Home Health Care And Assisted Living: Fill & Download for Free

Scheduling a personal home aide?Eligibity and services by state and client age and are determined by the Case Worker using a Determination of Functional Needs[1] .SOURCE: Disability Evaluations: More Than Completing a FormScheduling is fixed but flexibility for changes depend on the agency and individual caregivers.The states’ Human Resources Social Services will generally assign you a Case Worker.The case worker will assign you an agency from their agency in rotation if you are over 60.If you are under 60, you can hire a home aide (personal assistant) including a relatives and the state normally pays for the background check.The Case Worker will determine the amounts of hours and the client or agency will negotiate schedule.If you are over 60, your case comes under the Dept of Aging[2] and may includedMeals on WheelsLife Alert MonitoringHealth Aide wages apply to Medicaid spend-downAdult Day CareVisiting NurseCompainshipResources to support older adults and their caregivers can vary from state to state. See what is available to you.Eldercare LocatorUsing your ZIP code or city and state, find resources in your community, like Area Agencies on Aging, that provide information and assistance for older adults and caregivers.State Health Insurance Assistance Programs (SHIPs)Find links to state-specific SHIP websites with information about local, personalized counseling and assistance to people with Medicare and their families.Resources by State:Alabama Department of Senior ServicesAlaska Commission on AgingArizona Division of Aging and Adult ServicesArkansas Division of Aging and Adult ServicesCalifornia Department of AgingColorado Aging and Adult ServicesConnecticut Department on AgingDistrict of Columbia Office on AgingDelaware Division of Services for Aging and AdultsFlorida Department of Elder AffairsGeorgia Community Care Services ProgramHawaii Aging and Disability ProgramsIdaho Commission on AgingIllinois Division of AgingIndiana Division of AgingIowa Department on AgingKansas Department for Aging and Disability ServicesKentucky Department of Aging and Independent LivingLouisiana Aging and Adult ServicesMaine Office of Elderly ServicesMaryland Department of AgingMassachusetts Executive Office of Elder AffairsMichigan Aging and Adult ServicesMinnesota Office of Aging and Adult ServicesMississippi Aging and Adult ServicesMissouri Department of Health and Senior ServicesMontana Senior and Long-Term Care DivisionNebraska Seniors and AgingNevada Aging and Disability Services HomeNew Hampshire State Committee on AgingNew Jersey Division of Aging Services HomeNew Mexico Aging and Long-Term ServicesNew York Office for the AgingNorth Carolina Division of Aging and Adult ServicesNorth Dakota Department of Human ServicesOhio Department of AgingOklahoma Aging Services DivisionOregon Aging and People with DisabilitiesPennsylvania Department of AgingRhode Island Division of Elderly AffairsSouth Carolina Office on AgingSouth Dakota Department of Social ServicesTennessee Commission on Aging and DisabilityTexas Department of Aging and Disability ServicesUtah Aging and Adult ServicesVermont Department of Disabilities, Aging, and Independent LivingVirginia Department for the AgingWashington Aging and Long-Term Support AdministrationWest Virginia Bureau of Senior ServicesWisconsin Aging and Disability Resource CentersWyoming Department of Health Aging DivisionPrintShareContent created by Digital Communications Division (DCD)Content last reviewed on May 1, 20185 Qualities That Make An Excellent In Home CaregiverSenior services, home care and help from Michigan nonprofitSOURCE: 3 Ways Disabled People Can Benefit From an In-Home Caregiver -SOURCE: Make Caregiving Easier with a Caregiver Notebook Template - DailyCaringprintable caregiver daily scheduleApps and Tools to Help Caregivers Stay OrganizedSOURCE: [INFO] 5 Quick Scheduling Tips For Caregivers In LTC & Senior LivingFootnotes[1] https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.nasuad.org/sites/nasuad/files/hcbs/files/182/9053/DONR_Training_Manual.doc&ved=2ahUKEwiP_s_YlbrfAhWirIMKHZ7wCMgQFjAAegQIBRAB&usg=AOvVaw1GQShwktkS9_yiLVNxPTc8[2] Resources Near You

I agree with Deborah and think she nailed the fundamental drivers most people can control. Below is a time-based answer with a few more details.Short-term savings (<12 months) -1. Shop around for healthcare products and services. Most people reading this have healthcare insurance, whether through the private market or through an Affordable Care Act-created health exchange. Even so, you may get a better “deal” if you shop around and consider going outside of your insurance-directed options. Need an MRI that will cost you $800 in-network? Google it and call some of the providers you find online. Much like shopping for cars, there is often an “internet price” that customers can only access by coming to the provider through an online sales channel. Same goes for blood work, X-rays, etc. These are often the same providers your insurance company would send you to anyway; you’ve just avoided the significant overhead associated with healthcare distribution (more on this below). A small, often rabid, population of health shoppers is changing the distribution model of these more routinized services. Consider joining the revolution the next time you need a routine healthcare service.2. Shop around for prescription drugs. Same as #1, proactive consumers can save on the price of prescription drugs. Keep in mind once the drug leaves the factory floor it is the same drug no matter where you purchase it. Buy in bulk (example - 90 day supply), online, through a large big-box retailer (like Costco), even shop your grocery store pharmacy (who often have better deals than stand alone, nationally branded pharmacies). Nowadays you have options and some will be cheaper than others.3. Save money in pre-tax healthcare savings accounts like FSAs and HSAs. Because of the way these accounts work, if you use your FSA or HSA to pay for health out of pocket expenses it is like you are receiving a 30-40% discount. It may not feel like much on a $30 monthly prescription, but it adds up. If you tear a knee ligament in a pickup game of basketball you could save thousands. Keep in mind with FSAs you generally only have an opportunity to change your contribution rate once a year. With HSAs you can often change your funding level much more frequently to reimburse yourself for mishaps requiring medical attention.4. Diet, exercise, and minimizing risk. In the end, most of us can be simplified into a collection of behaviors. Try to shape yours by recognizing what the health and nutrition communities have been saying for decades, with some new ones recently added. Again, Deborah is right. I have expanded here:a. Diet. While the well-known “secret” to health is “diet and exercise,” what seems to be increasingly clear is the majority of the health gain is through diet. Think 90% diet and 10% exercise (not statistically supported, by the way). Competitive body builders eat a lot of peanut butter and egg whites because it almost effortlessly tones their physique in a way lifting more weights by itself cannot. You don’t need to go to such extremes, of course, and it is certainly controversial, but it is a trick that community has used for decades. More recently another community is starting to flourish (pun intended) around your gut bacteria. Whether it is fed with yogurt or other “probiotic” food sources, what seems to be increasingly clear is those little critters (bacteria) are more important to our overall health than ever previously believed. Related, wheat and sugar have also been identified as potential culprits in reduced health and wellness for some. And even if you ignore all of the above, more fruits and vegetables, particularly leafy greens that have all the nutrients and few simple carbs, are probably a best practice for everyone. As a final thought on diet, perhaps the most important decision is to experiment to find out what works for you. Give it 30 days. This number satisfies at least two criteria, the first being it takes 30 days to create a habit, the second is that amount of time allows your body to pass through an initial adjustment phase. From personal experience you’ll probably feel better sooner, but commit to that length of time to give any changes a chance to stick.b. Exercise. Strength training and cardiovascular workouts are the building blocks that support bone density and heart health. You cannot ignore Father Time, but you can (and should) cheat a little. Find exercise activities that develop into habits you can do over long periods. A few dumbbells, a flat bench and perhaps a rowing machine - I have a Waterrower I swear by - are all one really needs. [If possible, bring exercise equipment into your home so you can save on time and cost, as well as avoid the mental barrier of driving to a gym.] There are hundreds of exercises to do, find some you enjoy then set goals to give your mind something to look forward to. Related to exercise, stand up more. Consider purchasing a standup desk. You’ll feel more alert and are much more likely to move around. Sitting is increasingly associated with reduced health outcomes. In short, as with diet, your objective is to create habits, routines.c. Sleep. In most instances, the body damage incurred through daily living - cuts, bruises, scrapes, random aches and pains - will heal itself over time. Most of this healing occurs at night while you are sleeping. Think of quality sleep as you would a discount on your health expenses, as it very well may be. Allow your body to get the most from this recovery period. Light dinners, taper your alcohol consumption, hydration, reading right before falling asleep, etc., are all recommended strategies for maximizing the utility of this “down” time while another part of your body is laboring away. And, particularly if you are a morning person, you will begin to notice the impact of your nightly shutdown routine. You’ll feel better, more alert. It’s like an investment that pays you back the very next day. Given the cost to implement - usually less expensive than the alternatives – a nearly infinite ROI.d. Other risk factors. Beyond the daily stuff you can begin to incorporate into your lifestyle (i.e. smoking cessation), many people get jammed with one-off accidents the body was unprepared for. Pick-up sports, impact activities, weekend athletics, and some things that may qualify as “stupid human tricks” have outsized health risk. That 60 minutes of a weekend pick up game may be the most dangerous activity you engage in all week. Recognize while you may still have the “muscle memory” to dive for the ball, for instance, your muscles, joints, bones, and ligaments may no longer be up to the task. This gets harder as you age. Peak bone mass is early 30’s; brain function starts to deteriorate a little later. It is what it is (sigh).Medium-term savings (1-7 years) -1. Routinize short-term strategies. Get the basics down the first year. Make them a part of who you are. These become the building blocks that not only clear out the underbrush of what is a “healthy you,” but will give you the cycles to think about what is next. Just like a hungry person in a grocery store who has no chance of walking out with a basket full of vegetables and fresh, cold water fish, if you are distracted by immediate hunger demands, optimal health - and therefore lower possible healthcare costs - take a back seat. Play a different game.2. Dig deeper into family health issues. Track down through family members all the various health conditions your family has developed. Some of what you find may scare you, if you didn’t already know. However, recognize that while there are nearly 7,000 rare conditions, many have environmental and lifestyle factors that we have yet to put our collective scientific finger on. Start your list to keep you aware of what is in your family tree. It may also provide a little more inspiration to your (now) daily health regimen.3. Track health documents and expenses. Start a file for your health documents and expenses so you can watch for changes. Go digital when you can; big data will ultimately do much of the health sifting for you. Further, while you may have heard of electronic medical records (EMRs), the government-subsidized versions are intended to solve the problems of healthcare providers, not consumers. Do not wait for a user-friendly, lifetime portable solution to be handed to you. On the money side, “shoe-boxing” healthcare expense receipts is a great way to maximize the future value of your pre-tax savings dollars. Remember, you can always reimburse yourself for old (6 month, 6 years, etc.) expenses, so allow the tax-deferred magic of HSAs to work.4. Select health insurance plans that minimize the monthly overhead charged by health insurance companies. The fact is it is expensive to maintain a set of health provider relationships, user accounts and comply with regulatory requirements, among other costs indirectly paid for by the healthcare consumer (you). It is no wonder even healthcare professionals complain about how expensive healthcare has become. As a consumer there isn’t much you can do about these back office overhead costs that contribute to higher health insurance premiums. However, if you track your health documents and expenses over time your own “usage patterns” will emerge. Use your interaction with the health system as a template to determine what you need and don’t need, then find a healthcare insurance plan suited to your lifestyle. In the background are things like actuarial values, medical loss ratios (MLR) and pooled subsidization that you cannot control and will continue to evolve. It’s not so much the game is being played against you; it’s just not being played for you. Choose your own game.5. Watch health trends and innovation. Telehealth (Teladoc, FirstDerm), genetic testing (23andMe), retail clinics (CVSMinuteClinic) and others will increasingly allow for more and cheaper access to not only health services, but more detailed information about who you are. Just like the latest software release, expect there to be some “bugs” with each new feature and business model. Still, look for continued innovation in healthcare and remain open to ways it can help you. Sometimes it will be cost, other times greater access, a trend concierge medicine is currently riding. Expect change and, as in other aspects of life, do not rely solely on one source of information to keep you aware of changes you may benefit from.Long-term savings (>7 years) -1. Save for long-term costs. Within the next few years most people will have an opportunity to participate in HDHPs and save through HSAs. Particularly for younger workers who have the advantage of time - compounding growth in mutual funds, specifically – maximizing your HSA contributions for a decade or two and allowing that balance to grow can be an excellent hedge against future medical inflation. No one knows what healthcare costs will look like in the future, but we can look at where they are today and underlying trends. Keep in mind healthcare expenses are generally considered to be the third largest out of pocket expense for retirees (not everyone, not every year). Today’s tax regime makes HSAs the most tax efficient way to save for that portion of your retirement cost. Even if you don’t save in pre-tax accounts, consider that by the time you really need comprehensive (often expensive) healthcare in your older years, you will really want the means to access it. If other western single payer systems are any guide, should the US one day go that route, private options will remain available for those who can afford it. You will pay for the convenience, similar to in other consumable goods.2. Plan for long-term care. In the century before last we lived in communities of families where old age was a responsibility shouldered by the generation or two underneath them. You lived with family until you died. This is no longer the case for most, and while public assistance is available, for most the government requires you to deplete your savings before they pick up the increasingly expensive tab. Have a plan for what happens to you should you need long term care assistance. Many find peace of mind in long-term care policies, generally cheaper if you purchase them well in advance of needing them (say, in your 50’s). Talk with a financial planner who can walk through the scenarios.3. End of Life Medical Costs. An uncomfortable topic for sure, end of life discussions may be some of the most important for you and, importantly, your family. As a primer, read Atul Gawande’s, “Being Mortal” for an emotional, sobering pitch for better, more personal medical decision making in our final years. Gawande asks we consider quality of life alongside technical solutions offered by specialists whose job it is to “fix.” These life-sustaining, often automatic system responses are not only exceedingly expensive, but also often disconnected from most quality of life goals. Explore options in advanced medical directives (AMDs) and living wills. These can help avoid unnecessary stress and uncertainty with complicated and often unpredictable medical situations.4. Pass it on. By this point hopefully you’ve learned a thing or two about what works in health, as in life. Do your family the favor of sharing bits and pieces along the way. As every parent and grandparent knows, theory is easier than practice. Yet even information transfer is a skill that can be learned, and practiced. Take your process another step forward and give it scale by sharing.Of course, and as a disclaimer, none of these recommendations will guarantee a meaningful reduction in your healthcare costs, much less perfect health. But if you are reading this you have already won one of life’s first lotteries, namely access to an education. The suggestions above may enable you to press that advantage. And you may find, much as Csikszentmihalyi presents in the behavior theory classic, Flow, working towards goals is the source of most of life’s real happiness anyway.Good luck and good health.

Yes, no, maybe, and sorta. The CPT (Current Procedural Terminology) "codeset" is a list of procedures, treatments, diagnoses, etc., established and maintained by the American Medical Association. An appendectomy, for example, is code 44950. However, if the procedure is performed in connection with a laparoscopy it is code 44970. Obviously, this gets complicated. Together with the DSM (Diagnostic and Statistical Manual of Mental Disorders), IDC (International Classification of Diseases) and the "Formulary" (list of approved drugs) and a few others, all these things become the shorthand which express in a simple code what would (and what does) take a sentence or a paragraph to explain otherwise.I don't know, and I am too damned lazy to look it up, if Obamacare hands down to the insurance companies a list of codes they MUST honor. But you will note that the code itself is not random; those numbers MEAN something. Here is a list of CPT codes referring to "Evaluation and Management" which, as you will note, are all in the 99xxx range.(99201–99216) Office/other outpatient services(99217–99220) Hospital observation services(99221–99239) Hospital inpatient services(99241–99255) Consultations(99281–99288) Emergency department services(99291–99292) Critical care services(99304–99318) Nursing facility services(99324–99337) Domiciliary, rest home (boarding home) or custodial care services(99339–99340) Domiciliary, rest home (assisted living facility), or home care plan oversight services(99341–99350) Home health services(99354–99360) Prolonged services(99363–99368) Case management services(99374–99380) Care plan oversight services(99381–99429) Preventive medicine services(99441–99444) Non-face-to-face physician services(99450–99456) Special evaluation and management services(99460–99465) Newborn care services(99466–99480) Inpatient neonatal intensive, and pediatric/neonatal critical, care services(99487–99489) Complex chronic care coordination services(99495–99496) Transitional care management services(99499) Other evaluation and management servicesEach of the above codes, such as 99466-99480, has codes within it, so the above list is strictly the top level of the taxonomy. Trust me, unless it is in your blood to be a "coder" or health information management specialist, you don't want to knowAs a practical matter, insurance companies are more likely to report what they don't cover, as opposed to what they do. That is, we cover everything EXCEPT - and then follows a list of codes. Of course, your policy won't disclose any of this, because you are presumed to be too stupid to understand it.Now, here's a dirty little secret in the "reimbursement business." Skilled coders will look for and assign codes which get the highest payment and which can be defended as appropriate. But wait! There's more. Doctor's notes found in the patient record were once dictated by the doctor; she sat down and dictated the diagnosis, treatment, surgery, or whatever. Sample entry:Patient is a 46 y/o obese caucasian female delivered to ER at apprx. 2315 hrs Tue 7/3 pursuant to highway accident. Pt. complained of severe abd. pain. Exam disclosed distended lower anterior abdomen and continuous flatulence presenting as dense green amorphous clouds which obscured a clear view of point of emission. Admitted to surgery at 2345 hrs., Dr. Gagme assisting. Bilateral incision disclosed presence of a 45" 12 ply truck tire which was removed and sent to Pep Boys for exam. Sutured incision and ordered 10% sol of antibiotics IV. Recovery normal and prompt. Released at apprx. 0145 Wed. with instruction to avoid tires in diet.OK, I made that up. But not very much! Point being that what was once dictated by the Dr. is now assembled from a menu of options, the answers to which are inserted into a template. Badda-bing! Instant notes! So, the coding schema and the notes are all pretty much automated once a few data points are entered into the system. The submitted payment code is supported by a seemingly authentic set of notes.The funny part? EVERYONE - the insurance company, the providers, the coders and the dictation service ALL know that this is how it works.And so, the question of insurance company obligation to provide codes must be considered in the context of the way things actually work.It is not a pretty picture, is it?