Category Archives: Living with a Neurological Condition

An interview with Dr. Nancy Snyderman was published in Today’s Caregiver.  (I couldn’t find a date on the interview.)  Dr. Snyderman is asked her advice for family caregivers when dealing with the healthcare system and partnering with physicians in particular.

See:

www.caregiver.com/articles/interviews/nancy_snyderman_interview.htm

This is a nice quotation of Dr. Snyderman’s:

“To me, caregiving is about quality of life as much as it is about length of life. And it is about letting the person who is being cared for have a piece of the decision-making when possible. Life with dignity and death with dignity are two things that we do not talk enough about.”

The interviewer asks Dr. Snyderman what is the one most important piece of advice you would share with a caregiver?  Her reply:

“I know that you are probably overwhelmed with all kinds of decisions. But I want you to know that as part of this process, be in the moment as much as you can. You are going to remember things that today may seem minute. But they are going to come back and be some of the greatest gifts in your life. And the other thing I would say is that you will find that as a caregiver, you take care of everyone on the planet and you are on the back burner; that is not sustainable. Taking care of yourself is not selfish. It is self-preservational. Find the time to do that. You will have more to give in the end.”

The interviewer also asks:  “What do you advise family caregivers when dealing with the healthcare system?”  Dr. Snyderman says:

“I think this is particularly true for women. The good manners that our mothers taught us that help us in social situations and open up doors and allow you to have a lovely conversation at a dinner party–those same manners do not serve you well when you are advocating for someone who needs help. I have witnessed it firsthand. I have been that pit bull. I have relied on people to be that pit bull for me. But the reality is the system is complex. It is intimidating. It is labyrinthine. And whether you are the caregiver or the person who is being cared for, it is just downright complicated.”

In the interview, Dr. Snyderman refers to a for-profit business she started, CarePlanners.com.  This company provides services to family caregivers.

Robin

A social worker shared this New York Times article about long-term care insurance with me today.  As she says – it’s really nothing new but nicely put together in one article.

Here’s a link:

www.nytimes.com/2015/12/19/your-money/long-term-care-insurance-can-baffle-with-complex-policies-and-costs.html

YOUR MONEY
Retiring
Long-Term Care Insurance Can Baffle, With Complex Policies and Costs
New York Times
By John F. Wasik
December 18, 2015

Often there are seminars in the community about long-term care insurance.  These seminars are often led by HICAP (Health Insurance Counseling and Advocacy Program). HICAP is a service provided by county in California.  To find a HICAP counselor near you, do a web search for HICAP and the name of the county in which you live.

Happy holidays,
Robin

I recently posted that Medicare now rates home health agencies.  This post is about using the Medicare tool to find the 33 home health agencies in the San Francisco Bay Area that received 4, 4.5, or 5 star ratings.

The Medicare home health agency ratings aren’t super-easy to find but, after digging a layer or two down on the Medicare website, they can be discovered. Start at the Medicare home page of “Home Health Compare”:

www.medicare.gov/homehealthcompare/search.html

In the search box, type in “California,” indicating you want to search in the state of CA. On the right side, “Modify your search” by selecting a county, such as San Mateo County.

I also selected that I wanted to “Filter by” those agencies that provide all six services indicated (RN, PT, OT, ST, SW, HHA). Then I clicked on the green button for “Update search results.”

In that search, 73 agencies came up. Unfortunately you can only compare three at a time. I selected three agencies that I’d heard of previously.

If you select the “Quality of patient care” tab, you can see the star ratings.

Local support group member Dell did all the search work for us and compiled a list of 33 agencies in the SF Bay Area with 4, 4.5, or 5 star ratings.  Below, I’ve copied Dell’s list.

Robin

Wonderfully, local support group member Dell compiled a list of 33 agencies in the Bay Area that have a rating of 4, 4.5, or 5.

(Actually, this list could be longer because a single agency is typically listed in more than one city.  For example, I found CVH in San Mateo County while the list below shows them in San Ramon.  They have more than one office.  Perhaps the cities listed below are their main offices.)

RATING OF 5

INTERIM HEALTHCARE, SAN JOSE
DOMINICAN HOME HEALTH, SANTA CRUZ
ST CLAIRE’S HOME HEALTH, HAYWARD
LIFEGUARD HOME HEALTH, PLEASANTON
ASIAN NETWORK PACIFIC HOME CARE, INC, OAKLAND

RATING OF 4.5

SUNSHINE HOME HEALTH CARE, PLEASANTON
AMERICAN CAREQUEST, SAN FRANCISCO
CVH HOME HEALTH SERVICES, SAN RAMON
PREMIER HOME HEALTH PROVIDERS, SAN JOSE
MERIDIAN HOME HEALTH, NEWARK
TRUEMED, INC, SOUTH SAN FRANCISCO
CARELINK HOME HEALTH AGENCY, BURLINGAME
FARALLON HOME HEALTH CARE, BURLINGAME
MEDICS CHOICE HOME HEALTH, MILPITAS
QUALITY CLINICIANS CARE HOME HEALTH SERVICES, SANTA CLARA
LIFEGUARD HOME HEALTH SOUTHBAY & PENINSULA, MILPITAS
HEALTHFLEX HOME HEALTH SERVICES, OAKLAND
STAFFING HOME CARE, MILLBRAE
ASIAN AMERICAN HOME HEALTH CALIFORNIA, OAKLAND

RATING OF 4

SUTTER VISITING NURSE ASSOCIATION AND HOSPICE, SANTA CRUZ
SUTTER VISITING NURSE ASSOCIATION, NOVATO
PATHWAYS HOME HEALTH AND HOSPICE, SUNNYVALE
ACCENTCARE HOME HEALTH OF CALIFORNIA, SAN RAMON
VN HOME HEALTH CARE, SAN JOSE
PROHEALTH HOME CARE, SAN JOSE
AMEDISYS HOME HEALTH CARE, CAMPBELL
MARE ISLAND HOME HEALTH, VALLEJO
HOME HEALTH ALLIANCE, MILPITAS
ST JAMES HOME HEALTH, SAN JOSE
EMERITUS HOME HEALTH, SAN JOSE
AMITY HOME HEALTH CARE, HAYWARD
SAN BENITO HOME HEALTH CARE, HOLLISTER
INCARE HOME HEALTH SERVICES, SAN FRANCISCO

This email may be of interest to those with Medicare.

“Home health” is a Medicare benefit that few people seem to know about — unless you or a loved one ends up in the hospital or a rehab facility, and are then ready to be discharged to home again. If there’s a skilled need — RN, therapy (PT, OT, ST), or social worker — Medicare pays for a skilled professional to go to someone’s home to provide services. The person must be unable to leave their home, except to see an MD or attend a gathering in their faith community. When the “skilled need” is resolved or when a therapy cap is hit, the benefit ends. An MD must authorize “home health.”

As of July 2015, Medicare has started to provide quality ratings — one to five stars — to home health agencies in the US. Nine thousand home health agencies around the US were rated. Only 239 agencies in the US received five stars. In California, 1004 agencies were rated, with 42% receiving 4 or 5 stars.

The Medicare home health agency ratings aren’t super-easy to find but, after digging a layer or two down on the Medicare website, they can be discovered. Start at the Medicare home page of “Home Health Compare”:

www.medicare.gov/homehealthcompare/search.html

A Kaiser Health News (KHN) article notes:

“Medicare applied the new quality measure to more than 9,000 agencies based on how quickly visits began and how often patients improved while under their care. Nearly half received average scores, with the government sparingly doling out top and bottom ratings. … The ratings are based on agencies’ assessments of their own patients, which the agencies report to the government, as well as Medicare billing records. The data is adjusted to take into account how frail the patients are and other potential influences.”

“There was a wide variation in scoring among types of providers, a Kaiser Health News analysis found. Visiting nurse associations and agencies with religious affiliations tended to get the most stars. Home health agencies run out of skilled nursing homes and agencies run or paid for by local governments tended to perform poorly.”

“The star ratings were designed to capture overall quality by summing up the results of nine of 27 measures Medicare already publishes on its Home Health Compare website. Agencies were evaluated by how quickly they started visiting a patient, whether they explained all the drugs a patient was taking either to the patient or their caretaker and whether they made sure a patient got a flu shot for the season. The agencies also were judged on how much their patients improve in skills like walking, getting in and out of bed, bathing, breathing and being able to move around with less pain. Finally, the agencies were rated on how many of their patients ended up going to the hospital. The current star ratings are based on performance from the fall of 2013 through the end of last year. Medicare will reassess the stars quarterly.”

“Some in the home health industry are welcoming the ratings, but there is concern that consumers will interpret the scores differently than Medicare intends. The government considers three stars to be solid performers, but in rankings for restaurants, hotels and other common services, three stars are often interpreted as mediocre. … Another concern is that many of the quality results are self-reported by home health agencies.” 

You can find the full Kaiser Health News article (July 16, 2015) here:

khn.org/news/home-health-agencies-get-medicares-star-treatment/

A more recent KHN article notes that the ratings have another limitation:

“Bill Dombi of the National Association for Home Care and Hospice says that for one, they emphasize improvement. ‘The population in home health tends to be fairly aged with multiple chronic illnesses, where stabilization may be the goal rather than improvement,’ he said. Dombi said it’s unrealistic for a patient with Parkinson’s disease, for example, to get much better. But home health can help that person maintain some independence.”

Here’s a link to the more recent article (September 18, 2015):

khn.org/news/how-one-home-health-agency-earned-five-stars/

Robin