In-Home Care

Eligibility

Must be at least 22 years of age
Must require daily assistance or cueing and supervision with one ADL throughout the task
Must be under the care of a Primary Care Provider
Program participation must be ordered by a Primary Care Provider
Must live in a safe home environment
Must have one of the following insurances: MassHealth Standard, MassHealth CommonHealth, Accountable Care Organizations, One Care (Commonwealth Care Alliance, Tufts Unify), or Senior Care Options ( Commonwealth Care Alliance, Fallon, Senior Whole Health, Tufts, United Healthcare)

Caregiver Requirements

Must be at least 18 years of age
Can be a friend or related to the person needing care, but cannot be the legal guardian
Must be able to travel to the member requiring care
Must be invested and understand the needs, health, and wellness of the member
Must be deemed physically and mentally fit to provide care by a Primary Care Provider or Medical Doctor

Admission Process Group Adult Community Care (GAFC)

1. Phone Interview to Start Admission Process
To start the admission process a member of the intake team will call you to complete an application. The intake team member will be your main point of contact throughout the intake process and will be able to answer all your questions. The team member will ask for a picture of your photo IDs, proof of your address and will also help you sign a Release of Information for your primary care provider; you or your caregiver will need access to email.

2. In-Person Registered Nurse and Case Manager Assessment
Once intake receives the notes from your primary care provider, the team member will schedule a home visit with a registered nurse and case manager. The registered nurse will complete an assessment (the assessment is a conversation) during which they will confirm that you qualify for this program. The case manager will ask you to show them around the house. The case manager needs to confirm that the home is safe, clean, and an appropriate setting for you to receive care. We ask that you make sure you have working safety equipment in the home for this visit (a first aid kid, fire extinguisher, CO2/smoke alarms).

3. Request Medical Documentation
Next, the intake team member will reach out to your primary care provider to gather baseline medical information (medication list, diagnosis list, and notes from recent office visits). Make sure if you have not had a physical in the last 12 months you call and schedule one with your PCP. While notes from specialists can be helpful, we need to get a copy of your last physical from your primary care provider. Intake will send an order for this service to your primary care provider to sign.

4. Submit to Insurance for Authorization
Then, intake will submit the registered nurse’s paperwork and the primary care provider’s order to the insurance company for approval.

5. Admission Visit with Registered Nurse and Case Manager to Create Custom Care Plan
Once intake receives authorization from the insurance company, you can start the program right away. The intake team member will schedule an admission visit with the registered nurse and case manager. Loved Ones Care will sign an agreement with you. You will be seen daily by a caregiver starting at admission