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The Times They Are A-Changing

Come gather ’round people, wherever you roam, and admit that the waters, around you have grown!

Just like the Dylan song said, The Times They Are A-Changing in private duty home care. What are the issues that will impact how we conduct our business of home care over the next 5 years and what strategies will serve us as we await clarification on those issues? The home care industry is likely to be significantly affected by Patient Protection and Affordable Health Care Act (PPACA), changes to the Companionship Exemption and the introduction of licensure in states that have not had licensure in the past.


Nurse Power: The New Voice In Home Health

The contributions nurses make to the health and well-being of the patients we serve has a long history of positive results and outcomes.  Prior to the early 1920s, nurses worked with physicians as independent practitioners.  Nurses were sovereign in their decision making, and performed their jobs without interference or governance from any other discipline.

In the early 20s, the American Medical Association (AMA) began to see nurses as a threat to the fiscal stability of their medical practitioners.  Paul Starr’s enlightening book, “The Social Transformation of American Medicine,” outlines the purposeful and direct effort by the AMA to pass state and federal laws that put nursing under the direct control of doctors.  They were successful, and these laws, and more, are still in place today.

Yet, this stronghold is beginning to weaken. As modern healthcare puts more and more strain on our resources, nursing is reestablishing itself as a viable, strategic, and independent profession.  At the heart of this trend is the push for nurses to take their rightful role, in tandem with doctors, in the move to improve medical care in this country.