What if getting older didn’t have to mean losing your independence? What if care could come to you—on your terms, in your home, with someone you trust? I sat down with Natasha Armstrong, a registered nurse redefining home care and wellness in Johnston County. From IV drips that boost your energy to respite care that gives caregivers a break… she’s doing it differently. The question is: when your family needs help, will you know where to turn?

We talked to her a little bit about the infusion services they offer, the IV services they offer where they can give you nutrients and help you with, vitamin C and different types of things that you can get through an IV that you can't really get through oral care. We talk about the different home health services that they provide and the home care services they provide, and the difference in how it's paid for between Medicare and Medicaid, and the approximate cost of the different services that her company can provide.

So I think there's a lot of good information here and we've all got aging parents, and we've all got people that we know that if they're not already into this situation where they're gonna need these types of services, they're going to need these services in the future. And she answers a ton of questions.

I learned a lot. I think you'll learn a lot as well.

Welcome to another episode of Best of Johnston County, brought to you by Breeden Law Office. Our host, Jonathan Breeden, an experienced family lawyer with a deep connection to the community, is ready to take you on a journey through the area that he has called home for over 20 years. Whether it's a deep dive into the love locals have for the county or unraveling the complexities of family law, Best of Johnston County presents an authentic slice of this unique community.

The Best of Johnston County Podcasts comes out every single Monday and has now for over 18 months, and we're well over 85 episodes now. And so it's gonna be coming out. It's been coming out. Go back and listen to previous episodes. We've had almost every county commissioner, we had Congressman Brad Knott.

Welcome.

Natasha Armstrong: Thank you for having me.

Jonathan Breeden: No problem, no problem. I met you a few weeks ago through the Launch JoCo program. And that was fun. We did like a, a speed dating thing where we were trying to figure out, you know, with the two be good match and the mentor and the mentees, and I found your story.

Absolutely fascinating in the six minutes we gotta spend together. And I thought I gotta get Natasha on this podcast. So anyway, so tell the audience what's your name, what you do?

Jonathan Breeden: Alright, so let's start with IV Hydration Services. What is IV Hydration Services and who needs it?

Natasha Armstrong: Everyone needs IV Hydration Services. What IV Hydration is, it's a way to get the vitamins that you need in your body daily into your bloodstream directly. Sometimes when we take pills orally, it takes a while to metabolize through your body and it sit excreted out through the normal waste process. When you do a IV hydration, your body and your bloodstream gets the nutrients that you need immediately, and oftentimes you feel refreshed at that moment.

So it's a quicker way to introduce the fluids and the nutrients and the vitamins that your body could use.

Jonathan Breeden: So how often would you get that if you signed up for a regimen once a week, twice a week?

Natasha Armstrong: Well, it's safe to take once weekly. I usually encourage people to do IV Hydration once every two weeks.

See how your body tolerates it, see how you feel. What happens first is we will give you a medical exam with a nurse practitioner to make sure your body can handle fluids all at one time. Make sure you're healthy enough to get the fluids and get the vitamins and then once you're clear by a nurse practitioner.

We have a IV drip that's categorized for all of those symptoms that come along with that, you may want to take that one week. So the IV hydration is safe, but you are getting extra fluid into your body at one time. And it's easier because I can just give you a IV versus you drinking 500 ccs of water.

No one can really sit there at one time and drink all that water. But if I give it to you through a IV your cells get refreshed, your body gets refreshed, and it works faster.

Jonathan Breeden: So how long does it take?

Jonathan Breeden: Okay. So does insurance pay for this?

Natasha Armstrong: No. IV hydration is retail service, which means it has to come out of the client's personal funds. However, if you have a HSA or FSA card, it can be used as a wellness thing.

Jonathan Breeden: Okay.

Natasha Armstrong: So we can take FSA and HSA Cars for Wellness because it is a health wellness concept. I will give you a receipt, explain what services you provided, and you can send that for reimbursement for your HSA or FSA.

Jonathan Breeden: Oh, well that's really good. A lot of people have HSA and FSAs now.

Natasha Armstrong: Exactly.

Natasha Armstrong: Yeah. I think it be

Jonathan Breeden: So yeah. So you get a, you know, sort of a, some money pre-tax

Natasha Armstrong: mm-hmm

Jonathan Breeden: that you can use to spend on health.

Natasha Armstrong: On health.

Jonathan Breeden: All right. So that's one of the business and that business is separate from

Natasha Armstrong: the home care

Jonathan Breeden: first Choice home care.

Natasha Armstrong: Right. So with IV Hydration, we also offer the vitamin injections and the weight loss services. So we offer the GLP-1 and 2's, and we also offer the vitamin injections. So earlier you mentioned, well, who can get the IV hydration? Well the IV hydration is not good for people who maybe have heart conditions or kidney problems because it is a lot of fluid but what these other population, they can do the vitamin injections.

Jonathan Breeden: Okay. So what do you do with the GLP-1 and 2's?

Natasha Armstrong: Well, we have a nurse practitioner on staff and they, they give you the weight loss injections for the weight loss. So it will be the Ozempic, the Zepbound, the Wegovy, all those  GLP-1 and 2's the Semaglutide and Tirzepatide. We have those on staff and we have a nurse practitioner that can help customize a weight loss plan and we can give the medicine to you at that time.

Jonathan Breeden: Oh, okay. So y'all go to the patient house or the patient come to your office in Smithfield?

Natasha Armstrong: Each, either way. We do have concierge services or we can go to the patient's home and service them for anything. IV hydration, vitamin injections, or weight loss, or they can come into the office as well.

Jonathan Breeden: Okay, well meet people where they are.

Natasha Armstrong: Exactly.

So. Well that's cool. I didn't, I didn't know you provided those services. Alright, so the home health, there's all kinds of

Natasha Armstrong: home care

Jonathan Breeden: things you do home care. I know one of the things is the companion service, which I don't think people think about, but when I started reading the description of it, I thought, what a great idea.

So talk a little bit about that.

We provide licensed nurse aides and personal care aides to help these patients with their companion needs, such as taking them to the store, going to a movie helping them get dressed, bathe, do their hair, things that we take for granted that we can do every day.

Jonathan Breeden: Okay. And which of these services will be paid for by Medicare or Medicaid and which ones will not?

Natasha Armstrong: Medicare does not pay for any home care services.

Jonathan Breeden: It does not. I did not know that.

Natasha Armstrong: It does not. They will pay for home health services, but they will not pay for home care.

Jonathan Breeden: Okay.

They won't pay for home care for a nursing assistant to help give you a bath or dressing.

Jonathan Breeden: Okay.

Natasha Armstrong: So those patients would need to have either a purchase, a long-term care insurance policy that has a home care line in it, or they will have to pay privately for home care services. Now, Medicaid State Fund will pay for home care services if the person is applied and ordered by their doctor.

So the doctor would have to make sure there's a need for home care services, like that person could have a condition of some sort that would prohibit them from being able to give themselves a bath or get dressed, and the doctor will order home care services and then Medicaid will do an assessment to make sure they qualify.

Jonathan Breeden: Okay. So what percentage of your, I guess patients that you're helping now are you being paid by Medicaid? 'cause Medicare won't do it. And how many are paying are private pay?

Natasha Armstrong: I have about 20% private pay. Private pay comes in waves. And then I have about 80% of Medicaid patients. And I also have some Medicare Advantage Plans that pay for home care.

But generally, it's only a certain amount that can be allotted for home care.

Jonathan Breeden: Is that part of Medicare Part B? That's because I think that's one you everybody, you have to sign up for that.

Natasha Armstrong: That's the one you have to sign up.

Jonathan Breeden: Right.

Natasha Armstrong: That that,

Jonathan Breeden: but that's not in it.

Natasha Armstrong: That's the federal government.

Jonathan Breeden: Right?

Natasha Armstrong: They won't pay for any home care.

Jonathan Breeden: Okay. So that, so it's not Medicare Part B, it's a separate Medicare plan.

Natasha Armstrong: It's a separate, it's the Advantage Plan.

Jonathan Breeden: Advantage Plan. Okay.

Natasha Armstrong: Mm-hmm.

Jonathan Breeden: Which costs, which is another plan you have to choose to pay for

Natasha Armstrong: in addition to the Part B.

Jonathan Breeden: To Part B, that you have to have

Natasha Armstrong: Exactly.

Jonathan Breeden: Boy, that's confusing.

Jonathan Breeden: Okay. All right. Well, I look, I'm doing good though. I know more about it than most people, but I am a long way from an expert. But so, I mean. Private pay, and I know every, every, every case is different, but I think people think when they hear private pay and they hear registered nurses that this is some crazy amount of money to get these services.

I mean, you know, I mean, but I don't think it's nearly as expensive as people think. So, you know, I mean, people listing that don't have Medicaid, that like a ballpark. I mean, I'm not saying say, what are you charged for this? But like. Let's for just educational so people know. 'cause there's a lot of home care agencies out there.

I don't know what this stuff costs.

Natasha Armstrong: Mm-hmm.

Jonathan Breeden: But approximately what would people look to pay as a private payer if they're listening to this?

We have, as a agency, have to have for that service. And that can range anywhere from 40 to $60 per hour. So it can be pricey. But what I tell families use it when you need to use it. Sometimes we can negotiate with the families and maybe have certain types of like I might can work with someone who's been in the business for maybe 20 years, but they may have, their license might have lapsed.

So with that, I make a charge a little less. So there are ways we can work around the cost if we know what the needs are.

Natasha Armstrong: And I'm glad you asked that question. So there are a lot of home care providers. It's a saturated field, right? But what differentiates me is I can take care of the sick patient and the well patient. I have resources. I can do the IV hydration for the kids and I can do take care mama with the home care as well as the hydration. I feel like my business is unique because one, I grew up in Johnston County.

I grew up in Coonsburg for those who are real, Johnston County, people know exactly where that is.

Jonathan Breeden: Selma.

Natasha Armstrong: Selmapasem.

Jonathan Breeden: Pasem.

Natasha Armstrong: So I grew up there and I wanted to bring home care services with IV hydration to my town of, well, Johnston County Smithfield, to be is at. And I think that's what's so unique about me is I'm not a big corporation come and trying to dominate the market.

I want to give the services there are deserve to people in my community.

Jonathan Breeden: Right. Well, and you, you know your employees, you vet your employees. Right. Like, you're not just sending anybody out there.

Natasha Armstrong: Oh my god. No,

Jonathan Breeden: I agree. You're, you're not just running a right. You know these people sometimes I know, you know, some of their mamas and their grandmamas like, like this is, you know, you're being good people because some of these bigger, bigger companies just running ad taking anybody. Any CNA that signs up, but that's not what you're doing.

So I will run anybody through criminal record check. Then we do like, make sure they have a, a nursing assistant license. If they don't have a license, they go through extensive training to get a license. We try to sign them up to go to CNA school to get a license, we will work with them without a license, but they would've had to have had extensive training.

Jonathan Breeden: Right.

Natasha Armstrong: And then certain patients they can't work with because of the loss.

Jonathan Breeden: Right.

Natasha Armstrong: We also do an extensive in-house training with I'm the RN. I generally do the orientation training. We have about four RN's on staff that go out with the R, the the CNAs and the PCAs to the home to make sure that they know how to service those patients.

Jonathan Breeden: Well that's that's great. That's great. One of the services you provide that not all home health agencies provide is respite care. Talk a little bit about what that is and how you structure it.

Natasha Armstrong: Sure. We also do respite and infusion services, so we'll,

Jonathan Breeden: okay.

Natasha Armstrong: We'll circle back to infusion in a minute so I can explain the difference there.

Jonathan Breeden: Okay.

Natasha Armstrong: Everybody needs a break, right? I need a break. You need a break? We all need a break. Sometimes when you're a caregiver, you can't get a break. So what my team does is we give you a chance to get a break. You wanna go to Myrtle Beach for the weekend? That's fine. We'll take care of mama. Our staff will be there.

The a will be with her, the whole her, him, the whole time you're going away and you will have access to the office and the aide.

Jonathan Breeden: Well, that's really good. So what is this infusion services? I just assumed that was the same thing as the IV services, but obviously I'm wrong.

Natasha Armstrong: No, the infusion services and the IV hydration services are different in the fact that infusion services are paid for by insurance and by pharmacies.

But they can't afford to go to the infusion center, or they can't have the hour long time to go to the infusion center. Or they might be getting chemo and the chemo's 30 minutes, but they don't wanna ask their boss for two hours off to go get chemo. So the hospital can just call me and say, Hey Tasha, can you do this service at their home?

They can still go to work. I can do it after hours. And it's paid for by insurance.

Jonathan Breeden: Oh, okay.

Natasha Armstrong: So that's the difference with infusion versus IV hydration.

Jonathan Breeden: Well, that's awesome. That's awesome. It sounds like you kind of covered the gambit there with all your different services. So how can people get in touch with you?

Jonathan Breeden: Okay, well, so you got that covered. So the last question we ask everybody on this podcast, what do you love most about Johnston County?

Natasha Armstrong: Oh, what do I love most about Johnston County? I'm gonna say the red hot dogs.

Jonathan Breeden: The red hot dogs. Alright.

Natasha Armstrong: Nowhere else. Can you get a red hot dog? The red hot dogs brown. Who does that? I love the red hot dog.

Jonathan Breeden: You love the red hot dogs. That's awesome. That's awesome. Well, we'd like to thank Natasha Armstrong of First Choice Home Care, I'm gonna get the name right, and the infusion services as well for being our guest on this week's episode of The Best of Johnston County Podcast, reach out to her at www.jocohomecare.com.

Talking about who pays for it, right? Like we talked about here today, the difference between Medicaid, Medicare and Medicare Advantage and all that kind of stuff. Because if you don't know what your rights are. You gotta go get what are your rights, right? You gotta know these things so that you know to be able to make the best decision for your parents.

Oftentimes, these are adult children like me, heading into that age. My parents are starting to get older, having to make these decisions, and I think it's important, which is one of the reasons I wanted to bring this episode to you. So, like I said, would you please like, follow and subscribe to this podcast wherever you see it, whether it's on Apple, YouTube, Spotify, LinkedIn, TikTok, or any of the other Best of Johnston County pages.

Until next time, I'm your host, Jonathan Breeden.

That's the end of today's episode of Best of Johnston County, a show brought to you by the trusted team at Breeden Law Office. We thank you for joining us today and we look forward to sharing more interesting facets of this community next week. Every story, every viewpoint adds another thread to the rich tapestry of Johnston County.

If the legal aspects highlighted raised some questions, help is just around the corner at www. breedenfirm. com.