Families often use the two terms as if they mean the same thing. They sound alike, and many people say "home care" when they mean "home health care." The difference comes down to one word: health.
Home health care is medical care that a doctor orders. Nurses and therapists come to the house to treat an illness, an injury or a new condition. Home care is non-medical help with daily life, such as bathing, meals and getting around safely.
If you are weighing home care vs home health care for your mom or dad, it helps to know what each one offers, who qualifies, how each is paid for and when a parent needs both.
Home Care vs Home Health Care at a Glance
Both kinds of care happen in your parent's own home, and both aim to help an older adult stay as independent as possible. The difference between home care and home health care shows up in who gives the care, what that person does, and how the care is arranged and paid for.
| Home care | Home health care | |
|---|---|---|
| What it is | Non-medical help with daily life | Skilled medical care to treat or manage a condition |
| Who provides it | Trained caregivers from a licensed Home Care Organization | Nurses and therapists from a Medicare-certified home health agency |
| Typical tasks | Bathing, dressing, meals, housekeeping, rides, medication reminders, companionship | Wound care, injections, IV therapy, physical, occupational and speech therapy |
| Doctor's order needed | No | Yes |
| Who usually pays | Private pay, long-term care insurance, VA benefits, some Medi-Cal programs | Medicare, Medicaid and many private plans |
| How long it lasts | As long as the family wants it | Until the care goals are met |
| How often | A few hours a week up to 24 hours a day | Part-time visits, often a few times a week |
What Is Home Care?
Home care is non-medical help that keeps an older adult safe and comfortable at home. Caregivers assist with the activities of daily living: bathing, dressing, grooming, toileting, walking and moving from bed to chair. They also take care of the household tasks that pile up, including meal preparation, light housekeeping, laundry, errands and rides to appointments.
Caregivers give medication reminders and offer companionship too. A friendly visit each day means a great deal to a parent who spends long stretches alone.
Agencies use several names for this kind of help: personal care, companion care, custodial care and homemaker services. The names overlap, and you can ask any agency which tasks sit under each one. HomeCare Professionals offers personal care at home that covers bathing, dressing, grooming, toileting, mobility and transfers.
Home care leaves out nursing, therapy, wound care and injections. Medication help stays at reminders, because giving medications belongs to a nurse.
Since the help is non-medical, the schedule can bend around the family. At HomeCare Professionals, care schedules run from a few hours a day to 24 hours a day, 7 days a week.
What Is Home Health Care?
Home health care is skilled medical care delivered at home. A Medicare-certified home health agency provides it, and a doctor orders it. The goal is recovery, or keeping a medical condition steady.
Skilled nursing makes up a large part of it. A nurse may care for a surgical wound, give injections, manage IV therapy or monitor a condition that could change quickly. Physical, occupational and speech therapists help a parent rebuild strength, relearn daily skills or regain speech and swallowing.
Medical social workers help the family line up resources. The care team also teaches your parent and your family how to manage the condition at home.
One point confuses many families. A home health aide may help with bathing, but only as part of a skilled care plan. Medicare covers that aide help only while a parent also receives skilled nursing or therapy.
Home health does not cover housekeeping or meal preparation on their own. A parent who needs help with those tasks needs home care.
Who Qualifies, and How Long Care Lasts
Home health has gatekeepers, and the first one is the homebound rule. Your parent is homebound when leaving home is not recommended because of a condition, or when your parent needs help to leave, such as a cane, walker, wheelchair or another person. Leaving home also has to take a lot of effort. Short, infrequent outings, like religious services, and adult day care are still allowed.
Your parent also needs part-time or intermittent skilled care. A doctor or nurse practitioner must see your parent in person, confirm the need and order the care. A Medicare-certified agency then provides it.
Care is goal-based. Nurses or therapists visit a few times a week, and care ends when the goals are met. In most cases, skilled nursing and aide care together run up to 8 hours a day and 28 hours a week. For a short time, the limit can reach 35 hours a week if the provider decides it is necessary.
The gap in home health vs home care shows up most in how each one begins and ends. Home care has no medical gatekeeper. The family or the person decides, and care continues as long as it is needed.
It can start at a few hours a week and grow to live-in or round-the-clock care when needs change. A parent who feels stronger can scale back, and a parent who needs more can add hours.
How Each Type of Care Is Paid For
Home health and home care follow different payment paths. Medicare pays for covered home health services when a person is eligible, and Medicaid and many private plans cover it too. A person pays nothing for covered home health services. After the Part B deductible, there is a 20% share of the Medicare-approved amount for medical equipment.
Home care covers much of what traditional Medicare leaves out. That includes 24-hour care at home, homemaker services unrelated to the care plan, and personal care with bathing, dressing or using the bathroom when that is the only care a person needs.
Families in California use several routes to pay for home care:
- Private pay.
- Long-term care insurance.
- VA benefits, including Aid and Attendance and VA Home Health Aide and Homemaker services.
- Medi-Cal, through the CalAIM Community Supports benefit called Personal Care and Homemaker Services, which helps with bathing, meal preparation, grocery shopping and going to medical appointments.
- The Multipurpose Senior Services Program, which offers care management for older adults at risk of nursing home placement and may fund in-home care.
Each program has its own rules, and approval comes through the program or health plan. HomeCare Professionals describes these routes on its page about programs that may cover the cost of home care, and its team helps families review which ones may fit.
Which One Does Your Parent Need?
Everyday situations make the choice clearer. When you compare home care vs home health for a parent, most situations fall into one of these three.
- Your parent comes home from the hospital with a surgical wound, new medications to manage or therapy goals. Home health fits, because these needs call for a nurse or therapist.
- Your parent is medically stable but struggles to bathe, cook, get around safely or be alone for long stretches. Home care fits.
- Your parent is recovering from a joint replacement and no one is home during the day. Both are likely to help.
A simple question can guide you. Does your parent need a nurse or therapist to treat something? If so, home health is the place to start. If the help centers on daily tasks and safety, home care is the match.
Needs change over time. Many families begin with one type of care and add the other as recovery moves along.
For a home health referral, ask the doctor or the hospital discharge planner. The doctor decides whether your parent meets the requirements, and the discharge planner can tell you which agencies serve your area.
For daily help, ask a home care agency for an assessment. At HomeCare Professionals, the assessment looks at your parent's needs, preferences and home environment. The team then builds a personalized care plan around what it finds.
When Your Parent Needs Both
Many parents need both teams at once. Home health covers the nurse and therapist visits. Home health is part-time, so home care covers the hours and tasks in between: meals, bathing, transfers, standby help to prevent falls and rides to follow-up appointments.
Think about a hip replacement. A physical therapist visits a few times a week to build strength and review exercises. During the rest of the week, a caregiver prepares meals, helps your parent to the bathroom and stands by on the stairs.
HomeCare Professionals offers after-surgery care that covers walking, toileting, bathing, meal preparation and rides to post-op appointments. Its caregivers handle hip, knee and shoulder replacement and oncology procedures. They also help with medication reminders, laundry and housekeeping.
Both teams do their best work from the same plan. The nurse knows the wound-care steps, and the therapist knows the exercises and movement limits. The caregiver is in the home the most hours, so that person needs to know those details too.
HomeCare Professionals caregivers know the post-surgery protocols a physician requires. Families can pass along a doctor's instructions and the latest visit notes, so each person caring for your parent works from the same page.
How to Tell Them Apart When You Call a Provider in California
California licenses the two types of providers separately. That lets a family tell which kind of care an agency offers before signing anything.
Non-medical Home Care Organizations are licensed by the California Department of Social Services. Under the Home Care Services Consumer Protection Act, licensing has been required since January 2016.
The state also keeps a public online list of caregivers. Home Care Aides appear on the Home Care Aide Registry after a criminal background check run by the state, and anyone can search it.
Home health agencies follow a separate path. Those that bill Medicare must be Medicare-certified. A Home Care Organization license points to non-medical home care, and Medicare certification points to home health.
HomeCare Professionals is a licensed California Home Care Organization (HCO). That places its caregivers on the non-medical side of the line.
Where HomeCare Professionals Fits
Home health is medical care a doctor orders, and home care is non-medical help with daily life. HomeCare Professionals is a licensed California HCO that provides non-medical in-home care. Its services include personal care, 24-hour and live-in care, dementia care, after-surgery care, cancer care and veterans' care.
The team offers a free care assessment, in person or by phone when time is short. In some cases, care can start within a few hours. The team also helps families review payment programs.
Offices are located in Daly City, the East Bay, the South Bay, Vacaville, Sacramento, Fresno, Manteca, Chico, Red Bluff and Redding. To talk through what your parent needs, Contact Us.
