My name is Pat Conway. I'm a retired RN who used to work in home health care back in the day when a typical Medicare-reimbursed home health aide visit lasted up to 4 hours. Now I am taking care of my mother who has dementia, a supra-pubic catheter and is in a wheel chair most of the time. Her doctor has ordered daily 4-hr. Home Health Aide visits for her, but I can't find a single Medicare-certified home health agency in St. Paul, Minnesota that has sufficient staff to meet the MD's order.

According to Medicare Advocacy (www.medicareadvocacy.org),home health agencies avoid taking on long term, difficult patients by keeping their Medicare-reimbursed home health aide staff to a minimum. They form two separate divisions: the private-pay division, which has plenty of staff for all your private-pay needs, and the Medicare division which usually has sufficient RN, PTs and OT's but very few home health aides.  This "insufficient staff" ploy, however, is in violation of the Medicare Conditions of Participation for Medicare-certified home health agencies, which require all participating home health agencies to maintain a sufficient home health aide staff level to provide the home care services as ordered by the MD.  Doctors, family members and home care workers need to be educated in the Medicare Home Health Services benefit which pays for up to 28 hrs. of home health aide services per week.  Most Medicare recipients receive 3 to 6 hours of home health aide services per week today.  The problem is not with Medicare.  The problem is with the home health agency that is Medicare-certified but does not deliver on the full Medicare home health aide services mandated in the Medicare Statutes for all eligible Medicare beneficiaries.

After several attempts to report this noncompliance problem to the Chicago office of the Centers for Medicare and Medicaid Services, I learned that there is very little oversight of Medicare-certified home health agencies across the country.  It appears it is common practice to keep Medicare beneficiaries and the frontline home healthcare workers uninformed and unempowered. As members of Healthcare United, we need to do all we can to assure that the full range of Medicare home health benefits are explained and delivered to all the eligible Medicare beneficiaries in our care.

Won't you join me?

Thank you!

- Pat