Areas of Support
As a not-for-profit Agency, we rely on community support to help fill this gap. We rely on you, as much as you rely on us.
Health care does not end with a hospital stay. Once home, we help you recover from surgery, we help you manage a chronic disease or we assist with the physical and emotional needs of a terminally-ill loved one. We bring comprehensive, quality and compassionate care to your home. We have developed various services to treat the patient and not just the disease including: Alzheimer & Dementia program, complimentary therapies, bereavement program, wellness clinics, nutritional consulting, tele-monitor, private pay care, psychiatric nursing care, IV therapy, physical therapy, occupational therapy and chronic disease programs.
These are not luxury services. These are essential services. But insurance doesn’t always recognize all of the costs of a patient’s care. There is currently an $800,000 difference between the cost of the care we provide and what is reimbursed by insurance. And that “un-reimbursed gap” will only continue to grow as payment reform is fully realized.
One such non-reimbursed yet vital service provided to our home care patients is the tele-monitor program. Home tele-monitoring is a tool that provides benefits to patients receiving home health care that include daily assessment of the patient’s medical status and physician access to their patient’s health record via the Internet.
Early identification of disease symptoms allows the clinician to consult the patient’s physician and initiate intervention promptly. In addition, home monitoring enables and supports patient participation in managing their health. Some of the most common conditions that would be appropriate for tele-monitoring are: patients with congestive heart failure (CHF) and other cardiac issues; clients receiving inotropic medications, post myocardial revascularization, and post-surgical patients; clients with a chronic disease where frequent monitoring of vital signs and early detection of symptoms could prevent emergent care and/or hospitalization; clients with uncontrolled or poorly controlled hypertension.
We currently have 30 monitors and a staff of three who administer this program. Like many others, this program is provided at no cost to the patient or family and it not reimbursed by insurance. The cost of $100,000 incurred by the agency is an important investment towards the goal of our Empowering the Patient in the Community (EPC) approach. In fact, there are currently short-term plan to secure incremental community funding to acquire an additional 15 monitors, develop a physician education series and bring on incremental staff to meet the growing demand for this program and to meet the added needs of diabetes patients.
Medicare is the primary payer of home care and hospice service. Medicare Hospice services are paid at a daily rate regardless of the amount of care a patient requires. The majority of our patients require more care than is covered by this daily rate.
The Medicare reimbursement rate for Hospice ranges between $156-161 per day regardless or whether, in that one day, the patient simply receives one visit by the chaplain or four clinical visits by a nurse, a visit form the social worker and two visits by home health aides. While the reimbursement by insurance covers the cost for one health care professional’s visit to the home or nursing home, our services do not typically end there. As you can imagine, many patients require significantly more care than is covered by this reimbursement, especially in the final stages of terminal illness.
Most people do not realize that once a patient and family sign onto the hospice plan of care, our agency assumes all costs associated with the terminal illness. And as always, our primary goal is to care for the patients true needs regardless of the cost. For example, these costs can include everything from an oxygen tank rental, special mattresses, hospital bed rental, briefs, bed pads, specialized creams for skin care needs and all medications related to the illness. In addition, there is no charge for the ongoing bereavement support services and the support offered to community residents who were not cared for by our Hospice program. All of this support is offered at the agency’s expense.
Due to payment reform and continued cuts to the amount insurance reimburses, the true cost of home care, especially hospice care, is not accurately reflected in what insurances reimburse. And that “un-reimbursed gap” will only continue to grow as payment reform is fully realized. Despite these challenges, our agency remains committed to our hospice program. As a not-for-profit organization, community support has become more important than ever before. Our agency appeals to individuals and foundations for support and conducts fundraising events in the community to support our program. Our Hospice program continues to operate at a $77,000 plus loss. And without community support, our hospice budget would suffer an additional $145,000 loss.
Without continued funding from community funding, our agency would have to limit the amount and quality of care, limit our recruitment and training of hospice volunteers and limit the amount of bereavement support we currently offer to families.
Community Nurse Home Care is a not-for-profit charitable organization
and your contribution is tax deductible to the full extent permitted by law.