Home Health Care Glossary

When you are considering home health care services, it can be helpful to know the lingo. Here is a glossary of commonly used terms in home health care.

Activities of daily living (ADLs): basic tasks for self-care, such as bathing, dressing, eating, grooming, toileting, and moving (see also instrumental activities of daily living).

Assistive (personal or custodial) care: non-­‐medical assistance with activities of daily living (ADLs); one of two basic types of home care services (see also skilled care).

Care plan: a written description of the services required by the client that is developed by the case manager after performing a needs assessment; includes goals, services to be provided, and the quantity, frequency and duration of these services.

Case manager: an employee of a home health care agency, usually a registered nurse (RN), who is responsible for planning and coordinating the client’s care and supervising the staff members who provide that care.

Certified nursing assistant (CNA): a person who assists with the delivery of nursing care in many different health care settings (including the home) by performing basic nursing tasks under the supervision of a registered nurse (RN) or a licensed practical/vocational nurse (LPN/LVN); CNAs must complete a state-­‐approved training course and pass the state’s certification examination.

Durable medical equipment: Medical equipment (such as a hospital bed or power wheelchair) that is ordered by a doctor for use in the home and that will be used for an extended period of time; Medicare covers a portion of the cost.

Employment (registry) agency: an agency that provides the names of nurses and nurse assistants who are available to provide home care; the client contracts with, and pays, the care provider directly.

Homebound: the quality of being unable to leave the home without considerable effort and assistance; a doctor must certify that a client is homebound in order for the client to receive home health care benefits under Medicare.

Home health aide (HHA): a person who provides assistance with basic nursing tasks under the supervision of a registered nurse (RN) or licensed practical/vocational nurse (LPN/LVN); may also perform some housekeeping tasks (such as grocery shopping and meal preparation, light cleaning, and laundry); HHAs working in Medicare-­‐certified home health agencies must complete a state-­‐approved formal training course and pass the state’s certification examination.

Home health agency: an organization that coordinates and delivers skilled and assistive (personal) care services to clients in their homes.

Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) survey: also known as the patient experience of care survey, a national survey that asks consumers about their experiences with Medicare-­‐certified home health agencies; survey results are publically reported on Medicare.gov.

Hospice: a model of care that focuses on providing comfort care to people who are dying, and on supporting their families, during the end-of-life period.

Instrumental activities of daily living (IADLs): more complex tasks that a person must perform routinely in order to live independently, such as paying bills, using the telephone, taking medication, and doing laundry (see also activities of daily living).

Intermittent care: skilled nursing care that is needed or given on fewer than 7 days each week or less than 8 hours each day over a period of 21 days or less; one of the eligibility requirements to receive home health care benefits under Medicare.

Licensed home health agency: a home health agency that is licensed by the state to provide skilled and assistive (personal) care services.

Medicaid: a federally funded and state-­‐regulated insurance plan designed to help people with low incomes pay for health care, as well as those with higher incomes whose medical costs exceed a certain percentage of their income.

Medically necessary: health care services or supplies needed to diagnose or treat a health condition that meet accepted standards of medicine; one of the criteria that must be met in order for the service or supply to be covered by Medicare or Medicaid.

Medicare: an insurance plan that is federally funded by Social Security; all people 65 years and older are eligible to participate, as well as younger people with certain disabilities and those with ALS or end-­‐stage renal disease.

Medicare-­‐certified home health agency: a home health agency that is certified by Medicare and licensed by the state to provide skilled care services; an agency must be Medicare-­‐certified in order to receive payments under Medicare or Medicaid.

Medicare-­‐covered home health services: home health services covered under Medicare Parts A and B, including intermittent skilled nursing care, physical therapy, occupational therapy, speech therapy, home health aide services (when necessary to support skilled care), medical social services, durable medical equipment (e.g., wheelchairs, hospital beds, oxygen, and walkers), and medical supplies necessary for care.

Needs assessment: a formal evaluation of the client’s needs, abilities, and disabilities that is usually done by the case manager and that forms the basis for the client’s care plan.

Non-­‐medical home care (companion) agency: an agency that provides non-­‐medical services (such as assistance with light housekeeping tasks or running errands); these agencies may or may not be licensed and their services are not covered by insurance.

Occupational therapy: a health care specialty that focuses on helping people to regain or maintain their independence in performing everyday tasks; occupational therapists may recommend assistive devices and teach the person how to use them, recommend modifications to the home environment to make tasks easier, and teach new methods of accomplishing familiar tasks.

Physical therapy: a health care specialty that focuses on helping people to reduce pain and regain or maintain mobility.

Respiratory therapy: a health care specialty that focuses on helping people to regain or maintain lung function through the use of exercises and treatments.

Respite care: care designed to give the regular family caregiver a break from his or her caregiving responsibilities; may be regularly scheduled or intermittent.

Skilled care: care provided by a health care professional (such as a nurse, physical therapist, occupational therapist, respiratory therapist, or speech therapist); one of two basic types of home care services (see also assistive care).

Speech-­‐language pathology: a health care specialty that focuses on helping people to regain or maintain the ability to communicate, chew, and swallow.

State survey agency: the agency that inspects and certifies home health agencies for the Medicare and Medicaid programs.

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