About Home Health Care
What is home health care?
Home health care is a Medicare-covered benefit that provides skilled medical services in your home when leaving for appointments is difficult due to illness, injury, or a recent hospitalization.
What is the difference between home health care and personal care?
Home health care involves skilled medical services: nursing, therapy, and social work, ordered by a physician and covered under Medicare when eligibility criteria are met. Personal care involves non-medical support and is not covered by Medicare.
What is the difference between home health care and hospice care?
Home health care is focused on recovery, rehabilitation, and management of acute or chronic illness at home. Hospice care is a separate Medicare benefit focused on comfort and quality of life for patients with a life-limiting illness who are no longer pursuing curative treatment..
Where is home health care provided?
Home health care is delivered wherever your loved one lives – including private residences, assisted living facilities, and skilled nursing facilities. The defining characteristic is that care comes to the patient rather than the patient traveling to a clinic or facility.
Eligibility and Getting Started
Who qualifies for home health care?
According to Medicare, a patient qualifies for home health services if you are “homebound” which means:
- Leaving home requires the help of another person or a mobility aid.
- Their physician has advised against leaving home due to their current condition
- Leaving home is possible but requires a significant physical effort that makes outings infrequent
Does my loved one need a recent hospitalization to qualify?
Not necessarily. A physician can order home health services at any point when the eligibility criteria are met.
How do we get started?
Home health care begins with a physician’s order. You are also welcome to call us at (855) 415-5744 to ask questions before a referral is placed.
How quickly can care begin after a referral?
We work to begin services as quickly as possible following a referral – often within 24 to 48 hours of a hospital or facility discharge.
Can we choose our home health provider?
Yes.
Services and Care Team
What services does home health care include?
James River Home Health & Hospice provides the full range of Medicare-covered home health services, including skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social work, and home health aide services.
Will my loved one see the same clinicians at every visit?
We work to maintain staffing consistency wherever possible. Your Case Manager remains consistent throughout the course of care.
How many people will be coming into our home?
That depends entirely on your loved one’s plan of care and the combination of services their physician has ordered.
How often will someone visit?
Visit frequency is determined by your loved one’s plan of care and physician orders.
Do you offer specialty programs for specific conditions?
Yes. In addition to core skilled services, James River Home Health & Hospice offers condition-specific specialty programs.
Coverage and Cost
Does Medicare cover home health care?
Yes. Home health care is a covered Medicare benefit when the eligibility criteria are met.
Does Medicaid cover home health care?
Medicaid coverage for home health services varies by state and individual eligibility. In Virginia, Medicaid does cover home health services for eligible beneficiaries.
What if my loved one has private insurance?
Many private insurance plans cover home health services, though benefit structures vary by plan.
Are there any costs we should be aware of?
For Medicare-eligible patients who meet all coverage criteria, home health services are typically provided at no out-of-pocket cost. Our team will always verify coverage before services begin and communicate clearly if any coverage questions arise.
What to Expect During Care?
What happens at the first home health visit?
Your first home health visit is a comprehensive assessment conducted by a Registered Nurse. Your clinician will review your loved one’s medical information. Other disciplines: therapy, social work, aide services, are scheduled based on the plan of care.
How does the care team communicate with our physician?
Your Case Manager serves as the primary liaison between the home health care team and the ordering physician. Your physician is never out of the loop on meaningful changes to your loved one’s status.
What if my loved one’s condition changes between visits?
Call our on-call clinical line at (855) 415-5744. For neurological emergencies or any situation that feels immediately life-threatening — call 911 first.
Can my loved one receive more than one service at the same time?
Yes.
What if the care plan needs to change?
If your care team identifies a clinical need that was not addressed in the initial plan, they will communicate that recommendation to your physician and request an updated order. Your care evolves as your loved one’s needs evolve.
Discharge and Transitions
How long does home health care last?
Duration varies based on your loved one’s diagnosis, functional goals, rate of progress, and physician orders.
What happens when home health care ends?
Discharge planning begins well before the final visit. Your care team will ensure your loved one and their caregivers have a clear understanding of what comes next.
What if my loved one needs more support than home health can provide?
If your loved one’s needs exceed what home health can address, your care team will help you understand the options clearly
Can home health care resume if my loved one is rehospitalized?
Yes.