DISEASE MANAGEMENT FOR DIABETES CARE

Without effective self-management, diabetes can spiral into debilitating and even life-threatening conditions. If left untreated or poorly treated, diabetes can increase a risk for heart disease, stroke, high blood pressure, kidney disease, neuropathy, wounds, and blindness.

Skilled nursing care and disease management is vital to patients who may require additional care at home, specifically those with diabetic wounds or foot ulcers, new to insulin therapy, underlying disease processes that may contribute to poor diabetic control, or dealing with multiple new medications or frequent hospital admissions. 

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Diabetes is a chronic indicator that the pancreas is not producing enough insulin resulting in high blood sugar.  Well-managed, diabetes can simply mean adapting diet and medication, and monitoring blood sugar levels.

Diabetes Care

  • Assesses and monitors patient to ensure stability and reduce risks of complications.
  • Educates patient and family on understanding the disease and how it impacts health and well-being.
  • Educates on how to monitor the disease and what to do when levels aren’t where they should be.
  • Promotes medication management for all medication, not only diabetic medication, by focusing on proper usage to reduce medication errors and gain by better blood sugar control.
  • Establishes a plan on testing blood sugar levels before, during, an after exercise to ensure patient is exercising within safe limits.
  • Actively engages patient toward self-care and self-monitoring including understanding signs/symptoms, red flags and treatment for hypoglycemia/hyperglycemia; and identifying signs and symptoms that require emergency medical attention.
  • Offers nutritional assessment and provides instructions on a healthy diet.
  • Stresses the importance of regular foot exams to avoid complications and provides wound care, when necessary.

Improve blood sugar levels.

Improve overall health.

Reduce fatigue and improve energy level.

Reduce risk of vision loss.

Reduce risk of kidney disease.

Decrease dementia risk.

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Home health care provides necessary clinical care to an individual in their home. It refers to clinical services and support provided intermittently for those challenged by illness, age, disability; or those who are recovering from surgery, or an injury.

For Medicare recipients, a physician must certify that an individual needs home health care, medically necessary services to treat, rehabilitate, sustain or restore home-bound adults and seniors to their optimal health and in the setting where they feel most comfortable.

This includes skilled nursing, disease management, physical, occupational and speech therapy. 

Medicare

Original Medicare Part A typically covers home care services at 100 percent, provided the services are ordered by your surgeon, are performed by skilled professionals and are medically necessary. In addition, the patient must be essentially “homebound,” meaning that it is difficult for the patient to perform activities outside the home, except to go to doctor’s appointments.

Medicare enrollees may be eligible for skilled nursing care, disease management and in-home therapy as prescribed by a physician.  

Private Insurance

Most insurance plans provide some coverage for home care services. But plans, deductibles and out-of-pocket expenses will vary. These plans generally follow the same rules as Medicare regarding payment for long-term care services. If they do cover long-term care services, it is typically only for skilled, short-term, medically necessary care.

Like Medicare, the skilled nursing stay must follow a recent hospitalization for the same or related condition and is limited to 100 days. Coverage of home care is also limited to medically necessary skilled care. Most forms of private insurance do not cover custodial or personal care services at all. Your plan may help you pay for some of the copayments or deductibles. It is best to contact your home care provider of choice prior to your surgery to see if it is in-network with your insurance company. You will also want to contact your insurance company to determine if any pre-authorization is required for home care services.

Short Term and Long-Term Disability Insurance

Disability insurance may pay all or a portion of home health and home care services. It is best to contact your policy provider to determine your coverage.

Private Pay