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Cherokee Nation Home Health Services is a tribally incorporated not-for-profit home health care agency, that is Medicare and Medicaid certified to provide state-licensed home health care. The home health agency was established in 1981 by the Cherokee Nation to broaden its ability to provide services to elderly and disabled persons who were Medicare and Medicaid beneficiaries. For several years the home health conducted business within the framework of various departments inside the Cherokee Nation. It was the Balance Budget Act of 1997 which led to the reformation of the Medicare reimbursement rates paid to home health care agencies for services rendered that made it necessary for the tribe to move the home health into the free-standing entrepreneur environment while still maintaining its not-for-profit goals of compassionate high-quality patient care.
What is Home Health Care?
Home Health Care is skilled care and certain other health services that you get in your home for the treatment of an illness or injury. The following pages will help explain Medicare’s home health benefit and give you information about our company.
Who is Eligible for Home Health Care?
To get Medicare home heath care you must meet these four conditions:
- Your doctor must decide that you need medical care in your home, and make a plan for your care at home; and
- You must need at least one of the following: intermittent (not full time) skilled nursing care or physical therapy or speech language pathology services or continue to need occupational therapy; and
- You must be homebound [Homebound is defined as being unable to leave your home without considerable effort. When you leave it must be infrequent trips for a short period of time such as to receive medical attention or attend religious services]; and
- The home health agency caring for you must be approved by the Medicare program.
What Does the Original Medicare Plan Cover?
If you meet all four of the conditions in the previous section for home health care, Medicare will cover:
- Skilled Nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse).
- Home Health Aide services on a part-time or intermittent basis. A home health aide does not have a nursing license. The aide provides services that support any services that the nurse provides. These services include help with personal care such a bathing, using the toilet or dressing. These types of services do not need the skills of a licensed nurse. Medicare does not cover home health aide services unless you are also getting skilled care such as nursing care or other therapy. The home health aide services must be part of the home care for your illness or injury.
- Physical therapy, speech language pathology services and occupational therapy for as long as your doctor says you need it. Medicare covers these types of therapy:
1. Physical Therapy, which includes exercise to regain movement and strength to a body area and training on how to use special equipment or do daily activities, such as how to get in and out of a wheelchair or bathtub.
2. Speech Language Pathology Services, includes exercise to regain and strengthen speech skills.
3. Occupational Therapy, which helps you become able to do usual daily activities by yourself. You might learn new ways to eat, put on clothes, comb your hair and new ways to do other usual daily activities. You may continue to receive occupational therapy even if you no longer need other skilled care.
- Medical Social Services to help you with social and emotional concerns related to your illness. This might include counseling or help in finding resources in your community.
- Certain Medical Supplies, like wound dressing, but not prescription drugs.
- Medical Equipment, Medicare Part-B usually pays 80 percent of the approved amount for certain pieces of medical equipment, such as a wheelchair or walker.
Our home health care programs are licensed by the State of Oklahoma and our Service Region includes the following Oklahoma Counties:
Muskogee – Sequoyah – Wagoner
What is a Plan of Care?
A plan of care describes what kind of services and care you must get for your health problem. Your doctor will work with a home health care nurse to decide:
- What kind of services you need, and
- What type of health care professional should give these services, and
- How often you will need the services
Your plan may also include things like the kind of home medical equipment you need, what kind of special foods you need and what your doctor expects from your treatment.
Your doctor and home health agency staff review your plan of care as often as necessary, but at least once every 60 days. If your health problems change, agency staff must tell your doctor right away; your plan of care will be reviewed and may change. You will continue to get home health care as long as you are eligible and your doctor says you need it.
What if I Want to Change Home Health Agencies?
Medicare will only pay for you to get care from one home health agency at a time. You may choose to end your relationship with one agency and choose another at any time. You must tell both the agency you are leaving and the new agency that you choose that you are changing home health agencies.
Where Can I Get Help with My Questions?
If you have any questions about your Medicare home health care, please feel free to contact our offices at Cherokee Nation Home Health Services, and someone will be glad to answer them.