Home Care Agencies enable seniors to live independently in their own homes or stay with a family member through providing access to outside supportive care and assistance when needed. Referred to by many names including Home Care Agencies, Home Health Care Agencies, Home Health Agencies, In Home Agencies, Personal Care Agencies, Homemaker and Chore Services, and Companion services. Need help locating the appropriate home care services for your loved one? Let us match the appropriate agencies to your needs.

Home Health and Home Care agencies provide two main types of services that are custodial (skilled) or supportive (unskilled) care. Supportive services, provided by non-medical home care agencies, offer assistance with personal care such as bathing, grooming, dressing, in addition to help with meal preparation, housekeeping, and shopping. Assistance with self-administered medications, ambulation and exercises, and transportation to medical appointments is often requested. These custodial or supportive services can be arranged for any needed amount and frequency of time including up to twenty-four hours every day or on a respite or temporary basis. Such services can help an aging person cope with their declining abilities, maintain their independence, and often avoid relocating.

Skilled services provided by medical home health agencies, offer nursing care, physical, occupational, speech, and respiratory therapy as well as social services and hospice care. Following a specific plan of care, and under the supervision of a skilled discipline such as a nurse or therapist, a certified home health aide may provide personal care for a limited time. These skilled services are provided on an intermittent basis, with scheduled home visits to homebound clients only, under a plan of treatment ordered by a physician. These skilled services can avoid unnecessary hospitalizations, hasten hospital discharges, and enable an elder to stay at home during acute illnesses or while convalescing.

Supportive and custodial services (unskilled) are most often contracted with a home care agency on a private-pay basis for the desired amount of time and frequency of care. Medicaid has community-based programs in some states, designed to provide the elderly with personal care assistance in their homes as an alternative to institutional care. Some long-term care insurance policies allow coverage for home health aides, but it is necessary to obtain these home services through a licensed agency in order to qualify for reimbursement. Another option is to hire your own caregiver privately which is usually less expensive and can allow more input into the decision making process. This choice can be optimal with some luck and persistence, however in the employer role, managing care can be very time consuming, if not frustrating at times. On the other hand, skilled care services that meet specific guidelines including a plan of treatment ordered by a physician, and adherence to strict homebound requirements, are usually reimbursed by Medicare, Medicaid, and most private health insurance policies.

Types of Home Care Agencies

Home Health Care Agency, Home Health Care Agencies

Probably the oldest and most familiar provider of home care services is known as the home health agency. The home health agency is licensed and usually Medicare certified and accepts other 3rd party billing of health insurances. Medicare certification means that the agency has met specific federal guidelines and criteria regarding patient care. The main and distinctive purpose of this type of agency is to provide skilled care for treatment or rehabilitation services to homebound patients. Home care professionals must strictly adhere to a physician approved plan of care that is deemed medically necessary and updated every 60 days in order for Medicare benefits to continue.

Home health agency services include skilled nursing, physical and occupational therapy, social work, and home health aide while under professional supervision. Home health care agencies focus more on the skilled medical aspects of care and the home health care aide serves only as a supplement to this care. Regardless of reimbursement eligibility, Medicare will only pay for skilled care in the home for a limited period of time to treat an illness or injury. The HHAs can provide a pre-authorized amount of personal care while under professional supervision however must discontinue care when skilled care needs are no longer justified.

Individuals often may still have ongoing personal care needs even though skilled services are no longer required. As a result of this common need, some home health agencies offer a private pay, non-certified component within their agency for nursing assistants to continue providing personal and custodial care. Hiring a non-medical home care agency directly or a privately hiring a caregiver is another option when continued care through a home health agency is not feasible.

Home Care Agency, Home Care Agencies or Non-Medical Home Care Agency

A non-medical home care agency is generally an agency that provides home care services which are not considered to be skilled care. These agencies provide what is termed non-skilled supportive custodial care that is supplied by home health aides, certified nursing assistants (CNAs) and also non-certified nurse aides, homemakers, and companions. These greatly needed services range from housekeeping and companion care to assistance with personal care such as bathing, dressing, toileting, and eating. Unskilled care is not reimbursable under Medicare and therefore is paid for privately, or in some cases by private long-term care insurance. A physician's order is not required as the need for care is not deemed medically necessary and patient homebound status not required. A professionally authorized and monitored care plan is unnecessary.

These private pay agencies are usually still licensed under authority of each state but licensure requirements and regulations vary widely from state to state unlike federally regulated Medicare certified home health agencies. Most agencies employ their workers, do background checks and manage payroll and taxes. Most of these agencies professionally supervise and monitor their staff with regards to patient care. Non-Medical home care agencies play an undeniably big role filling gaps in home care services not covered under skilled care. Un-skilled home care services such as personal care assistance or other cooking and cleaning help is often what may be needed most and by many in order to remain in their homes.

Registry or Staffing Agency

A private duty registry or employee staffing agency simply acts primarily as an employment service for a variety of skilled and unskilled healthcare workers including nurses, nurse assistants (CNAs) and rehab therapists. Many states do not require these types of agencies to be licensed or conform to specific regulatory requirements. The management of staff is the key difference between these private duty registries and both the home care and home healthcare agencies previously addressed. Generally homecare and home healthcare agencies actually employ their workers that are sent into client's homes while registries do not. The registry matches an independent healthcare contractor with the patient needs, refers them to the client, and then collects a finder's fee. Consequently, the caregiver in the client's home does not work for the registry but instead the client acts as the employer. He or she becomes the supervisor, usually pays the worker directly, and is responsible for all payroll taxes including social security withholdings.

Registries and staffing agencies can be reimbursed for their services sometimes through long-term care insurance, Medicaid and private pay. These agencies refer various types of employees providing skilled care from licensed nurses to personal care and companion assistance from nursing assistants. Requesting an employee referral through this type of service is similar to hiring an individual privately on your own. Managing your own employee offers more independence but at same time additional responsibility without the advantage of employee background screening and licensure verification that many registries undertake.

Private Hire or Independent Providers

Private hire or independent caregivers include various types of nurses, therapists, nursing aides, homemakers, and companions. They are privately employed and managed by those who require their services. All responsibility for recruiting, hiring and supervising falls upon the client or family. Clients pay the caregiver directly; manage payroll taxes, and social security withholdings. Agency rates are usually higher then private hire employees due to recruitment and management overhead costs incurred. Less dependence on agency staffing with the possibility of saving money may or may not be offset by the time-consuming responsibility of managing a private caregiver.