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Corporate History A local health provider and community partner for over 20 years. –WellCare Health Services started in 1989, providing non-skilled services.

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Presentation on theme: "Corporate History A local health provider and community partner for over 20 years. –WellCare Health Services started in 1989, providing non-skilled services."— Presentation transcript:

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2 Corporate History A local health provider and community partner for over 20 years. –WellCare Health Services started in 1989, providing non-skilled services to our patients in New Hanover county. –In 2000, G. Wayne Long purchased the certificate of need for Home Health from NHRMC and became WellCare Home Health, providing skilled services. Industry leader and nationally recognized for quality of care. –#8 Home Care agency in North Carolina according to CMS data. –Leader in Southeastern North Carolina as the one of the top 4 providers, by volume, in our 12 county service area.

3 Relevant Corporate Statistics: Any given day we serve over 1000 patients Any given day we serve over 1000 patients 500 employees 500 employees 120,000 visits per year 120,000 visits per year 24 hours/day clinical coverage 24 hours/day clinical coverage 7 days/week licensed admission staff 7 days/week licensed admission staff Specialized credentials & programs Specialized credentials & programs

4 Locations & Areas Served 7 office locations in a 12 county coverage area: 7 office locations in a 12 county coverage area: –New Hanover : Ashton & 17 th Street locations –Bladen : Whiteville location –Brunswick : Supply location –Columbus : Elizabethtown location –Pender : Burgaw location –Onslow : Jacksonville location –Wayne : Goldsboro location –Service coverage also provided in Duplin, Sampson, Jones, Cumberland and Robeson

5 Home Care Services Personal Care Services Personal Care Services CAP (Community Alternative Program) CAP (Community Alternative Program) –CAP/C (Children) –CAP/DA (Disabled Adults) –CAP/MRDD (Mental Retardation/Developmental Disabilities) EPSDT (Early, Periodic, Screening, Diagnosis & Treatment) for children EPSDT (Early, Periodic, Screening, Diagnosis & Treatment) for children PDN (Private Duty Nursing) PDN (Private Duty Nursing) Private Pay Private Pay Geriatric Care Management Geriatric Care Management Stay at Home Services Stay at Home Services Voice Care Voice Care

6 PCS Qualifications Program is administered by Medicaid Program is administered by Medicaid Up to 60 hours/month Up to 60 hours/month Maximum 3.5 hours /day Maximum 3.5 hours /day Must have blue Medicaid card Must have blue Medicaid card Service must be provided in clients home Service must be provided in clients home Ordered by primary care physician Ordered by primary care physician Some pregnant women with Medicaid may qualify Some pregnant women with Medicaid may qualify Client must qualify by having at least 2 deficits out of the 6 different ADLs (Activities of Daily Living) listed below: Client must qualify by having at least 2 deficits out of the 6 different ADLs (Activities of Daily Living) listed below: –Bathing –Dressing –Ambulation –Eating –Toileting –Incontinence Care

7 CAP & MRDD Qualifications Programs funded by Medicaid Programs funded by Medicaid Case management and care plan approval by the local county CAP or LME office Case management and care plan approval by the local county CAP or LME office Provide PCS, Home and Community support and Respite Provide PCS, Home and Community support and Respite Service must be provided in clients home Service must be provided in clients home Ordered by primary care physician Ordered by primary care physician

8 Private Duty Nursing Qualifications Medicaid, Private Insurance, Private Pay Medicaid, Private Insurance, Private Pay Can be up to 24 hours/day Can be up to 24 hours/day LPN or RN will provide the care LPN or RN will provide the care Services ordered by MD or if private pay, then services requested by family Services ordered by MD or if private pay, then services requested by family

9 Home Health Services Nursing Nursing –Psychiatric –Pediatrics –Certified Wound Specialists –Cardiac (Heart Nurse) –Incontinence Care (Diaper service for adults/children) –Infusion Therapy (including chemotherapy) Physical Therapy Physical Therapy Occupational Therapy Occupational Therapy Speech Therapy Speech Therapy Social Work Social Work Nurse Aide Nurse Aide

10 Payor Sources Medicare Medicare Medicaid Medicaid Private Insurance Private Insurance –Co-pays Long Term Care Insurance Long Term Care Insurance Private Pay Private Pay

11 Fee Schedule Home Health (Medicare, Private Insurance, Workers Comp) Home Health (Medicare, Private Insurance, Workers Comp) PCS/Plus(Medicaid) PCS/Plus(Medicaid) CAP/C/D/MRDD(Medicaid) CAP/C/D/MRDD(Medicaid) EPSDT (Medicaid) EPSDT (Medicaid) VA (Veterans Administration) VA (Veterans Administration) Private Duty Nursing (Private Pay) Private Duty Nursing (Private Pay) –LPN $40/hr –RN $45/hr –Aide $18/hr, Weekend $20/hr, Holiday $27/hr Pill Tray Fills (Private Pay) Pill Tray Fills (Private Pay) –$45/pill fill Voice Care (Private Pay) Voice Care (Private Pay) –Install $25 –Monthly $35

12 How do I get the service? Call your doctor and ask for a referral for Home Health or Call your doctor and ask for a referral for Home Health or Call our Intake Dept at or and we will take care of it for you. Call our Intake Dept at or and we will take care of it for you. You dont just have to be coming home from the hospital to have a need. You dont just have to be coming home from the hospital to have a need.


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