We often write about differences among the Florida licensed long-term care (LTC) entities but recently someone asked what they all have in common. Good question! Here’s a run-down on that information.
Home health agencies come in two varieties: those that provide skilled care and those that don’t. Let’s look at each one.
Skilled home health agencies are those that provide skilled care, defined as services rendered by a licensed healthcare professional, such as nursing, physical, occupational and speech therapies and medical social work. Skilled agencies in Florida require not only a license but accreditation from one of the three national accrediting organizations: The Joint Commission (TJC), Accreditation Commission for Health Care (ACHC) or Community Health Accreditation Partner (CHAP). These orgs’ requirements for agencies go above and beyond the State’s guidelines, and the accreditation process includes a policy review and site visit.
Skilled agencies have a two-step process which takes approximately nine months, and this timeframe depends on many factors. The first step is to apply for State licensure, which includes a scheduled on-site survey. Once the license is issued and an initial accreditation is awarded, (the process may take up to six months), the agency then begins providing skilled care to patients. These services may be paid for by insurance or by the client, or may even need to pro bono. When the agency has provided care to a requisite number of patients, the second step is to indicate its readiness for an unannounced accreditation survey, which must be completed within one year.
After the agency passes the second accreditation survey, it receives a lengthier accreditation approval. The period of time for accreditation is affected by how long it takes the agency to provide care to the required number of skilled patients, the accrediting org’s scheduling availability, and if there are any issues to be remediated after the survey.
Non-skilled home health agencies provide non-skilled care, meaning those that are not rendered by a licensed professional as described above. These services include personal care (assistance with activities of daily living [ADLs] and instrumental activities of daily living [IADLs]), as well as homemaker/companion services. In Florida, these agencies take approximately five months to proceed through the licensing process; there is only one survey, and it is scheduled. Accreditation is not required, but is available.
Nurse registries are under another Florida LTC license type and resemble skilled agencies with some distinctions. Nurse registries can provide skilled and non-skilled care, but no therapy services; the only skill is nursing care. The licensing process is similar to the non-skilled agency in that there is only one survey, which is conducted by the State, and it is announced. Nurse registries may have limitations in payor acceptance, so it behooves anyone considering this license type to inquire of the major plans in the area to be sure they will pay a nurse registry to care for an enrollee. Accreditation is not required, but is available.
Florida also offers registration for Homemaker Companion Service (HCS) companies. These are relatively quick to get started and offer only non-hands-on care. Homemakers and companions can provide light housekeeping services, transport and accompany clients on outings and offer services such as keeping company with the client, playing board games, etc. An HCS can be operational in approximately 30 days.