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Medical Social Services in Minnesota

Home Care Resources

Several community resources are available to help after the patient returns home after a hospital stay. A social worker will help the patient and family determine which resources are available in the patient's home community and which will be appropriate.

Home Health Care
A home health care agency is a public or private agency that specializes in providing skilled nursing and other therapeutic services, such as physical therapy, in the home. Each patient's home care needs are different. Various levels of care are available. Home care is usually provided as needed. A doctor or nurse referral is needed for home health care. The home care agency will work with the patient and family to set up an appropriate plan of care that might include:

  • Registered nurse
  • Licensed practical nurse
  • Home health aide (assists with personal care)
  • Homemaker (assists with light housekeeping, meal preparation, etc.)
  • Live-in caregiver (lives in patient's home around the clock)
  • Physical/occupational/speech therapists, social worker, respiratory therapist, dietitian

Help locating a home health care agency is available on the Medicare home health compare Web site . The agency can provide information about its services.

Hospice
A hospice is a public agency or private organization that provides comfort care and supportive services to terminally ill people and their families. Hospice agencies provide both home care and inpatient care, at various levels. The hospice will work with the patient and family to set up an appropriate plan of care that might include:

  • Registered nurse
  • Licensed practical nurse
  • Home health aide
  • Chaplains
  • Physical therapists
  • Social worker
  • Dietitian
  • Volunteers

Costs of Home Health Care/Hospice
Costs of home health care/hospice vary depending on the agency selected, which services, and how often those services are needed. The agency can advise what services are needed and which will be covered by insurance. Most third-party payers cover only intermittent care and many only cover skilled care. Extended services can be very costly. Sources of payment for home health care and hospice are:

  • Medicare
  • Private health insurance
  • Medical Assistance/Medicaid
  • Other programs
  • Private pay

Home Care and Hospice Agencies in Rochester
Many home care and hospice agencies are available in and around Rochester, Minn. Please contact the Medical Social Services office at 507-284-2131, for a list.

Lifeline
Lifeline is an emergency alert system that works through the telephone, linking a patient's home to a medical center. The user wears or carries a small push-button device. In an emergency, pushing the button automatically signals the telephone to call for help. In Rochester, call the Lifeline coordinator at Saint Marys Hospital at 507-255-6908 for more information about the program.

Home-Delivered Meals (Meals On Wheels)
Home-delivered meals are available for those who live at home but cannot prepare meals properly. Volunteers deliver the meals which are prepared in nursing homes, senior living kitchens, hospitals or restaurants. Diabetic and low-sodium diets are available upon request. In Rochester, call Family Service Rochester Inc., 507-287-2010.

Adult Day Care
Adult Day Care, when available, generally is a daytime program that provides a full range of scheduled activities. Skilled services may also be available. Requirements for admission and participation in the program vary, as do costs. Contact the local Public Health Nursing Office or County Department of Social Services office for more information.

Adult Day Care in Rochester
Please contact the Medical Social Services office at
507-284-2131, for a list of adult day care resources.

Medical Equipment/Oxygen
After leaving the hospital, a person may need medical equipment or home oxygen to help adapt to a temporary or permanent disability. The cost of durable medical equipment that is prescribed by a physician may be covered by Medicare, Medical Assistance and many private insurances. Home oxygen may be covered under certain conditions. The local American Cancer Society may also provide medical equipment for those with cancer. The American Legion, Veterans of Foreign Wars or other service organizations are other possible resources.

Durable medical equipment is defined as an item that:

  • Can withstand use
  • Is primarily and customarily used to serve a medical purpose
  • Is necessary and reasonable for treatment of an illness or injury or to improve functioning
  • Is appropriate for use in the home

Medical equipment suppliers are listed in the Yellow Pages under "Hospital Equipment and Supplies."

Please contact the Medical Social Services office at
507-284-2131, for more home care resources.

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