WHAT IS EXTENDED CARE?
Extended Care Home Health is a specialized initiative crafted to deliver at-home medical assistance to individuals enduring chronic incapacitation. This is accomplished through adept nursing services, often referred to as “Private Duty Nursing.” The primary objective of Extended Care is to enable medically vulnerable children and adults with debilitating conditions to remain in the comfort of their homes, surrounded by their family members, and receive personalized one-on-one skilled nursing care. By offering skilled nursing within the home environment, this approach enhances overall well-being and minimizes the likelihood of infections, complications, hospital stays, and deterioration in health conditions. Furthermore, it facilitates enhanced supervision and communication with the primary care physician, ensuring comprehensive and attentive healthcare management.
WHO QUALIFIES?
Patients dealing with chronic and incapacitating conditions, with an emphasis on children, although those above 18 years are also accommodated. Each patient must have a medical necessity letter and a doctor’s prescription for skilled nursing hours. Advanced authorization is essential for all participants in Extended Care. Suitable individuals should need numerous hours of skilled nursing care each day or week, with hours varying from a minimum of 10 hours to a maximum of 168 hours per week (continuous care). The allocation of these hours and days can be adjusted to best suit the patient’s requirements.
Common Diagnoses
- Anoxic Brain Injury
- Cerebral Palsy
- Williams syndrome
- Osteogenesis Imperfecta
- Prader-Willi Syndrome
- Ventillator Dependent
- Epilepsy
- Spastic Quadriplegia
- Chronic respiratory failure
- Congenital Malformations
- Aortopulmonary Septal Defect
- Tetralogy of Fallot
- Chromosomal Abnormalities
- Autism
- Hydrocephalus
- Hypoplastic Left Heart Syndrome
- Bronchopulmonary Dysplasia
- Mandibular Hypoplasia
- COPD
- Muscular Dystrophy
- Moyamoya Disease
- Spina Bifida
- Malignant Neoplasm
WHAT DO WE DO?
Each patient is assigned a comprehensive case manager, who develops and implements a plan of care with the primary care physician. Each plan is tailored to the patient’s specific needs. The care plan is then followed by our team to provide assessments, skilled nursing care, education, and communication bridges between patients and all collaborating healthcare members. Our nurse-to-patient ratio is 1:1. We direct hire nurses to fit the individual patient’s needs by matching the nurse to the patient’s level of care, family structure, and scheduling needs. We can provide routine skilled nursing services and obtain labs, UAs, cultures, and swabs to assist providers with diagnosis and treatment. We also continue to monitor our patients while in the hospital and assist with their discharge planning and follow-up care post-hospitalization. Through our individualized care model, we can achieve optimal outcomes for our patients.
Prior authorization is required for all extended-care patients
Medicaid is the primary payer source, through traditional insurance is accepted as well, with single-case agreements (SCA). Our single-case agreements allow us to provide services to a patient who may not be in our existing insurance network, they also allow us to negotiate rates on behalf of our patients when a patient has advanced challenges or advanced training required for staffing.
ACCEPTED INSURANCES
Insurances accepted include but are not limited to:
- AmeriHealth Caritas
- United Healthcare Community
- Aetna Better Health
- Louisiana Homecare Connections
- BCBS
- Vantage
- Traditional Medicaid
- Medicaid Waiver
Skilled nursing services include all necessary medical tasks that are part of the plan of care and can be administered in the home.
Examples include but are not limited to:
- Administration of medications (Narcotics)
- O2, Trach and ventilator support
- Bi-Pap, and other respiratory treatments
- Feeding Tubes
- Catheters
- Wound Care
- CPT Vests
- Assessment
- Education
- Additional Complex Care