Providing home care to assisted-living patients

Services are reimbursed like a home visit

Assisted-living centers may be a new source of patients for your hospital's home health agency, suggests David Mungenast, principal of CHI Consulting, a health care consulting firm in Ann Arbor, MI, and president and chief executive officer of Southwest Rehabilitation Hospital in Battle Creek, MI.

In some areas, particularly in advanced managed care markets where inpatient lengths of stay have been pared to the bone, patients are being discharged to assisted-living centers on a short-term basis, with a long-term goal of going home, he says. Patients temporarily discharged to assisted-living centers are too dependent to live at home but too independent for a nursing home.

"As managed care penetrates an area, we find that utilization of assisted-living facilities increases dramatically. Payers want to get people into less expensive and less restrictive settings," he says.

At the assisted-living centers, patients receive three meals a day and help with housekeeping and other activities of daily living while they recover. Many also need home health services, he says.

Since managers at assisted-living centers are unlikely to be interested in contracting for health care services for their residents, home health agencies can work out an arrangement to provide the services on an individual basis, Mungenast adds. "An assisted-living facility is a person's residence from a reimbursement perspective. If you provide the services, it's billed just like a home visit. That kind of arrangement is quite positive for providers."

Private managed care companies and Medi-care will pay for home health visits in an assisted- living center, he adds.