Home Safety Assessments in the Home Care Environment

A home safety assessment is an important tool for home health care in verifying the safety of patients and their home environment, identifying and correcting deficiencies, and minimizing and preventing losses. As the majority of reimbursement for home care services is through Medicare or Medicaid, the government plays a major role in setting the quality of care standards that organizations should follow. Periodic on-site inspections are performed to ensure compliance with the laws, regulations, and standards of care. The federal government works in partnership with state agencies (including the state health department or state licensing authority for healthcare facilities), which often set additional regulations that govern the licensing of home health care providers. In addition, private insurers and the home care companies themselves may set quality standards of their own to follow.

There are several categories that make up a comprehensive home safety evaluation:

  • Basic Home Safety and Patient Safety Issues: The home should be free of fire, health and safety hazards. Home care providers during the assessment will provide instruction in fire prevention and assist both caregivers and patients in establishing fire plans. They will provide education and training in the proper operation, maintenance, storage, and cleaning of in-home medical equipment to lower the incidence of infections caused by contaminated equipment, ensuring optimal performance of the equipment. Home care providers will also provide instruction in patient safety, including fall prevention, the correct lifting and transferring techniques for non-ambulatory patients, and proper administration and storage of medication. They’ll encourage CPR training for the family/caregiver, and provide a list of phone numbers to call in emergency situations.
  • Overall Home Environment: The set-up of each room will be evaluated for optimal efficiency. The home must be clean and free of excess clutter that can hamper mobility, cause accidental falls, and lead to misplaced supplies. Patients will be notified of risks associated with environmental hazards, such as untethered scatter rugs, poor lighting, slippery floor finishes, and mobile furniture.
  • Accessibility & Patient Mobility: The patient’s accessibility in and out of the home, between rooms, and into the bathroom will be evaluated. His or her mobility will also be assessed. For example, the assessment will evaluate if the patient is ambulatory on his or her own or whether assistance required. Does the patient need a wheelchair or walker? If the patient is not ambulatory, a list of checkpoints must be reviewed, such as the width and height of doorways, stairway usage, and carpets that may inhibit mobility, among other factors.
  • Patient/Family Issues: The patient’s/family’s ability to comprehend instructions will be evaluated. They will need training and education on all of the in-home medical procedures and proper use of equipment and supplies. They must be able to demonstrate competence and proficiency at performing all the required tasks, and be able to properly operate, maintain, troubleshoot, and clean the equipment. Also, the patient’s general hygiene must be observed and whether he or she is reliant on others for personal hygiene care. Additionally, any patient comments regarding abuse, neglect, lack of care, or any other problems and concerns should be addressed immediately. A home health care agency will have an established set of protocols for reporting these types of problems.

Documentation of the home safety assessment and any corrective actions is imperative, with any changes or substandard safety issues noted, evaluated and solved during follow-up visits.

Home assessments are an important component of home care. They determine the degree of safety, function and comfort of patients in their homes, and evaluate the need for adaptive equipment and assistive devices. Through the use of home assessments and appropriate modifications, home care providers are able to decrease the risks of patient falls and misuse of medications, improve patients’ accessibility in and around their homes, and keep patients living independently in their home environments as long as possible.

Manchester Specialty provides specialized insurance and risk management solutions to the home health care and hospice industry. We work exclusively with local brokers and would be happy to review your operation and how well your insurance program addresses the various exposures your operation faces. You or your local agent/broker can contact us at 855.972.9399 for more information about our products and services.