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Tag: Care
North Carolina Individual Health Care Insurance
If you don’t get the benefit of group medical insurance from your employer, or the insurance offered is extremely limited, you can select an individual policy and can get fee-for-service, Health Maintenance Organization (HMO), or PPO protection. But you should keep in mind that individual plans may not offer benefits as broad as those in-group plans. If you’ve a non-cancelable policy, you can keep it as long as you keep paying the monthly premium. The insurance provider can raise the cost, but can’t cancel your policy. Before picking a medical insurance policy, be confirmed what it will pay for and what it won’t. To know about individual medical insurance plans, you can call insurance corporations, HMOs, and PPOs in your community, or consult an agent.
In North Carolina, high quality health care is available all across the state. But it comes at a price, as physician visits, laboratory work and hospital stays are expensive. Individual medical insurance can solve this problem providing a financial life belt to needy individuals so that they can pay their medical bills.
Apart from medical care, individual medical insurance plans also cover some related types of insurance, especially when you are single: individual health care, individual long and short term disability, temporary medical insurance, long term care and dental insurance. These plans can help you in different situations when you badly need them.
Individual medical insurance gives you a sense of security and peace of mind. If you’ve a health care policy, you can sleep in peace with the knowledge that if something unfortunate happens, you won’t need to worry about financial help.
In North Carolina, a lot of licensed medical insurance corporations offer a wide variety of insurance policies for individuals and you can find one designed to meet your needs and budget. The plans are affordable because you select your coverage options from a menu.
The price of your health care policy depends on a number of factors, but it’s you who are in control of the premium by your choice of coverage options, deductibles and co-pays.
Arizonans Prepare to Opt Out of Health Care Reform
Health care reform hasn’t even passed yet and Arizona conservatives are putting together a ballot measure to allow citizens to 1)seek out and receive healthcare services that are otherwise legal, or 2)choose not to participate in any health care system of any type. This initiative, which is similar to other planned in two dozen other states, is backed by Steve Forbes. Forbes’ reasons are good; he wants to promote free enterprise.
But like all free enterprise advocates, he overlooks the fact that we don’t have free enterprise in health care now — we have a poorly functioning patchwork quilt of programs, in which the “free-est” enterprise is manifested by providers who abuse Medicare to line their pockets and by insurance companies who try not to pay claims. And if we opt out of what little we have, what does that do to the state?
And what about the patient — a.k.a. the customer?
I can see many unintended consequences for the state if this measure should get on the ballot and pass:
1)it could be tied up in the courts for years, while the Supreme Court gets ready to decide whether this is a case in which the wishes of the state trump Federal law. During that time, millions are spent by insurance companies to try to protect their businesses and hedge their bets, rather than spent on delivering care conscientiously;
2)it could undermine what little reform is left in the proposed health insurance reform legislation, because insurance companies would have to deal with the uncertainties of having to insure everybody and not knowing who will opt out;
3)It would allow the healthy people to opt out, leaving the sick in the insurance pool, which would
4)Lead to the departure of insurers from the state because they can’t make any money insuring only the sick;
5)It could drive up premiums for people who want to be insured because they are realistic and know they are likely to get sick at some point in their lives, and limit their choices;
6)It could create a population that is unhealthy, unproductive, and infecting or affecting the rest of us;
7)It could cause even more people to go to the emergency rooms for primary care, driving up costs further.
I don’t know whether to laugh or cry over the shortsightedness of all this. I realize many Americans don’t like the current version of health insurance reform that may or may not pass (depending on the outcome of the Massachusetts election), but what do they propose to put in its place?
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Democratic Governors Voice Concern Over Health Care Bill
Republican governors are not alone in being concerned about what the proposed health care legislation might mean for their already overstrained budgets: Democrats share the same worries. “We’ve got concerns,” Gov. Jack Markell of Delaware said in an interview Wednesday, hours before getting elected as the chairman of the Democratic Governors Association. “And we’re doing our best to communicate them. We understand the need to get something done, and we’re supportive of getting something done. But we want to make sure it’s done in a way that state budgets are not negatively impacted.”
From the start, Republican governors have been more outspokenly critical about the health care legislation – in particular, the bill proposed by Harry Reid of Nevada, the Senate majority leader – which they said would saddle them with millions of dollars in additional Medicaid costs as insurance coverage is expanded. At their own meeting two weeks ago in Texas, Republican governors declared Democrats felt the same way as they did, but were less apt to say it out of loyalty to President Obama.
Asked about that, Mr. Markell responded: “Perhaps we’ve expressed some of our concerns less publicly. But I believe all governors are certainly concerned about what the potential impact is of some of these bills.”
Mr. Markell said that there was no division between governors and the administration on the need to get some sort of health care bill through; he said that he was reminded of the need in conversations with small businesses struggling with health care costs and constituents who have been unable to get health care coverage. He said his concern was some of the bills being considered would do that by shifting some of the costs to the state – but said he remained confident, after conversations with the White House, that would not be the case.
Whatever the outcome of the health care deliberations, Mr. Markell said he did not believe it would affect the electoral outcome for governors in 2010, a year in which 19 gubernatorial seats currently held by Democrats are on the ballot. The key issues, the governor said, were jobs and the economy.
And to that regard, Mr. Markell said that he was hopeful that the White House and Congress would dispose of the health care deliberations and move on to discussing some sort of jobs creation legislation.
“Right now I believe we need to be focused really significantly on the state level on jobs and on the economic climate overall,” he said. Asked if Mr. Markell thought Mr. Obama and Congress were spending too much time on health care at the expense of the economy, he responded: “Well I feel it would be terrific if they could finish health care and move on.”
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Extending health care to more kids
OneWorld Community Health Center is looking for 6,000 kids.
The agency that generally provides health care to the underserved has received $706,264 from the federal government to create a program to enroll thousands of children in either of two government insurance programs for low-income children.
Many metro-area children are eligible but aren’t enrolled because their families don’t know the programs exist or don’t know their kids could qualify, said Andrea Skolkin, chief executive officer of OneWorld. That means some of those children are going without health care or are getting far less than they could.
OneWorld’s goal is to enroll at least 6,000 children. The agency’s outreach effort has just begun.OneWorld will place staff members in day care centers, schools, after-school programs, churches, food pantries, organizations and other places.
“We want to be where people are versus making people come to us,” Skolkin said.
They will contact families at those sites and determine whether they have children who qualify but aren’t enrolled in Medicaid or the state’s Children’s Health Insurance Program.
The staff members will have laptops to take down information and scanners to scan in citizenship documents and proof of Nebraska residency. Children must be citizens to receive the health care benefits.
The agency also will take referrals. For information, call 502-8888.
OneWorld, based in the Livestock Exchange Building, 4920 S. 30th St., has hired a director and will employ five full-time staffers for the program. OneWorld also has a clinic in Plattsmouth.
President Barack Obama this year allocated $40 million to agencies in 42 states and Washington, D.C., for programs to conduct enrollment efforts over the next two years.
Through a competitive process, OneWorld was one of 69 entities to receive money. Iowa doesn’t have a program among the 69. An additional $40 million will be distributed in 2012.
Enrollment among children in Medicaid and the Children’s Health Insurance Program has gradually risen in Iowa and Nebraska. The economy has worsened and awareness of the programs has broadened, spokesmen in Iowa and Nebraska say.
A child qualifies for Medicaid if his family’s annual income is at or somewhat above the federal poverty level, which is $18,310 for a family of three.
Qualifying for CHIP isn’t as stringent. In Iowa, the state raised the CHIP ceiling this year to 300 percent of the federal poverty level, or $54,930 for a family of three. Nebraska raised its income ceiling for CHIP from 185 percent this year to 200 percent, or $36,620 for a family of three.
The Nebraska Department of Health and Human Services has estimated there may be close to 15,000 eligible children who aren’t enrolled. The Iowa Department of Public Health estimated there could be as many as 38,000 children who aren’t covered.
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Alexander, Corker criticize passage of Senate health care bill
Tennessee Sen. Lamar Alexander released a statement this morning saying the Senate-approved health care bill is riddled with “sweetheart deals” that will increase taxes and damage education.
Fellow Republican, Sen. Bob Corker, said the bill is “fundamentally flawed” and called for bipartisanship.
The bill, approved on a 60-39 vote, must still be merged with legislation passed by the House.
“The Senate health bill will prove to be an historic mistake if this or anything like it is ultimately signed by the president,” said Alexander, who is chairman of the Senate Republican Conference.
“Congress set out to reduce health care costs to Americans and Democrats have managed to do the exact opposite. Their written-in-secret bill will increase health insurance premiums, raise taxes, cut Medicare and dump millions of Americans into Medicaid.
“For Tennessee, Medicaid’s expansion and the bill’s ‘sweetheart deals’ would cost our state more than $750 million over five years when fully implemented, forcing tax increases or damaging higher education—or both.
“Instead, we should start over and move step-by-step to reduce health care costs using the steps that Republicans have repeatedly proposed: let small businesses pool resources for health insurance; allow purchasing of health insurance across state lines; end junk lawsuits against doctors; eliminate waste, fraud, and abuse; expand health savings accounts; and promote wellness and prevention.”
Corker said in his statement, “I’ve spent almost three years and countless hours in bipartisan meetings working toward reforms that would enable all Americans to access affordable, private health insurance.
“I wanted a bipartisan health care reform bill that would stand the test of time. Instead, we were forced to vote on a 2,000-plus page, fundamentally flawed, partisan bill that expands Medicaid by sending $25 billion in unfunded mandates to states, takes $464 billion away from Medicare and leverages it to create a new entitlement, uses budget gimmickry to hide its true cost; increases federal costs, and actually causes Americans to face increased taxes and premiums.
“It’s my sincere hope that Congress returns in 2010 more willing to work in a bipartisan fashion, and my work on financial regulatory reform gives me hope that that’s possible.”
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What is home health care and why do I need it?
What is Home Health?
Home Health Care is skilled nursing care and certain other health care services that you receive in your home for the treatment of an illness or injury. This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).
This could also include physical, occupational, and speech therapy. Medicare Part A will cover home health expenses at 100%. Private duty home care is not covered by Medicare and is paid for by the individual receiving the service. This type of service usually includes housekeeping and other routine personal care services (cooking, laundry, and shopping, and live in care givers.).
***FREE OF CHARGE***if Medicare approved
Call or email now to see if you are Medicare/Medicaid Qualified
If you or someone you know needs help with
1. Diabetes
2. High Blood Pressure
3. Wound Care
4. Arthritis/Joint Pain
5. Any Chronic Illness or Disease
We Also Provide:
1. Light House Keeping/Laundry Services
2. Senior Transportation
3. Meal Preparation
4. And Much More At No Charge to YOU!!
CLICK LINK BELOW TO WATCH VIDEO ABOUT HOME CARE http://www.tahc.org/associations/1626/files/TAHC new VO.wmv
II. How to get Medicare Home Health Care:
• Your doctor must determine you need medical care in your home.
• You will need at least one of the following services: skilled nursing care, physical or speech therapy.
• You must be homebound. Homebound means that leaving your home is a considerable and taxing effort
III. What qualifies as Skilled Home Care Services?
• Wound Care for pressure ulcers or surgical wounds
• Physical Therapy (fall prevention, recent fractures, recent stroke, TIA’s, endurance issues, or transfer training)
• Occupational Therapy (recent strokes, ADL training-such as dressing, grooming, and bathing)
• Speech Therapy (swallowing issues, aspiration, recent stroke, pneumonia)
• Patient and Caregiver education
• IV Therapy
• Injections (diabetes, B-12)
• Medication Management
IV. Home Health vs. Hospitalization:
• In many cases home health care services may be appropriate to prevent an individual from being hospitalized.
• Most patients and their families prefer to stay at home rather than be placed in the hospital or skilled nursing facility when their condition allows them to remain at home.
• Home health care is usually less expensive and in some cases just as effective as care in a hospital or skilled nursing facility.
Home health care assists a person in their recovery from an illness, accident, surgery, or change in their medical condition. Professional health care and rehabilitation services are delivered in a person’s home environment under the direction of their personal physician.
Services offered include:
Skilled Nursing
24/7 Availability
Physical Therapy
Wound/Ostomy Care
Occupational Therapy
Infusion Therapy
Speech Therapy
PT/TNR results in home
Home Care Aides
Pain Management
Medical Social Workers
Rehabilitation
Who pays for home health care?
If you are Medicare eligible and qualified for care, there is no out of pocket cost to you. Home care can also be paid for by many private insurances or a variety of public programs.
To qualify for Medicare home health services, there are five basic requirements:
1. Your physician must determine that you need home health care services
2. Your own physician must write the orders for home health services, and oversee your care
3. You must need skilled services that are provided by a nurse or therapist
4. Your physician must determine that you are homebound, requiring considerable effort and help to leave home
Because benefits and requirements can vary, we can help you check with payors about your specific benefits, even before beginning services, so you can have this information at the start of care.
-Medicare pays 100% of the cost for home health care for individuals 65 years of age or over or permanently disabled.
-Private insurance will pay for home health care. Benefits vary per policy and verification of benefits is required.
-Medicaid pays 100%. Pre-authorization is required.
-Workers Compensation Insurance.-Private Pay.
We can HELP you in a number of ways.
· Patient specific health data with observations by a professional nurse are reported to the physician.
Helping patients and their families to understand and follow physician’s orders regarding nutrition, special diets, medications, and general nursing care:
· Assisting with home management of catheters and feeding tubes.
· Giving injections ordered by the physician and teaching patients and family the proper techniques for doing so.
· Helping patients restore strength and independence through physical therapy exercises,
Educating diabetic patients on how to manage diet, insulin, and other health related measures. Enabling the patient with ostomy how to resume a full, active life.
· Assisting patients with bathing and personal grooming (ADLS).
Paloma Home Health Agency Inc.
Phone: 972-346-2013
Email: palomahomehealth@hotmail.com
Frequently asked questions about home health care
Q: What is home health care?
A: Home health care is a service that permits patients to receive personalized health care, maintaining their quality of life in the privacy and comfort of their homes.
Q: Why home health care?
A: Home health care is a cost-effective option for receiving health care services. Returning to one’s home and family can quicken recovery and improve the quality of life for both patient and family or caregiver.
Q: Who pays for home health care?
A: Most health insurance companies, HMOs, PPOs and Workers Compensation cover home health care. In addition, Medicare and Medicaid pay for home care services. Some insurance providers do not cover all home health services. Our staff will verify health coverage for the patient.
Q: What criteria are required for Medicare to approve services?
A: The following criteria are used to meet Medicare requirements:
• The patient is a Medicare recipient.
• The patient must be homebound. This is defined by Medicare as “normal inability to leave the home and that leaving the home requires considerable and taxing effort.”
• The skilled care must be medically necessary as determined by the physician.
Q: What if I have a problem at night or on the weekend?
A: We have registered nurses on call 24 hours a day, 7 days a week.
Q: Do I need a physician’s order for home health care?
A: Yes, all health care provided in the home occurs under direct order and supervision of the patient’s physician.
Q: What types of services can be provided at home?
A: Many medical conditions that previously required hospitalization can safely be treated in the home. Home care services may include but are not limited to:
Skilled Nursing:
• Observation and assessment of condition
• Patient and family education of disease process
• Management and evaluation of patient care plan
• Medication education and management
• Dressing changes
• Home safety education
• Wound care
• Catheter care
• Injections
• IV therapy
• Ostomy care
• Pain management
• Diabetic care
• Nutritional support
Assistance with Daily Living:
• Bathing/dressing
• Transfer/ambulation
• Light meal preparation
• Light housekeeping
• Grocery shopping
• Medication reminder
• Laundry
• Companionship/Conversation
• Reading/writing
• Pet sitting/walking
• Escort to appointments
• Live-ins
• Respite
• Exercise therapy assistance
Q: How does Paloma Home Health Care, Inc. ensure quality care in the home?
A: Providing continuous quality care to patients is paramount to all we do. All patients are given a patient satisfaction survey that is incorporated into our ongoing evaluation process to continually increase our patient satisfaction. New programs and processes are developed through our quality improvement team to promote favorable outcomes.
Q: How do I find out more about home health care?
A: Please call our office to learn more about how you can benefit more about the service, at 972 346 2013
Q: What services can Paloma Home Health Care, Inc. offer?
A: Our services include but are not limited to:
• Supportive Care Education of Disease Process
• Individual and Family Counseling
• Management and Evaluation of Patient Care
• Observation and Assessment
• Home Safety and Emergency Education
• Medication Education
• Assistance with ADLs
• Nutrition Education
• Restorative Therapy (Physical, Occupational and Speech)
Paloma Home Health Agency Inc. provides quality service to the elderly, sick, and disabled
Let us meet your everyday needs
Fact Sheets Home Health Care
Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.
More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.
At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services, home health care usually involves helping seniors recover from an illness or injury. That is why the people who provide home health care are often licensed practical nurses, therapists, or home health aides. Most work for home health agencies, hospitals, or public health departments that are licensed by the state.
How Do I Make Sure That Home Health Care Is Quality Care?
As with any important purchase, it is always a good idea to talk with friends, neighbors, and your local area agency on aging to learn more about the home health care agencies in your community.
In looking for a home health care agency, the following 20 questions can be used to help guide your search:
How long has the agency been serving this community? Does the agency have any printed brochures describing the services it offers and how much they cost? If so, get one. Is the agency an approved Medicare provider? Is the quality of care certified by a national accrediting body such as the Joint Commission for the Accreditation of Healthcare Organizations? Does the agency have a current license to practice (if required in the state where you live)? Does the agency offer seniors a “Patients’ Bill of Rights” that describes the rights and responsibilities of both the agency and the senior being cared for? Does the agency write a plan of care for the patient (with input from the patient, his or her doctor and family), and update the plan as necessary? Does the care plan outline the patient’s course of treatment, describing the specific tasks to be performed by each caregiver? How closely do supervisors oversee care to ensure quality? Will agency caregivers keep family members informed about the kind of care their loved one is getting? Are agency staff members available around the clock, seven days a week, if necessary? Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day? How does the agency ensure patient confidentiality? How are agency caregivers hired and trained? What is the procedure for resolving problems when they occur, and who can I call with questions or complaints? How does the agency handle billing? Is there a sliding fee schedule based on ability to pay, and is financial assistance available to pay for services? Will the agency provide a list of references for its caregivers? Who does the agency call if the home health care worker cannot come when scheduled? What type of employee screening is done?
When purchasing home health care directly from an individual provider (instead of through an agency), it is even more important to screen the person thoroughly. This should include an interview with the home health caregiver to make sure that he or she is qualified for the job. You should request references. Also, prepare for the interview by making a list if any special needs the senior might have. For example, you would want to note whether the elderly patient needs help getting into or out of a wheelchair. Clearly, if this is the case, the home health caregiver must be able to provide that assistance. The screening process will go easier if you have a better idea of what you are looking for first.
Another thing to remember is that it always helps to look ahead, anticipate changing needs, and have a backup plan for special situations. Since every employee occasionally needs time off (or a vacation), it is unrealistic to assume that one home health care worker will always be around to provide care. Seniors or family members who hire home health workers directly may want to consider interviewing a second part-time or on-call person who can be available when the primary caregiver cannot be. Calling an agency for temporary respite care also may help to solve this problem (see the Respite Care fact sheet for more information about these services).
In any event, whether you arrange for home health care through an agency or hire an independent home health care aide on an individual basis, it helps to spend some time preparing for the person who will be doing the work. Ideally, you could spend a day with him or her, before the job formally begins, to discuss what will be involved in the daily routine. If nothing else, tell the home health care provider (both verbally and in writing) the following things that he or she should know about the senior:
Illnesses/injuries, and signs of an emergency medical situation Likes and dislikes Medications, and how and when they should be taken Need for dentures, eyeglasses, canes, walkers, etc. Possible behavior problems and how best to deal with them Problems getting around (in or out of a wheelchair, for example, or trouble walking) Special diets or nutritional needs Therapeutic exercises.
In addition, you should give the home health care provider more information about:
Clothing the senior may need (if/when it gets too hot or too cold) How you can be contacted (and who else should be contacted in an emergency) How to find and use medical supplies and medications When to lock up the apartment/house and where to find the keys Where to find food, cooking utensils, and serving items Where to find cleaning supplies Where to find light bulbs and flash lights, and where the fuse box is located (in case of a power failure) Where to find the washer, dryer, and other household appliances (as well as instructions for how to use them).
A WORD OF CAUTION . . .
Although most states require that home health care agencies perform criminal background checks on their workers and carefully screen job applicants for these positions, the actual regulations will vary depending on where you live. Therefore, before contacting a home health care agency, you may want to call your local area agency on aging or department of public health to learn what laws apply in your state.
HOW CAN I PAY FOR HOME HEALTH CARE?
The cost of home health care varies across states and within states. In addition, costs will fluctuate depending on the type of health care professional required. Home care services can be paid for directly by the patient and his or her family members, or through a variety of public and private sources. Sources for home health care funding include Medicare, Medicaid, the Older Americans Act, the Veterans’ Administration, and private insurance.
Medicare is the largest single payer of home care services. The Medicare program will pay for home health care if all of the following conditions are met:
The patient must be homebound and under a doctor’s care; The patient must need skilled nursing care, or occupational, physical, or speech therapy, on at least an intermittent basis (that is, regularly but not continuously) The services provided must be under a doctor’s supervision and performed as part of a home health care plan written specifically for that patient The patient must be eligible for the Medicare program and the services ordered must be “medically reasonable and necessary” The home health care agency providing the services must be certified by the Medicare program.
To get help with your Medicare questions, call 1-800-MEDICARE (1-800-633-4227, TTY/TDD: 1-877-486-2048 for the speech and hearing impaired) or look on the Internet at http://www.medicare.gov.
WHERE CAN I LEARN MORE ABOUT HOME HEALTH CARE?
There are several national organizations that can provide additional consumer information about home health care services. These include the following:
The National Association for Home Care, which can be reached at 202-547-7424 or by visiting its website at www.nahc.org. The postal address is: 228 7th St., SE; Washington, DC 20003. The Visiting Nurse Associations of America, which can be reached at 617-737-3200 or by visiting its website at http://www.vnaa.org. The postal addresses are: 99 Summer St., Suite 1700; Boston, MA 02110.
To find out more about home health care programs where you live, you will want to contact your local aging information and assistance provider or area agency on aging (AAA). The Eldercare Locator, a public service of the Administration on Aging (at 1-800-677-1116 or http://www.eldercare.gov can help connect you to these agencies.
Case Study
WHEN IS HOME HEALTH CARE APPROPRIATE?
Because it is not always clear to the average person when an ailing senior needs home health care and when he or she needs nursing home care, it is usually best to consult a medical professional for advice. The following case study describes one situation in which home health care proved to be the right choice.
Francis is 84 years old and recently had a stroke. She was hospitalized briefly and then discharged to continue recovering at home. To enable her to return home, her doctor called a home health care agency, and the agency gave Francis a complete home health care plan for six weeks. Since the doctor ordered the home care for Francis, Medicare paid for it.
For the first week after Francis went home, a nurse visited her every day. The nurse met with Francis’s family to discuss her special dietary needs and to arrange for exercise therapy to help Francis regain her strength. Once that was done, the nurse visited Francis twice a week to check on how well she was recovering. The home health care agency also sent a homemaker, a personal care attendant, and a physical therapist to visit Francis several times during the week. The homemaker would do the shopping and cook light meals. The personal care attendant would help Francis bathe, get dressed, and walk. The physical therapist would keep Francis moving and see to it that she got some exercise to aid in her recovery.
Paloma Home Health Agency Inc. provides quality service to the elderly, sick, and disabled
Let us meet your everyday needsWe can be reached at 972-346-2013 or http://www.palomahomehealth.com