What is an adult day health center?
The AW Adult Day Center is a 50-person capacity day program. Care and supervision, monitoring of general health, social interaction and peer contact for physically impaired or socially isolated patients is provided in a friendly and safe environment. Nursing, social services, activities and dietary services are provided within the context of the program.
Who qualified for the services?
Services are available to persons with functional impairments who are 50 years of age or older, who reside in the community and do not require 24-hour care.
Are the services covered by my insurance?
AW Adult Day Health Center is Medicaid-certified and services are covered 100% by Medicaid.
Are home health services appropriate for me?
AW Home Health encompasses a wide range of medical services delivered in the patient’s home. Care is often initiated following a hospitalization or short-term stay in a rehabilitation facility. Your physician can also prescribe home healthcare if there has been a recent decline in health status, treatment or medication additions or changes, or a deterioration of an existing condition.
What services are available to me through home health?
Intermittent visits involve a nurse or therapist coming to your home to perform clinical procedures or to guide you through a therapy session.
In what locations of St. Louis and the surrounding areas can I get home health services?
AW Health Care serves patients who need home healthcare in the St. Louis City metropolitan area and the Missouri counties of St. Louis, Jefferson, St. Charles, Warren and Lincoln. AW also serves Illinois patients who reside in the Illinois counties of Bond, Clinton, Macoupin, Madison, Monroe, St. Clair and Washington.
How do I qualify for these services?
To qualify for skilled nursing or therapy home health visits under Medicare guidelines, the patient must be homebound, meaning it takes a challenging effort to leave the house. If trips outside the home are for medical purposes, or are infrequent and of short duration, a patient may still be considered homebound.
Are the services covered by my insurance?
In most cases, home health services are covered 100% by Medicare and some insurance plans. AW Health Care is Medicare-certified and has contracts with Medicare Advantage plans such as UHC/Medicare Complete.
What will the nurse do for me?
Depending on your need, the nurse will come to your home to provide care that you may otherwise receive in the hospital or nursing facility. This could include things such as IV infusions, wound care, medication and illness education, assessment and much more. The nurse will communicate closely with your doctor and healthcare team to keep you as healthy as possible and out of the hospital.
What will the therapist do for me?
The physical or occupational therapist will come to your home to assist you in developing a safe physical program that will help restore your function and maintain your independence so you can safely live in your home for as long as possible. The therapist will evaluate your risk for falls and will design your program to reduce that risk as much as possible.
How often will the nurse and/or therapist come to my home?
The plan of care developed is specific to each person. Depending on your needs, the nurse and/or therapist may visit one time or several times per week. At each visit the nurse and/or therapist will re-evaluate you and will adjust the care plan based on your needs and progress toward your goals.
How much will this service cost me out of pocket?
Most insurance plans, including Medicare pay 100% of costs for skilled home healthcare for patients who qualify to receive the services, leaving the client with no out of pocket expenses. Call our friendly staff today to discuss your needs. We will be happy to tell you what your costs, if any, would be.
What is personal home care?
Personal home care is a program designed to implement non-medical tasks to meet the client’s physical needs and thereby enable the client to remain in his/her home rather than at a skilled nursing facility. Services include meal preparations, cleaning and personal assistance.
Are the services covered by my insurance?
AW Health Care provides personal care services in the home that are covered by Medicaid and some long-term insurance plans. If your loved one is a veteran or the surviving spouse of a veteran who served in a foreign war, there may be resources available to help cover the costs of personal care in the home. There is also a private pay option available. We will exhaust all resources to help you meet the needs of your loved one. Please call and speak with one of our Senior Care Consultants for more information.
AW Health Care is also Medicare- and Medicaid-certified, which is a requirement of many long-term care insurance plans.
How do I initiate services?
A registered nurse will complete a thorough assessment to gain a full understanding of the issues and concerns faced by the client and the family. The assessment targets available options that best fit the client. Together, we formulate a care plan that incorporates your needs, your wishes and your preferred schedule. Our caregivers are available 24 hours a day, seven days a week.
Do I need a referral from my doctor to attend therapy sessions?
The state of Missouri requires a doctor’s prescription, or referral, in order for treatment from a therapist to begin. Clients can contact their doctor to request a referral or a prescription. We are happy to call the doctor for you, however often the doctor will prefer to see you in his/her office prior to writing a script for therapy. Prescriptions can then be faxed to our office at 314.754.9317 or brought in to our office.
Will my insurance cover the therapy?
Everyone’s insurance coverage is different. We are currently in network with several insurance providers and are constantly working to expand our list. Our business office will contact your insurance provider to verify coverage and explain the benefits at the first visit.
Do I need to contact my insurance company?
While it is important for every person to educate themselves on their own insurance plan, our business office is happy to do the leg work for you and will do all necessary pre-certifications and verification of coverage.
How much will therapy cost me?
Everyone’s insurance coverage is different. If the client’s insurance company requires a co-pay or co-insurance, payment will be expected at each visit. We will make sure that you are fully informed of any costs involved, prior to delivering care.
What if I have questions about coverage and billing?
Our business office is happy to answer any questions regarding billing. Please call 314.726.5600 and ask for the outpatient billing department. It is highly recommended that people educate themselves on their own insurance plan and benefits.
How do I schedule appointments?
After obtaining a referral from the doctor, a client or client representative can call 314.726.5600 to set up an “initial outpatient therapy appointment”. The scheduler will ask questions regarding the client’s insurance and contact information. Subsequent visits will be scheduled once the therapist has performed the initial evaluation and frequency and duration of therapy has been established.
What can I expect during my first visit?
During the first appointment, called the initial evaluation, the therapist will ask you to complete a Client Information Sheet and Medical History Form. This information is vital in assisting the therapist to gather the pertinent information needed in order to devise a plan of care specific to your needs. The therapist will also ask questions about your injury, pain or problem. Guided by the questions and answers, the therapist will perform a physical evaluation which may consist of testing muscle strength and length, assessing posture and walking or testing balance. The findings of this evaluation will guide the therapist in devising a plan of care specific to you, which will then be discussed and agreed upon.
What if I don’t agree with my plan of care?
The therapist devises the plan of care using his/her training, experience, and professional opinion. The therapist’s goal is to assist you to reach your goals. If a treatment suggestion makes you uncomfortable, the therapist will work with you to devise a plan of care that is appropriate and comfortable.
Does everyone do the same thing in therapy?
Everyone’s therapy is different. The activities completed in therapy are based on the findings of the tests and measures performed during the initial evaluation, evidence of efficacy for the specific problems or injuries, and the client’s goals for recovery. With some surgeries, the surgeons provide protocols for the therapist to follow in order to avoid injury and promote healing while returning to function.
Will I do the same thing at every therapy session?
Each session will be guided by the client’s response to the previous session, the body’s response to the previous session, and the progression towards the goals.
How long will I need to take therapy?
The length of therapy varies for each client and depends mostly upon their expectations, their rate of recovery, goals, motivation level and compliance. The duration of therapy also depends on the therapist’s professional opinion, the doctor’s recommendations, and insurance guidelines.
How should I dress for therapy?
If at all possible, you should come to therapy in comfortable clothing and athletic shoes. Often, clients will be asked to lie down, kneel, ride a bike, walk on a treadmill or take off their shoes. Dresses and skirts may be inappropriate for the tasks. The therapist will inform the client if a specific item of clothing will be needed for the next treatment session.
What if I am unable to attend my scheduled therapy session?
We appreciate a timely phone call should you need to cancel or reschedule your therapy session. Due to insurance guidelines, several cancelations or a prolonged absence from therapy may result in discharge from therapy.
I’ve been discharged from therapy but I’ve been reinjured. Can I come back to therapy?
We hope that you don’t suffer another injury, but if you do, a new referral or prescription from a doctor will be necessary return to therapy. After the new referral or prescription is obtained, the same evaluation and care plan process occurs as did for the first therapy sessions.