no longer qualify for certain services or that services have to be cut back or discontinued.Get as much information as possible. “Your physician should be aware if you feel you’re not getting the services you need,” said Kara Gainer, director of regulatory affairs for the American Physical Therapy Association.

Also, contact the organization in your state that oversees home health agencies and let them know you believe your agency isn’t following Medicare’s rules, said Sharmila Sandhu, vice president of regulatory affairs for the American Occupational Therapy Association. This should be among the numbers listed on the bills of rights sheet.Unlike nursing homes, home health agencies don’t have designated long-term ombudsmen who represent patients’ interests.

Some agencies may not understand the changes that Medicare is implementing; confusion is widespread. Advocates such as the Center for Medicare Advocacy or the Medicare Rights Center can help you understand what’s going on and potentially intervene on your behalf. A Hartford HealthCare spokesman said he couldn’t comment on the situation, citing privacy laws. “Our goal is to continue to provide the right care at the right place at the right time with the orders reflecting the specific treatment goals and medical needs of each patient,” he wrote in an email.

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