VNS Health MLTC: Personal Care (Home Health Aide)

A needs assessment determines the coordination of a home health aide for personal care and help with activities of daily living (ADLs).

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Cost
$0
Prior Authorization Required
Yes
Provider Referral or Order Required
No

How To Receive

Details on how to apply

  1. Contact the VNS Health MLTC Care Team at (888) 867-6555 (TTY 711) for prior authorization.

  2. While a provider order is not required, services are determined by a nursing assessment.

    • The nursing assessment is arranged by the Care Team.

  3. If you or your loved one are not immediately placed (contracted) with a licensed home care services agency (LHCSA) for home care services, it may be either an issue of authorization or of locating a home care agency with availability.

    • VNS Health will make every effort to secure LHCSA services, though sometimes these efforts are unsuccessful for a period and require patience. VNS Health will continue to search for a LHCSA for you or your loved one and will usually provide monthly updates on placement progress.

What to do if the home health aide (HHA) is late or doesn't show up.

PLACED: If you or your loved one are already contracted with a home care agency and the home health aide (HHA) is late or does not show up:

  • If you have a way to contact them directly, give them the benefit of the doubt and call them first.

  • If you are unable to reach the HHA directly, contact the home care agency. The agency is responsible for HHA scheduling, communication, and accountability.

  • If you have repeated issues with the HHA, and the home care agency is aware, then contact you or your loved one's insurance provider who will take action.

CDPAS: If your loved one is self-directing their personal care and the care provider, whether a family member or someone outside the family, is late or does not show up, this is a personal matter that must be discussed directly with the person providing care.

Availability
Ongoing, based on assessment and change in condition
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Determined by a needs assessment conducted by a registered nurse, the Care Manager will coordinate the provision of personal care and help with such activities as personal hygiene, dressing and eating, and home environment support.

Personal care involves what are called activities of daily living, or ADLs. These are activities critical to daily living. Personal care is needed when people are no longer able to perform these activities independently or have a lot of difficulty doing so. ADLs comprise bathing or showering, personal hygiene such as shaving and brushing teeth, toileting, transferring (getting in and out of bed, for example), walking, and eating.

While personal care is hands-on care, it is not nursing care. Personal care assistants do not provide medical care or complete nursing tasks, unless permitted through nursing delegation and overseen by a registered nurse

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