September Services, Inc. - Solutions for Aging with Grace

In the options section of this site, we gave a basic overview of in-home care. In this section, we will give you
a more detailed description of different types of in-home care options, based on regulatory license conditions and requirements. This section will also outline the varying levels of care that exist within the in-home care industry.

Three Common types of In-Home Care:

Medicare In-Home Care

Non-Medical (Custodial) In-Home Care

Private Duty (Medical) In-Home Care

Medicare In-Home Care

What is it?

This type of In-Home Care is sponsored by Medicare. If you qualify for Medicare, you may be eligible to receive in-home care from a certified Medicare Agency.

Pros:

Is paid for by Medicare - No direct cost to you
Provides basic skilled nursing that may be necessary to an overall care plan

Cons:

Can only provide basic services - will not typically accommodate overall care management
"Red Tape" - dealing with bureaucratic boundaries can cause delay in service

Bottom Line:
This is a good option to supplement with private care. Since Medicare will cover the costs, those who need physical
therapy or other specific task-oriented health services will see a great benefit in utilizing such an agency.

Non-Medical (Custodial) In-Home Care

What is it?

These are what are referred to commonly as "Adult Sitting Services." These agencies will usually advertise themselves as
"Non-Medical Home Health Care..." They provide custodial and companionship services to older adults who need basic assistance with their overall in-home care.

Pros:

There are lots of agencies to choose from in this category
It is not as expensive as Private Duty skilled care (about 5% less expensive)
Can be a good supplement to other care options (people in assisted living, care by family members...)

Cons:

More likely (not always) to use contract labor
Do not usually use RNs - RNs do not typically supervise all levels of care with an assigned care management team
Are limited in their ability to grow with the needs of the client (typically only carry Aides on staff...)

Bottom Line:
This option is popular because there are so many non-medical agencies out there, this is because it is much easier
to obtain a license to operate as a non-medical agency, and the regulations are much more lax; therefore making it
a much more profitable business model, hence the reason for why there are so many franchises in this field. There
are several very qualified and reputable agencies out there that carry this license, and it is a good service for those
with basic needs.

Private Duty (Skilled) In-Home Care

What is it?

September Services is proud to carry its license in skilled care. This type of care offers all of the same
companionship and custodial care you would find in a non-medical agency, but goes several steps further
to ensure the highest quality of care and consideration.

Pros:

Can grow and adapt to growing needs of a less independent older adult
Uses all levels of nursing care (RNs, LVNs, HHAs/CNAs) - can fulfill Doctor's Orders
Can customize care plan to suit any individual client's needs

Cons:

Is more expensive than custodial care (on average - 5% higher)
Is not covered by Medicare
Direct pay can be difficult for many families

September Services does work with Long Term Care Insurance Providers and can help you get
reimbursed for your expenses

Bottom Line:
This is the cream of the crop in the in-home care industry. This type of service includes direct RN
supervision of all cases (even custodial cases). All services are monitored and reassessed from time
to time to ensure that the client is receiving the care needed. This service can grow with growing health
needs. September Services, for example, uses Home Health Aides, Licensed Vocational Nurses, Registered
Nurses, and Gerontologists -- if that's not enough, we go even further by providing in-house care
management by a nationally credentialed Care Manager.