This is the twenty-seventh in a series of articles intended to demystify retirement living options.

The previous article described medical services available at home, possibly creating an alternative to living in an assisted living center or skilled nursing facility. But how do you choose an agency that will provide the quality of care you or your relatives need?

Recommendations from doctors, nurses, family, and friends are a good place to start.

A second source of information is Medicare. Services to Medicare enrollees need to be provided by Medicare-certified agencies if Medicare is to pay, and Medicare collects and posts a great deal of information about each agency at the federal government’s Medicare Home Health Compare website at http://www.medicare.gov/homehealthcompare/.

A recent search for providers that offer services in Prescott yielded a list of seven agencies. The site has a “compare” feature that allows you to choose up to three organizations to compare at once.

The site lists the percentage of time that each agency met certain objectives, and how those numbers compare to Arizona and national averages.

For example, 75 percent of Granite Mountain Home Care’s patients who were having trouble breathing when they started getting care had less trouble breathing when they finished getting care. The national average is 64 percent, so one can conclude that this agency is doing a good job in this area.

Good Samaritan Society Prescott Home Health checks whether patients have had pneumonia shots 94 percent of the time; the national average is 68 percent, so clearly Good Samaritan pays much more attention to this issue than is typical.

As another example, 89 percent of Granite Mountain Home Care’s patients would recommend the agency to friends and family; the Arizona average is 72 percent, so Granite Mountain is outperforming the average by quite a large margin.

The website identifies twenty-seven measures, and an agency that does a good job on one measure may not do a good job on some others. You may want to look at all the measures, paying particular attention to ones relevant to your care or the care of your friend or relative.

For example, a measure related to care of people with diabetes may mean little for people who don’t have that condition. A measure concerned with wound healing after surgery isn’t of much interest for people who haven’t had, and don’t contemplate having, surgery.

Medicare suggests a number of questions to ask when choosing a home health agency. It makes sense to talk with two or three agencies before choosing one. Asking thoughtful questions and taking careful notes can help you get the most out of this little-understood benefit.

The brochure “Medicare and Home Health Care” found at http://www.medicare.gov/Pubs/pdf/10969.pdf offers a checklist to help you choose an agency.

A few questions it suggests are:

• Can the agency meet my special needs for language or cultural preferences?
• Does the agency have the staff to provide the services I need, or can it help me arrange for additional services I may need, such as Meals on Wheels? 
• Does the agency have staff available at night and on weekends for emergencies?

AARP offers another checklist that is at times even more comprehensive: 

http://assets.aarp.org/external_sites/caregiving/checklists/checklist_inHomeCare.html.

It is worth noting that Medicare will pay for services for any individual from only one home health agency at a time. You can switch agencies at any time, but it won’t pay two agencies if you are receiving services from two at the same time.

According to Allison Kantor, Home Health Clinical Supervisor at Good Samaritan, most people don’t realize two important facts about Medicare coverage of home health services: first, Medicare typically pays 100% of the cost, assuming that people have not assigned their Medicare benefits to an HMO.

Second, while Medicare will typically cover a maximum of only 100 days of care in a skilled nursing facility after a hospital stay, there is no time limit for coverage of home health services.

Kantor noted that sometimes people pay out-of-pocket for home health services that Medicare doesn’t cover, to reduce disruption for the patient. For example, she explained, “They may hire us to come to the house to draw blood instead of taking Grandma to the lab.”

-- Next -- 108. What Types of Nonmedical Services Can the Elderly Get at Home?