The Home Health Aide, Home Health vs Home Care

The role of the home health aide (HHA) differs slightly between a certified home health care agency and a licensed home care agency.

Helpful Highlights

  • The role and responsibilities of the home health aide (HHA) in certified home health care are directly tied to the care plan goals and interventions. Their time and tasks are limited.

  • The role and responsibilities of the HHA in licensed home care are outlined in the service plan and are broader than in home health. Their time and tasks are not limited.

  • The home health HHA cost is covered by insurance. The home care HHA cost is predominantly private pay (out of pocket).

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HHA, certified home health agency

Certified home health care is ordered by a provider and gives short-term, intermittent medical care to your loved one based on a care plan. Care is predominantly provided by some combination of nursing, physical therapy, occupational therapy, speech therapy, medical social worker, and home health aide (HHA).

In home health, everything personnel do for your loved one is tied to the goals and interventions outlined in the care plan, including the HHA. The HHA performs predominantly personal care services that are deemed necessary by the care plan, which are assigned by the nurse - things such as toileting, transferring, bathing and hygiene, and dressing. If related to the care plan goals and interventions, the HHA may also change linens, do laundry, prepare simple meals, give medication reminders, and assist with self-administration of medications (meaning they do not administer medications to your loved one directly but rather help your loved one to do so). They generally do not provide additional housekeeping, run errands, or provide transportation.

The HHA is typically only present for a couple of hours per day, a couple of days per week. Their time under certified home health guidelines is limited. Because their time and tasks are directly tied to what's in the care plan, home health agencies are not reimbursed for any extra time and attention the HHA may provide your loved one.

The importance of the HHA in home health should not be minimized, however, as they are often the "eyes and ears" in the home, picking up on subtle signs of improvement or decline in your loved one and reporting these important changes to both you and the home health care team.

HHA, licensed home care agency

Licensed home care does not require a provider order and home health aide (HHA) care is arranged and offered according to a service plan. Care is non-medical*, provided by unlicensed caregivers.

*Some states do permit HHAs with advanced training and under the oversight of a registered nurse to perform a limited set of nursing/medical tasks, which may include some direct administration of medications.

In home care, the service plan, developed together with your loved one to meet their needs and preferences, details the level of care to be provided and when (number of days, number of hours per day). The levels of care include companionship, homemaking, personal care, and transportation. The HHA encompasses all these levels of care, providing companionship, housekeeping, and transportation (if available), as well as helping your loved one with activities of daily living (ADLs).

The HHA is present for as many hours a day, as many days per week as is agreed upon and outlined in the service plan. Their time under licensed home care is not limited. Changes in the schedule and level of care can be made at any time based on changes in your loved one's needs. (Note that those arrangements should be made with the home care agency and not with the HHA directly!)

The home care HHA can be integral to your loved one's health and quality of life. They often spend a lot of time with your loved one and develop a trusting and tight relationship that allows them to make keen observations about your loved one and encourages your loved one to open up about their thoughts, feelings, and health concerns. Many home health aides come to be highly valued by families.

no content in this app, regardless of date, should ever be used as a substitute for any direct legal advice you receive from your lawyer or other qualified legal professionals.

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