Corporate HistoryCorporate History

A local health provider and community partner for A local health provider and community partner for over 20 years. over 20 years. – WellCare Health Services started in 1989, providing non-WellCare Health Services started in 1989, providing non-

skilled services to our patients in New Hanover county. skilled services to our patients in New Hanover county. – In 2000, G. Wayne Long purchased the certificate of need In 2000, G. Wayne Long purchased the certificate of need

for Home Health from NHRMC and became WellCare for Home Health from NHRMC and became WellCare Home Health, providing skilled services. Home Health, providing skilled services.

Industry leader and nationally recognized for quality Industry leader and nationally recognized for quality of care.of care.– #8 Home Care agency in North Carolina according to CMS #8 Home Care agency in North Carolina according to CMS

data.data.– Leader in Southeastern North Carolina as the one of the Leader in Southeastern North Carolina as the one of the

top 4 providers, by volume, in our 12 county service area.top 4 providers, by volume, in our 12 county service area.

Relevant Corporate Relevant Corporate Statistics:Statistics:

• Any given day we serve over 1000 Any given day we serve over 1000 patientspatients

• 500 employees500 employees

• 120,000 visits per year120,000 visits per year

• 24 hours/day clinical coverage24 hours/day clinical coverage

• 7 days/week licensed admission staff 7 days/week licensed admission staff

• Specialized credentials & programsSpecialized credentials & programs

Locations & Areas ServedLocations & Areas Served

• 7 office locations in a 12 county coverage 7 office locations in a 12 county coverage area:area:

– New Hanover : Ashton & 17New Hanover : Ashton & 17thth Street locations Street locations – Bladen : Whiteville locationBladen : Whiteville location– Brunswick : Supply locationBrunswick : Supply location– Columbus : Elizabethtown locationColumbus : Elizabethtown location– Pender : Burgaw locationPender : Burgaw location– Onslow : Jacksonville locationOnslow : Jacksonville location– Wayne : Goldsboro locationWayne : Goldsboro location– Service coverage also provided in Duplin, Sampson, Service coverage also provided in Duplin, Sampson,

Jones, Cumberland and RobesonJones, Cumberland and Robeson

Home Care ServicesHome Care Services• Personal Care ServicesPersonal Care Services• CAP (Community Alternative Program)CAP (Community Alternative Program)

– CAP/C (Children)CAP/C (Children)– CAP/DA (Disabled Adults)CAP/DA (Disabled Adults)– CAP/MRDD (Mental Retardation/Developmental CAP/MRDD (Mental Retardation/Developmental

Disabilities)Disabilities)

• EPSDT (Early, Periodic, Screening, Diagnosis & EPSDT (Early, Periodic, Screening, Diagnosis & Treatment) for children Treatment) for children

• PDN (Private Duty Nursing)PDN (Private Duty Nursing)• Private PayPrivate Pay• Geriatric Care ManagementGeriatric Care Management• Stay at Home ServicesStay at Home Services• Voice Care Voice Care

PCS QualificationsPCS Qualifications• Program is administered by MedicaidProgram is administered by Medicaid• Up to 60 hours/month Up to 60 hours/month • Maximum 3.5 hours /dayMaximum 3.5 hours /day• Must have blue Medicaid cardMust have blue Medicaid card• Service must be provided in client’s homeService must be provided in client’s home• Ordered by primary care physicianOrdered by primary care physician• Some pregnant women with Medicaid may qualifySome pregnant women with Medicaid may qualify• Client must qualify by having at least 2 deficits Client must qualify by having at least 2 deficits

out of the 6 different ADLs (Activities of Daily out of the 6 different ADLs (Activities of Daily Living) listed below:Living) listed below:– BathingBathing– DressingDressing– AmbulationAmbulation– EatingEating– ToiletingToileting– Incontinence CareIncontinence Care

CAP & MRDD QualificationsCAP & MRDD Qualifications

• Programs funded by Medicaid Programs funded by Medicaid

• Case management and care plan Case management and care plan approval by the local county CAP or LME approval by the local county CAP or LME officeoffice

• Provide PCS, Home and Community Provide PCS, Home and Community support and Respitesupport and Respite

• Service must be provided in client’s homeService must be provided in client’s home

• Ordered by primary care physicianOrdered by primary care physician

Private Duty Nursing QualificationsPrivate Duty Nursing Qualifications

• Medicaid, Private Insurance, Private Medicaid, Private Insurance, Private PayPay

• Can be up to 24 hours/dayCan be up to 24 hours/day

• LPN or RN will provide the careLPN or RN will provide the care

• Services ordered by MD or if private Services ordered by MD or if private pay, then services requested by pay, then services requested by familyfamily

Home Health ServicesHome Health Services• NursingNursing

– PsychiatricPsychiatric– PediatricsPediatrics– Certified Wound SpecialistsCertified Wound Specialists– Cardiac (Heart Nurse)Cardiac (Heart Nurse)– Incontinence Care (Diaper service for Incontinence Care (Diaper service for

adults/children)adults/children)– Infusion Therapy (including chemotherapy)Infusion Therapy (including chemotherapy)

• Physical TherapyPhysical Therapy• Occupational TherapyOccupational Therapy• Speech TherapySpeech Therapy• Social WorkSocial Work• Nurse AideNurse Aide

Payor SourcesPayor Sources

• MedicareMedicare

• MedicaidMedicaid

• Private InsurancePrivate Insurance– Co-paysCo-pays

• Long Term Care InsuranceLong Term Care Insurance

• Private PayPrivate Pay

Fee ScheduleFee Schedule• Home Health (Medicare, Private Insurance, Home Health (Medicare, Private Insurance,

Workers Comp)Workers Comp)• PCS/Plus(Medicaid)PCS/Plus(Medicaid)• CAP/C/D/MRDD(Medicaid)CAP/C/D/MRDD(Medicaid)• EPSDT (Medicaid)EPSDT (Medicaid)• VA (Veterans Administration)VA (Veterans Administration)• Private Duty Nursing (Private Pay)Private Duty Nursing (Private Pay)

– LPN $40/hrLPN $40/hr– RN $45/hr RN $45/hr – Aide $18/hr, Weekend $20/hr, Holiday $27/hrAide $18/hr, Weekend $20/hr, Holiday $27/hr

• Pill Tray Fills (Private Pay)Pill Tray Fills (Private Pay)– $45/pill fill $45/pill fill

• Voice Care (Private Pay)Voice Care (Private Pay)– Install $25Install $25– Monthly $35Monthly $35

How do I get the service?How do I get the service?

• Call your doctor and ask for a referral Call your doctor and ask for a referral for Home Health orfor Home Health or

• Call our Intake Dept at 362-9405 or 1-Call our Intake Dept at 362-9405 or 1-888-815-5310 and we will take care of 888-815-5310 and we will take care of it for you.it for you.

• You don’t just have to be coming home You don’t just have to be coming home from the hospital to have a need. from the hospital to have a need.