Home Care Agencies

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Home Care Agencies

Caring for the sick at home is the oldest form of health care. Today, a wide range of health and social services can be given in the home. Whether a person is being treated for cancer, is recovering from it, or has advanced disease, home care may be an option. Through home care you can get expert, compassionate health care in your home instead of in a hospital or other facility.

Types of home care agencies

Many providers offer home care services, including:

  • Home health agencies
  • Hospices
  • Homemaker and home care aide agencies
  • Staffing or private-duty agencies
  • Medical equipment and supply companies
  • Home infusion or pharmaceutical (medicine) companies

Some home care providers are professionals who do not work for any kind of agency. Some agencies are registries that keep lists of professionals and workers for hire. Sometimes, several types of home care providers may work together for one company so they can offer a wide range of services.

The choice of a home care provider is an important one for you, your family, and your doctor. To help you make the best choice, we will review the types of home care agencies and suggest some questions you might want to ask. They type of agency you choose will depend on your health care needs. You should also keep in mind what your insurance will cover and what your out-of-pocket costs will be.

Home health agencies

If you need skilled home care services, they will usually be given by a home health agency. The same agency may offer different kinds of home care services through nurses, therapists, social workers, homemakers and home care aides, medical equipment and supply dealers, and volunteers.

Some agencies limit their services to nursing and 1 or 2 other specialties. If care is needed from more than one specialist, the home health agency will set up a team to provide care that covers your needs. Because home health agencies hire and supervise their personnel, they assume liability for all care. Home care services are usually available 24 hours a day, 7 days a week, though most home services are done during the day if possible.

Hospice care

This type of care involves a core team of skilled experts and volunteers who provide all-around medical, psychological, and spiritual care when cure is no longer possible. Hospice care is usually based at home so that families take part in the patient’s care. Trained hospice professionals are on call 24 hours a day. They help the family care for the patient, help ensure that the patient’s wishes are honored, and keep the patient as functional and free from pain and other symptoms as possible. They also help support the family through this time. Many hospice programs are Medicare certified and licensed according to state requirements. For more information, please see our document called Hospice Care. You can read it online or call us for a free copy.

Homemaker and home care aide agencies

These agencies help patients by preparing meals and helping them bathe, dress, and keep house. They may also sit with patients who cannot be left alone for medical or safety reasons. This is sometimes called “companion service.” Some states require that these agencies be licensed and meet certain standards of care.

Pharmaceutical and infusion therapy companies

These companies deliver medicines, equipment, and nursing services for people who need intravenous (IV) fluids, nutrition, or treatments at home. They also give special feedings through tubes that are placed in the stomach or intestine (tube feedings). Nurses teach patients and family members to give these medicines, fluids, or feedings at home. They often stop in to be sure everything is working well, and you can call them any time there are problems. Some pharmaceutical and infusion therapy companies are certified by Medicare.

Durable medical equipment and supply dealers

These companies provide products ranging from breathing machines (respirators), oxygen tanks, wheelchairs, and walkers, to catheter and wound-care supplies. They deliver these products, install or set them up, and teach patients and caregivers how to use them. Most of these companies do not give physical care to patients, but a few offer pharmacy and infusion services. They may provide a nurse to give medicine and tube feedings to patients and teach the patient and family the proper way to give these on their own. Some offer respiratory therapy services to help patients use breathing equipment. Those that bill Medicare must meet federal minimum standards. Some states require that these companies be licensed.

Staffing registries/private-duty agencies

Private-duty agencies provide people with nursing, homemaker, home care aide, and companion services. In most cases, these agencies are not licensed or regulated by the government. Staffing registries often serve as employment agencies for home care nurses and aides. They match the provider with the patient and collect a finder’s fee. When you hire someone matched by a registry, it’s much the same as hiring them yourself – the person works for you, and you pay them. As an employer, you may also have to pay payroll taxes, Social Security, and unemployment insurance.

Independent providers

These are nurses, therapists, aides, homemakers, and companions who are privately employed by the people who need their services. The patient or family must recruit, hire, and supervise these providers. The patient or family pays them directly, and may also be responsible for payroll, Social Security, and unemployment insurance. You can contact the IRS to learn more. (See the “To learn more” section.)


Last Medical Review: 05/08/2013
Last Revised: 05/08/2013