In-Home Care and Community-Based Long Term Care Services

Long term care services include medical and non-medical care for people with a chronic illness or disability. There are several options for in-home and community-based services which provide opportunities for older adults or those with physical disabilities to receive services in their own home or community rather than going to a nursing facility.

Types of care include in-home home health and personal care assistance, companion care, adult day services; technology based monitoring such as PERS (Personal Emergency Response Systems) and medication monitoring systems such as DAP (Dispense A Pill).

Paying for Care

Many people are under the impression that Medicare will pay for long term home care services but usually this is not the case. Medicare covers medically necessary care and focuses on acute care, such as doctor visits, drugs, and hospital stays. Medicare does not pay for non-skilled assistance with Activities of Daily Living (ADL), such as bathing and dressing. Medicare coverage also focuses on short-term services such as physical, speech or occupational therapy to help a person regain function after a fall or stroke. It may also pay for part-time or intermittent skilled nursing care that is ordered by a doctor and provided by a Certified Home Health agency, for a limited number of days. Medicare will also help pay for medical supplies and durable medical equipment such as wheelchairs, hospital beds, oxygen, and walkers.

Some people may qualify for a public program such as Medicaid, EISEP and Veterans benefits but others will pay for care with personal income and savings, long term care insurance and reverse mortgages. Learning more about the "rules" for when Medicare, Medicaid, or other options might pay for long term care is important and may affect your decisions.


Selecting a Provider

There are a number of important questions to be asked when selecting and privately paying for health or personal care services in the home. Below is a checklist of some questions you may want to consider before selecting a provider:

  • Is the provider licensed?
  • How long has this provider been serving the community?
  • Does the provider do background checks prior to hiring its employees?
  • Do they evaluate the patient's home care needs and consult with the patient's physicians and family members? Is there a fee for this assessment?
  • Is there a written care plan that is left in the home?
  • How often can you expect a supervisor to visit the home?
  • Whom do you call with questions or complaints?
  • What are the fees for the service and when and how often will you is billed?
  • Are there minimum hour requirements?
  • What procedures does this provider have in place to handle emergencies?
  • Are they available 24 hours a day, seven days a week?

Choosing a service that meets your needs and financial situation can be daunting. If you need assistance understanding your options please call Ontario County NY Connects to get information and assistance on home and community based options available at 585-396-4047