The 6 Best Visiting Nurse Services of 2020

Skilled home health care options for 2020

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First Look

One day you or a loved one might need a visiting nurse for medical care in your home. In the United States, it’s a relatively common experience. According to the Centers for Disease Control and Prevention (CDC), about 4.5 million Americans are treated in their homes every year by more than 12,000 home health care agencies. Many people prefer the ease of having medical care in their own home, rather than having to travel to a hospital or doctor's office.

When the time comes, you’ll need to do some research to find a visiting nurse service that fits your personal needs. With that in mind, we reviewed over 40 top home health care companies to find the best options for visiting nurses, for a variety of needs. Read on to see who made the cut.

Our Top Picks

Best Overall: AccentCare

AccentCare

AccentCare

Pros
  • Programs for chronic conditions including congestive heart failure (CHF), COPD, diabetes, and dementia

  • Specialized programs, including behavioral health and stroke

  • Tele-monitoring program for early intervention

Cons
  • Potential for confusion because some locations have different names

  • Website’s location search page is not accessible directly from the home page

We selected AccentCare as the best overall provider of skilled home health care based on its accessibility (there are over 165 locations) and performance ratings that are above industry standards. In 2019, AccentCare received a 4.8-star overall quality rating from the CMS (Centers for Medicare and Medicaid Services). All of AccentCare's agencies are CHAP-accredited (Community Health Accreditation Partners) and have earned an overall 4.6-star quality rating and recognition from the We Honor Veterans program.

AccentCare treats over 140,000 patients a year. Along with skilled home health care and private duty nursing, it offers hospice care, personal care services, and care management.

AccentCare also uses technology to supplement visiting nurse home care visits with tele-monitoring that can deliver biometric data (blood pressure, pulse, blood glucose, etc.) in close to real-time to keep the medical support team informed and ready to take action if necessary.

According to data and analytics company LexisNexis Risk Solutions, AccentCare is the fifth largest provider of skilled home health in the U.S.

Best National Presence: Kindred Healthcare

Kindred Healthcare

Kindred Healthcare

Pros
  • Toll-free, 24/7 help line staffed with registered nurses to help identify appropriate care options

  • Search by State website feature makes it easy to see exact locations

  • 140 Kindred at Home locations were named to the HomeCare Elite list of the most successful U.S. home care providers

Cons
  • Kindred’s “Quality Innovation and Responsibility” report on key clinical and quality measures hasn’t been updated since 2018

  • Each location has its own insurance contracts, so coverage will vary by location

With nearly 700 sites in 41 states, Kindred Healthcare gets our nod for having the best national presence for visiting nurse services. According to LexisNexis Risk Solutions, Kindred Healthcare is the largest provider of skilled home health in the U.S. and the second-largest hospice provider. It has 45,000 employees and serves 150,000 patients each day.

Although it supports people of all ages, many of Kindred’s home services are focused on the aging population. Kindred at Home offers a variety of services, including skilled nursing, palliative care, cardiac care, dementia and Alzheimer’s care, pulmonary care, orthopedic care, and stroke and brain injury care. In addition to Kindred at Home, the company also operates transitional care hospitals, inpatient rehabilitation hospitals, and subacute units.

Kindred’s toll-free number has knowledgeable agents who can direct you to the nearest location that offers the services you need.

Best for Post-Operative Assistance: Elara Caring

Elara Caring

Elara Caring

Pros
  • Also offers hospice care and behavioral health services

  • Delivers proactive customized care (CAREtinuum)

Cons
  • Only available in 16 states

We selected Elara Caring as the best visiting nurse service for post-operative assistance based on its focus on recovery and rehabilitation, including nursing, physical therapy (PT), occupational therapy (OT), and speech therapy

Their CAREtinuum program, a system that uses predictive analytics to identify patients at risk, sets it apart from other companies for post-operative assistance. For example, Elara’s CAREtinuum Fall Risk Program patients are 72% less likely to return to the hospital due to falling.

Elara Caring offers a wide range of in-home clinical services, treating more than 65,000 patients a day. Along with skilled home health, Elara Caring offers hospice care, personal care, and behavioral care. Its behavioral care supports a wide range of conditions, including depressive/anxiety disorders, schizophrenia, bipolar, and other disorders.

Even though Elara only has locations in about one-third of the states in the U.S., LexisNexis Risk Solutions ranks Elara Caring the ninth largest provider of skilled home health in the country.

Best Technology: Encompass Home Health & Hospice

Encompass Home Health & Hospice

Encompass Home Health & Hospice

Pros
  • Locations in 39 states

  • Variety of programs to enhance skilled nursing, including skilled therapy, balance and fall prevention, and orthopedics

Cons
  • Not all locations offer hospice

  • Website offers Spanish translation, but only portions of the site are available in Spanish

We chose Encompass Home Health & Hospice for its easy-to-use technology that makes a customer’s online experience simple, with comprehensive information quickly available. Its online software streamlines each step, from referral processing to scheduling to management of physician orders, to optimize patient care and attention. This connection between patients, doctors, and in-home care providers makes processes easier and more transparent.

In addition, Encompass’ web portal provides one-stop access to manage diagnoses, patient history, medications, and plan of care. Encompass is also able to deliver better care for patients through predictive analysis, to identify potential risks. According to LexisNexis Risk Solutions, Encompass is the nation’s fourth largest provider of Medicare-certified skilled home health services.

Best for Specialized Care (chronic conditions): Interim Healthcare

Interim Healthcare

Interim Healthcare

Pros
  • Interim's proprietary HomeLife Enrichment is designed to promote a more engaged existence at home for patients and their families

  • Interim HealthCare University offers caregivers more than 300 Continuing Education Units

  • Available in nearly 50 states

Cons
  • Independently owned franchises allow for noted inconsistencies in customer satisfaction

We chose Interim HealthCare for its focus on home care for adults or children with special needs due to an injury or illness. This could include caring for someone who is developmentally delayed or a patient who needs to use a feeding tube. Specialized offerings include home care for arthritis, (MS) multiple sclerosis, joint replacement, hypertension, paraplegia and quadriplegia, TBI (traumatic brain injury), and pediatric care.

Interim also offers many specialized interactive online training courses and live webinars for specific types of care such as dementia. Interim HealthCare University provides extensive training resources available for free to employees, including over 300 lessons for both clinical and non-clinical staff and management in areas such as fall prevention, home care technology, and transitioning from a facility.

Interim’s HomeLife Enrichment program looks beyond basic needs to address the mind, spirit, and family as well as the body. The focus is to add purpose, dignity, and self-worth to basic safety and independence.

Interim HealthCare has a network of more than 320 independently owned franchises (employing nurses, aides, therapists, and other health care personnel) serving about 173,000 people every year.

Best for Hospice (End-of-Life Care): Heartland Hospice Care

Heartland Hospice Care

Heartland Hospice Care

Pros
  • Advance directive not required in order to begin providing hospice care

  • Fully accredited by ACHC, the Accreditation Commission for Health Care

  • Provides employees with training programs, continuing education, and tuition assistance

Cons
  • HCR ManorCare spent six weeks in Chapter 11 bankruptcy in 2018

Heartland Hospice Care is the largest not-for-profit hospice agency in the U.S. and the third largest provider for hospice care in the U.S., according to LexisNexis Risk Solutions. We chose it for its specific focus on providing the comfort and quality of life that hospice is known for, with the added benefit of a fast and effective response to patient discomforts such as pain, shortness of breath, and anxiety.

Heartland Hospice has locations in 27 states, offering services such as pain and symptom management therapies. Heartland can provide hospice care in any “home”—including a private home, an assisted living facility, or a skilled nursing center.

While some hospices require a do not resuscitate (DNR) order before admittance, Heartland doesn’t. In situations where Medicare will be paying for the care, a DNR is not required because the care is considered palliative (comfort, instead of care to cure your condition).

Heartland Hospice develops talent by offering its employees training and education opportunities at many of its locations. For example, its nursing assistant training programs include assistance with the cost of taking a state certification exam.

Heartland Hospice also offers bereavement services, advanced planning services, and the possibility to grant funds to help offset financial burdens created by terminal illness.

What Is a Visiting Nurse Service?

A visiting nurse service is a home health service that provides in-home skilled medical care. If your doctor prescribes home health care, your options include visiting nurse services provided by a social service agency, a hospital, or a private company. Visiting nurses help perform rehabilitation and recovery from a surgical procedure, an injury, or an illness to patients of all ages.

What Types of Services Do Visiting Nurses Typically Provide?

A visiting nurse is a skilled medical professional, usually a registered nurse, who oversees all aspects of the medical care you receive at home, as ordered by a physician.This might include evaluating your medical condition and health needs, monitoring your vital signs and assessing for risk factors, and administering medication. A visiting nurse is also trained to care for specific conditions such as COPD, diabetes, dementia, and Alzheimer’s, change dressings for surgical incisions or wounds, and provide hospice care.

When your visiting nurse leaves, they make sure that you and your caregivers have the necessary information and supplies to support the plan of care.

Is a Visiting Nurse the Same as a Home Health Aide?

A visiting nurse is a skilled medical professional, while a home aide typically has limited formal medical training and provides services such as help with personal hygiene, meals, and transportation.

Does Medicare Cover Visiting Nurse Services?

If you have Medicare, home health care, such as that provided by a visiting nurse, is covered 100% by Medicare when your doctor certifies you meet the required guidelines.

If you do not have Medicare, consult with your healthcare insurance to determine your policy parameters for coverage, including necessary copayments, if any.

Hospice (including a visiting nurse, if one is on your team) is covered by Medicare, Medicaid, the Veteran’s Health Administration, and private insurance. Although most hospice care is provided at home, it is also available at hospitals, assisted living facilities, nursing homes, and dedicated hospice facilities.

Always double-check coverage with your insurance provider and ask the visiting nurse service if they accept your insurance plan.

How We Chose the Best Visiting Nurse Services

For this ranking, we looked at more than 40 home health providers. The primary criteria were the number of locations and national footprint, so the ranking would be useful to a large number of people. In addition to reviewing companies' areas of expertise, we also looked at their website interface, navigation, and usability and how they are ranked in areas such as quality care and patient satisfaction by services such as the U.S. government’s Centers for Medicare and Medicaid Services (CMS) Home Health Star and Home Health Compare.

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