Nursing Care Home Health and HealthCare Pharmacy Facts Page
Patient Eligibility Facts
Choosing a Provider
Choosing the right
home care provider can be a difficult and emotional decision. But, the
choice is yours. How do you decide which company is right for you? Home
care companies differ in the services they provide and the qualifications of
their staff.
To assist you in the selection process, we have compiled a list of questions
to guide your decision. Ask these questions either directly to the home
care company or to your physician, discharge planner or case manager.
Types of Service:
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What types of services does the company provide?
- Home nursing, respiratory care, infusion therapy, and medical
equipment are just a few of the specialized home care services.
- Is
the company specialized or does it provide more general care?
- Some providers are specialists in home care, providing a limited
menu of services. Others are generalists and provide a more extensive
range of services.
- Does
the company provide services to pediatric patients?
- Not all providers are equipped to provide services to children.
Level of Service:
-
Is
service available 24 hours a day, 7 days a week?
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How
promptly will your calls be returned?
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How
quickly will the company respond to changes in your service?
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How
quickly can your service begin?
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Will the
company bill the insurance company on your behalf?
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Will the company investigate your insurance coverage for home care?
Qualifications of Staff:
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What are
the qualifications of the staff who will be providing your care? Are they
licensed nurses, pharmacists, respiratory therapists?
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What type of training is provided for staff?
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What type of quality programs does the staff participate in?
Office Locations:
Diabetic Peripheral Neuropathy
Facts
What is Diabetic Peripheral Neuropathy (DPN)?
Diabetic Peripheral Neuropathy is a serious
complication of diabetes and has been considered to be progressive and
irreversible. Between 26% and 50% of people with diabetes are diagnosed
with DPN and up to 100% develop some degree of neuropathy 5 years after
diagnosis of diabetes. Over 20 million people have neuropathy of all
causes (Source: www.neuropathy.org).
What are the
Symptoms?
The symptoms
of DPN are prickling, tingling or burning pain and numbness in the feet,
legs and/or hands. These can be worse at night interrupting sleep and
can make exercising, walking and even driving a car extremely
difficult. Many people have problems with balance and falls are common.
How is Diabetic Neuropathy Treated Today?
At best, the current management strategies
treat the symptoms of the disease rather than the underlying cause,
which is increasingly believed to be poor microcirculation to the nerves
and tissues in the extremities. Controlling blood sugars can help in
the early stages, but once the diabetic neuropathy is more advanced,
many of the medications used to control pain cause unpleasant side
effects and may not be effective.
What are the
Complications?
Diabetic
Peripheral Neuropathy leads to serious complications including chronic
ulcers, falls that result in fractures and other serious injuries and
amputations. Here are a few facts:
- DPN accounts for more hospitalizations than all other diabetic
complications combined.1
- Total costs for DPN exceed $37B annually.1
- One in three people over 65 fall each year –
at an annual cost of $20B.2
- Patients with DPN are 15 times more likely to
report injury during gait-related activities than those without DPN and
have an increased incidence of leg and foot fractures.3
- DPN is the leading cause of diabetic foot
ulcers and amputations. 87% of non-traumatic amputations are due to DPN.
There are 80,000 amputations in the US each year and 3,000 in VA
hospitals.4
- Over 7% of all people with diabetes will develop a diabetic ulcer (DU)
per year.5
- Medicare costs for diabetic ulcers exceed $15K
per patient per year.4
- 11% of patients with a DU require a lower extremity amputation (LEA)
within 3 years. The 3-year survival rate is 50%. 50% of lower extremity
amputees require a second LEA within 5 years.
– What Can a
Person with Diabetic Neuropathy Do to Prevent these Complications?
The American Diabetes Association recommends
routine foot exams and screening for loss of protective sensation. On
October 17, 2001, CMS (Medicare) issued a Coverage Decision Memorandum
stating that all people with loss of protective sensation (LOPS) would
be covered for two foot exams per year. Education on personal foot care
and prevention should also be provided to patients. Wearing
well-fitting shoes and examining one’s feet regularly are key to
prevention of foot ulcers and amputations.
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Peripheral Neuropathy Treatment Program
Facts
Who Can Benefit from the Peripheral Neuropathy
Treatment Program?
Patients with numbness or pain in their feet
or legs combined with difficulty with gait or balance abnormalities may
qualify for this program. People with diabetes and peripheral vascular
disease (PVD) are most likely to benefit, although many other types of
neuropathy do respond.
What is the Treatment Program Protocol?
The program typically consists of 3 therapy
sessions per week and lasts 4 weeks – although some patients may take
more treatments. The therapy consists of monochromatic infrared photo
energy called Anodyne Therapy, along with balance, gait and
strengthening physical therapy exercises. This 12-session protocol has
been clinically proven over ten years on thousands of neuropathy
patients to provide the best outcomes. An ongoing home treatment
program may be recommended after the twelve sessions are complete.
Will Insurance Cover This Therapy?
Medicare and most insurance companies cover
physical therapy programs when prescribed by your physician. Patients
should ask their insurance carrier if their insurance plan covers
physical therapy.
What is Anodyne Therapy?
The Anodyne Therapy System is a safe,
FDA-cleared, drug-free, non-invasive device that uses near-infrared
light emitting diodes to safely increase local circulation and reduce
pain. Use in thousands of patients since 1994 has demonstrated that the
Anodyne Therapy System increases local circulation in patients with DPN,
who often have severe vascular impairment. The results of this improved
circulation have been published in numerous medical journals and include
improved sensation and nerve function, pain reduction and healing of
chronic diabetic ulcers. New data shows that treatment with this
therapy can also improve balance and gait and reduce the risk of falls
by 96% in the elderly patient with neuropathy.
Is Anodyne Therapy Safe for Everyone?
Anodyne Therapy may be used in any patient
except over the womb during pregnancy and directly over a cancerous
tumor. It can even be used safely over pins, implants, screws,
pacemakers and defibrillators.
Are There Any Serious Side Effects or Drug
Interactions?
There are no known drug interactions.
However, as circulation improves and the symptoms of diabetic peripheral
neuropathy are reduced, sometimes less diabetes medication is required.
It is important to check blood sugars regularly during this program and
reduce diabetes medication as needed. The only known side effect is a
slight potential for a topical burn.
Physician Care Plan Oversight
As of January 1, 1995, the CMS (prior known as
HCFA) allows separate payment to the Physician Care Plan Oversight
(PCPO) services rendered to home health patients. Physicians,
not the home health agency, will get paid for Physician Care Plan
Oversight. Physician Care Plan Oversight - Patient Care Coordinators
keep physicians informed for a patient's condition. Physician Orders,
lab work and patient evaluations are detailed in the patient's file.
Physicians may submit claims for care plan oversight services to those
patients that qualify (patients with complex multi-disciplinary care
needs requiring 30 minutes or more of care plan oversight within a
calendar month). For more information on the Physician Care Plan
Oversight, visit our link.
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