If you're managing or starting a home health agency, understanding the roles of each discipline involved can feel like a daunting task. Are you struggling to identify who does what and how each role contributes to patient care? Without this clarity, your agency might face inefficiencies, compliance challenges, and even risks to patient safety.
At The Home Health Consultant, we've supported hundreds of home health agencies in overcoming these exact hurdles. With extensive experience in regulatory compliance, staffing, and operational efficiency, we know what it takes to build a compliant and patient-focused home health agency.
By the end of this guide, you'll have a clear understanding of each critical discipline in home health. You'll be better equipped to manage your team, enhance operational efficiency, and provide the high-quality care your patients deserve.
What is a Discipline?
In home health, disciplines are categories of clinical care. Each discipline has a specific role in delivering care based on the patient's medical, psychosocial, and emotional needs. Each discipline operates within its scope of practice and collaborates with others to provide holistic, patient-centered care.
What’s the Difference Between Eval-Level vs. Non-Eval Level Skilled Care Workers?
Before we dive into each of the disciplines, it’s important to understand this concept. In home health care, every discipline includes two levels of professionals: eval-level and non-eval level. The difference between them impacts how care is delivered. It also affects how teams function.
What Is an Eval-Level Skilled Clinician?
Eval-level clinicians are responsible for assessing a patient’s condition and developing a care plan. These professionals have the authority to evaluate the patient’s needs and determine treatment goals. They can also make changes to the plan as necessary.
Examples of eval-level clinicians include:
- Registered Nurses (RNs)
- Physical Therapists (PTs)
- Occupational Therapists (OTs)
- Speech-Language Pathologists (SLPs)
- Medical Social Workers (MSWs)
These clinicians can also carry out the treatment plan themselves. However, in larger teams, their primary role is evaluation and oversight.
What Is a Non-Eval Level Skilled Clinician?
Non-eval level clinicians implement the care plan created by their eval-level counterparts. They do not conduct initial assessments. Neither do they make clinical decisions regarding treatment modifications. Instead, they follow the plan of care as prescribed and report any changes needed to the eval-level clinician.
Examples of non-eval level clinicians include:
- Licensed Vocational Nurses (LVNs)
- Physical Therapy Assistants (PTAs)
- Occupational Therapy Assistants (OTAs)
- Speech Therapy Assistants (STAs)
- Certified Home Health Aides (CHHAs)
These professionals ensure the day-to-day execution of care. They provide essential support to patients. This allows eval-level clinicians to focus on higher-level planning and oversight.
Why Does This Distinction Matter?
Understanding the difference between eval-level and non-eval level staff is essential to understanding the disciplines in their entirety. Agencies must ensure that only eval-level clinicians perform evaluations and adjust treatment plans. Likewise, they must deploy non-eval level clinicians appropriately.
What Are the Disciplines of Home Health Care?
Home health services focus on restoring patient independence after illness, injury, or surgery. Unlike in-home hospice, home health is often short-term and aimed at improving a patient’s condition. The following disciplines are essential to any home health agency’s success.
Skilled Nursing: What Do RNs & LVNs Do in Home Health?
Registered Nurses (RNs) and Licensed Vocational Nurses (LVNs) are at the center of home health care. RNs and LVNs:
- monitor chronic conditions
- educate patients and families
- administer medications
- provide direct clinical services like wound care and injections
Nurses also serve as the primary coordinators, ensuring the care plan is followed and adjusted as needed. Without strong nursing staff, a home health agency cannot operate effectively.
Physical Therapy: What PTs Do in Home Health
Physical therapists (PTs) play a vital role in rehabilitation. They help patients recover strength and mobility after:
- onset or exacerbation of the disease process
- surgery
- strokes
- falls
A good PT program can prevent hospital readmissions, a key metric for agency success. PTs work closely with nurses and occupational therapists to ensure patients regain as much independence as possible.
Occupational Therapy: What OTs Do in Home Health
Where physical therapy focuses on movement, occupational therapy (OT) ensures patients can safely perform daily activities. OTs help patients relearn or adjust to everyday tasks like:
- dressing
- bathing
- cooking
- cleaning
They do this by teaching adaptive techniques or introducing assistive devices. For agency owners, offering OT can significantly improve patient outcomes and satisfaction scores.
Speech-Language Pathology: What SPLs Do in Home Health
Speech therapists (SLPs) address communication disorders and swallowing difficulties. These are common issues in stroke patients and those with neurological conditions. Their work is crucial for improving patient independence and quality of life.
Agencies that provide SLP services can serve a broader range of patients, making them more competitive in the market.
Medical Social Services: What Social Workers Do in Home Health
Social workers help patients and families navigate financial, emotional, and logistical challenges. Their responsibilities can include:
- connecting families with community resources
- assisting with advance care planning
- providing much-needed emotional support
- Identifying and handling unsafe or abusive living environments
This discipline is often overlooked, but it is essential for holistic patient care.
Certified Home Health Aides: What CHHAs Do in Home Health
Home health aides (CHHAs) assist patients with tasks like:
- Bathing
- Dressing
- Light housekeeping
- Light cooking
While CHHAs can appear similar to occupational therapists, they play very different roles.
Occupational therapists (OT) are more focused on teaching and educating a patient on how to go about daily life. For example, if a patient is in a wheelchair, an OT would educate that patient with adjusting to their new living situation. This could look like training the patient on how to use a cane.
A CHHA, on the other hand, does not provide education or medical care. A CHHA’s role is more focused on ensuring patient comfort and safety. Agencies that prioritize well-trained CHHAs often see higher patient satisfaction and lower hospital readmission rates.
What Is the Best Way to Manage Home Health Disciplines in My Agency?
Running a successful home health agency requires more than just hiring staff. Proper management of home health field staff includes:
- proper onboarding
- credential maintenance
- care coordination
- patient focused care
- focus on compliance
By building a strong clinical team, agencies can provide comprehensive and compassionate care while meeting regulatory requirements.
At The Home Health Consultant, we specialize in helping agencies structure their internal processes, ensure compliance, and optimize operations.
For more information on your home health or hospice agency’s staff, check out our article on ‘Staff Resumé Must-Haves’ by clicking below.
With the right approach, you can build an agency that not only meets industry standards but also makes a meaningful difference in the lives of your patients and their families.
*This article was written in consultation with Mariam Treystman.
*Disclaimer: The content provided in this article is not intended to be, nor should it be construed as, legal, financial, or professional advice. No consultant-client relationship is established by engaging with this content. You should seek the advice of a qualified attorney, financial advisor, or other professional regarding any legal or business matters. The consultant assumes no liability for any actions taken based on the information provided.
Topics:
