McAllen Senior AdvisorWhat is home health care?
Home health is skilled nursing, physical, occupational or speech therapy, and home health aide visits ordered by a physician for a patient who is homebound, provided by a licensed agency and, when Medicare pays, a Medicare-certified one.
HHSC's directory lists 177 home health agencies with offices in Hidalgo County, 87 of them certified so they can bill Medicare or Medicaid; an office's address does not limit where its staff travel.
Who qualifies for Medicare home health?
A Medicare beneficiary qualifies when a physician certifies they are homebound and need intermittent skilled nursing or therapy under a plan of care, and the agency is Medicare-certified; Medicare then pays in full with no copay for covered visits.
Homebound means leaving home takes considerable effort and happens rarely, such as for medical appointments or religious services.
How long does home health last?
Home health continues for as long as the patient remains homebound and needs intermittent skilled care, with the physician recertifying the plan of care every 60 days; for many patients it lasts a few weeks after a hospital stay, with visits of under an hour.
When home health ends, ask whether attendant care or an adult day center should take over.
What should we ask a home health agency?
Ask whether the agency is Medicare-certified, which disciplines it can send (nursing, physical, occupational and speech therapy, aides), how soon the first visit will happen after discharge, and how to reach a nurse after hours.
The patient may choose any certified agency that serves their address; a hospital referral is a suggestion, not a requirement. Ask the agency how it coordinates with the doctor and with any attendant or adult day center already involved.
Where are licensed home health providers in Hidalgo County?
HHSC's records show 177 licensed home health providers in Hidalgo County, 68 in McAllen, 33 in Edinburg, 20 in Mission, 19 in Pharr, 17 in Weslaco, 7 in Palmview.
| City | Licensed providers | Licensed capacity |
|---|---|---|
| McAllen | 68 | — |
| Edinburg | 33 | — |
| Mission | 20 | — |
| Pharr | 19 | — |
| Weslaco | 17 | — |
| Palmview | 7 | — |
| San Juan | 3 | — |
| Donna | 3 | — |
| La Joya | 2 | — |
| Mercedes | 1 | — |
Every one is on the roster.
Side by side
| Home health provides | Home health does not provide | |
|---|---|---|
| Care | Skilled nursing and therapy visits | Hours of personal care |
| Order | Care under a physician's plan | Care on request without an order |
| Payment | Medicare in full for covered visits | Long-term daily help |
Sources: Texas Health and Safety Code ch. 247 and 242; 26 TAC chapters 553, 554, 558 and 559; HHSC directories, TULIP and handbooks; CMS; CareScout; VA rate tables, as cited above. See our editorial standards.
