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Helpful Consumer Information



What is Home Care?

Home Care is supportive care that is provided in the patient’s home. The term is often used as an “umbrella term” to refer to any type of service that offers in-home care. It is a common misconception that home care is only for the elderly, since people of all ages may require home care. We always recommend that individuals in need of home care search for licensed, high quality agencies. The benefits of licensed home care agencies include state monitoring and regulations, which place consumer protection and welfare first. Choosing a licensed agency will help ensure that consumers receive the best quality care for themselves or their loved ones. The goal of home care is to support all needs of the individual so he or she can remain at home. These services should provide a combination of care, along with life assistance. While the focus is on patient care, home care also benefits loved ones by guaranteeing that the patient will be in good hands while receiving expert care. We urge consumers to be well-informed BEFORE they choose a home care provider. The following resources offer consumer information at no cost:

  • The NJ Board of Nursing – (973) 504-6430 – request "A Consumer's Guide to Homemaker-Home Health Aides"
  • The Home Care & Hospice Association of NJ – (732) 877-1100
  • NJ EASE - (800) 222-3737 - A Statewide Program in every county to provide help with assessing your needs and locating the right community resources for you, as well as help to qualify for state assistance and/or Medicaid.
  • 211 Community Resources – Just dial “211.” This will help you find resources in your community. Visit nj211.org for basic needs, family matters, Emergency Preparedness or help in difficult times.


››Services:

Home Care and Hospice offers a broad range of health care and supportive services to people in their place of residence. Based on the type of agency, services may include some or all of the following:
  • Professional nursing (RN and LPN)
  • Certified Home Health Aides (trained for medical and personal care)
  • Therapies: physical, occupational and speech-language
  • Medical social services and counseling
  • Homemaker and Companion Services (non-medical, no personal care)
  • Infusion therapy and specialized high-technology services
  • Laboratory and diagnostic services
  • Case management services
  • Nutritional support therapies and counseling
  • Behavioral and mental health counseling and support services
  • Preventative health and wellness programs
  • Hospice and bereavement services
  • Telehealth services

››Types of Agencies:

Licensure is a quality control which gives consumers the protection of state regulations and oversight. There are three types of agencies in New Jersey that are licensed to provide direct hands on care to consumers in their place of residence:
  • Home Health Agencies
  • Health Care Service Firms
  • Hospices
In addition to licensure, an agency may have one or more of the following:
  • Accreditation - ACHC, CAHC, CHAP, NIHCA and TJC.
  • Medicare Certification- required for care to be reimbursed by Medicare and for certain Medicaid services.
  • Medicaid Approval- required for home health aide and private duty nursing care to be reimbursed by Medicaid.

››Certified Home Health Aides:

NOTE: In the state of NJ, Certified Home Health Aides (CHHAs) are permitted to work only for licensed agencies and under the supervision of a registered nurse. They are NOT permitted to practice independently. CHHAs receive training and certification and also must go through a criminal background check process. CHHAs are re-certified every two years by the NJ Board of Nursing.



HOME HEALTH AGENCY (HHA)
Description    Regulation 
  1. Typically provides intermittent skilled visit services


  2. At a minimum must provide at least skilled nursing, home health aides, and physical therapy. Generally also provide occupational therapy, speech-language pathology, medical social work and nutrition counseling.


  3. Approved for most payers, including Medicare and Medicaid. Note that certain insurance companies may restrict use to agencies they contract with.
 
State: Licensed as a home health agency by New Jersey
Department of Health
N.J.A.C. 8:42
N.J.A.C. 8:42E
www.state.nj.us/health/healthfacilities/rules.shtml

Federal: Medicare Certified by Centers for Medicare and Medicaid Services (CMS) 42 CFR Part 484

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/index.html

Accreditation: Not required by state or federal regulations. May be required for managed care contracts. Voluntary decision- agency may elect to be accredited by one of the following:
- Accreditation Commission for Health Care (ACHC)
- Community Health Accreditation Partner (CHAP)
- The Joint Commission (TJC)



HEALTH CARE SERVICE FIRM (HCSF)
Description    Regulation 
  1. Typically provides hourly services. Generally provide home health aide and nursing services. May also provide therapy, housekeeping, companion and/or other services.


  2. No mandatory services required by regulation


  3. May be approved for Medicaid, managed care or other community programs. Cannot provide Medicare services nor skilled Medicaid home health services as defined in N.J.A.C 10:60
  State: Licensed as a health care service firm by New Jersey Department of Law & Public Safety, Division of Consumer Affairs N.J.A.C. 13:45B (subchapters 13 & 14)

www.state.nj.us/oag/ca/ocp/regulate.htm

Federal: There are no federal regulations for health care service firms

Accreditation: Required as of May 21, 2019. The law does not make a distinction between health care service firms that receive Medicaid funding and those that do not. ALL Health Care Service Firms are to obtain accreditation regardless of the medical services they provide or the sources of reimbursement.

www.njconsumeraffairs.gov/hcservice/Pages/default.aspx

Accrediting Bodies:
- Accreditation Commission for Health Care (ACHC)
- Commission on Accreditation for Home Care (CAHC)
- Community Health Accreditation Partner (CHAP)
- National Institute for Home Care Accreditation, Inc. (NIHCA)
- The Joint Commission (TJC)

* ACHC, CAHC, CHAP, NIHCA & TJC are NJ Medicaid approved and approved by NJ Division of Consumer Affairs.


HOSPICE
Description   Regulation 
  1. Provides comprehensive care to the terminally ill including skilled nursing, social work, chaplain, and volunteer services.


  2. Approved for most payers, including Medicare and Medicaid. Certain insurance companies may restrict use to agencies they contract with.
  State: Licensed as a hospice by New Jersey Department of Health
N.J.A.C. 8:42C
N.J.A.C. 8:43E

www.state.nj.us/health/healthfacilities/rules.shtml

Federal: Medicare Certified by Centers for Medicare and Medicaid Services (CMS) 42 CFR Part 418

http://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/Hospice/index.html

Accreditation: Not required by state or federal regulations. May be required for managed care contracts. Voluntary decision- agency may elect to be accredited by one of the following:
- Accreditation Commission for Health Care (ACHC)
- Community Health Accreditation Partner (CHAP)
- The Joint Commission (TJC)

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