Gathering in an interior office cubicle during a recent tornado warning, Steve Smith, Donna Sorge and Meg Cunningham of the Visiting Nurse Association of Vero Beach started talking about private nursing and home healthcare.
The circumstances seemed oddly appropriate. After all, there’s a virtual whirlwind of information – and misinformation – swirling around the Internet these days about the various forms of home healthcare available and what those services will cost.
As the U.S. population ages, the demand for a wide variety of home healthcare services has exploded. So has the number of providers.
Smith estimates that upwards of 60 different providers of various stripes now offer some form of home healthcare just in the Vero area. But that pales in comparison to the nation as a whole.
The Centers for Medicare and Medicaid Services estimates there are close to 10,000 registered home healthcare agencies now operating in this country.
The Centers for Disease Control and Prevention says tens of thousands more healthcare registries and private-hire firms, as well as licensed and unlicensed individuals, are also offering their services online to an often-bewildered population.
That’s a lot of information for consumer to wade through and the nomenclature can be confusing.
The term “private care,” for example, may sound exclusive and pricey but, according to Smith, “the private care side is mostly non-skilled.”
VNA program director Sorge joins him by saying that category of care might include paid companions who drive patients to doctors’ appointments, do light housekeeping and meal preparations.
The next step up might be “home health aides” who – at least at VNA – are certified nursing assistants. “They,” according to Sorge, “provide hands-on care. They can do bathing, shampoos and also light housekeeping, medication reminders and any kind of personal care.”
At VNA, these home health aides are supervised by a registered nurse.
“Each client is assigned to a nurse and that nurse will come out and make a field visit. She’ll do all the vital signs, she’ll do the assessment, she will check and supervise the home health aide, which is very important, and make sure that everything is going properly. She will update the plan of care, make sure current treatments are still appropriate and consult with the physician.
“We have also care managers,” Sorge continues, “who go to the doctors with the patient and then record everything that is going on. So let’s say the patient’s daughter is in New York. The care manager could then tell the daughter everything that happened at the visit. These nurses also do medication management and they’ll do injections, they’ll do any kind of colostomy changes or ileostomy changes. And they’re all RNs (registered nurses).”
Registered nurses and licensed practical nurses, of course, cost more than non-skilled care.
For that reason, what you might pay for home healthcare can vary widely.
While Smith places the lower range of non-skilled rates in the Vero area around $18 to $28 per hour, the National Association of Professional Home Care (NAPHC) warns there are additional and often-overlooked expenses to consider.
For example, NAPHC points out, “When you hire a private pay caregiver, you become an employer and the caregiver becomes a household employee.”
That’s important insofar as your existing homeowner’s insurance policy may not cover the cost should that household employee slip and fall or in any other way be injured.
Moreover, NAPHC also reminds people that as an employer, you are also responsible for knowing the immigration and visa status of your employee.
And then there’s the tax man.
“You are legally responsible,” says NAPHC, “for withholding Social Security taxes, Medicare taxes, federal unemployment taxes and filing all of that with the IRS” for each employee. Failure to do so can result in hefty fines and even possible prison sentences.
Unlike most private hires or online services, says Smith, the VNA screens its providers with both level-one and level-two background checks along with drug screening and testing. It also protects clients against theft, abuse and injury lawsuits, and assumes the responsibility for all workman’s compensation, unemployment insurance, Social Security taxes and federal withholdings.
While it probably is tempting for Smith and Sorge to claim the VNA is the only place in Indian River County that can be trusted to provide home healthcare, they both steadfastly refuse to do so. They do, however, urge caution. And research.
They are also quick to point to VNA’s long-term track record – it was chartered here in 1975 – and they both point to the variety of other services the VNA offers, including helping to arrange insurance, pension, veterans’ benefits and Medicare or Medicaid payments.
Your physician – or your loved one’s physician – can provide precise details about what kind of care is needed and can make recommendations on which local providers to contact.
Smith and Sorge are quietly confident the VNA will be at or near the top of that list.
The VNA of Vero Beach is at 1110 35th Lane. The phone number is 772-778-0159.
