Home Care and Home Health Care: What’s the Difference?

More than 7.6 million Americans currently receive some form of in-home care, allowing them to live more independently and safely in their homes, rather than making a sudden move to an assisted living facility or other residential center.

While there are a variety of in-home care options available to families seeking help, many families wait until there is an acute need for in-home care before researching their options.

Rather than facing a stressful decision, review this helpful primer on the various home health care and home care options available to families in New York State.  Home Care

Certified Home Health Care Agencies vs Licensed Home Care Services

In-home care can broadly be divided into Home Care Services and Home Health Care Agencies.

In New York State, Certified Home Health Care Agencies provide home health aides, nursing visits and therapies including physical therapy, occupational therapy and occupational therapy.  These services are specific to an injury or illness, are short term arrangements and paid for by government funding such as Medicare.  The receiver of care must meet strict criteria of need in order for these services to be provided to them.

Licensed Home Care Services also provide home health aides and nursing however the client is responsible for payment – either through direct payment or through a variety of insurance plans.   These services can be extended for as long as the client requests the assistance and is able to pay for the services.

In New York State, both Certified Home Health Care Agencies and Licensed Home Care Services are regulated by the NYS Department of Health. Certified Home Health Care Agencies (CHHAs) are also regulated by Federal laws because they are receiving federal funds.

Care Providers

In New York State, direct care workers who work with either Certified Home Health Agencies or Licensed Home Care Services fall under three titles with differing levels of training and responsibility:

Companions, Personal Care Aides and Home Health Aides

There are 6 general categories of patient care-related tasks called “Activities of Daily Living,” which include toileting, bathing, dressing, ambulation, transfers and eating.  Direct care workers are assigned to clients based on the client’s level of care needed and the training of the direct care workers.

A Companion requires no specific medical training because they can only perform “hands-off” assistance to their clients.  Companions are usually assigned to a client who needs housekeeping, companionship, guidance and reminders throughout the day.

Personal Care Aides (PCAs) receive 40 hours of classroom training on household management and basic patient care.  PCA’s are not allowed to perform complex patient care tasks and are typically assigned to clients who are self-directing and need some hands-on support with the above mentioned activities. A PCA can perform the same duties as a Companion, but a Companion cannot perform the same duties as a PCA.

Home Health Aides (HHAs) receive a total of 75 hours of home health care training, including 16 hours of hands-on training under the supervision of a Registered Nurse (typically in a residential care setting). While in a client’s home, an HHA will follow the directions of a client’s Registered Nurse Supervisor or similar health care management team and is expected to take on more of a lead role in the client’s care.  HHAs proactively assist clients who are not self-directing at all times or have more complex medical needs than are covered in a PCAs training program.  A Home Health Aide can perform the same duties as a Personal Care Aide however a Personal Care Aide cannot perform the same duties as a Home Health Aide.


Many Home Health Care agencies employ both PCAs and HHAs for their clients, however as a client’s needs change, their care plan might require changing caregiver skill levels from PCA to HHA services.  At SelectCare Home Health Care Services, we believe this change in care providers can be extremely jarring for clients who have already built a bond with their initial caregiver.  As a result, we only employ HHAs as a way to promote continuity of care for our clients.

SelectCare Home Health Care Services hopes you found this basic guide useful as you begin to consider care options for yourself or an older loved one. SelectCare offers its clients Home Health Aide, Licensed Practical Nurse and Registered Nurse services to ensure every family gets the support they need.

To learn more about SelectCare, call us today or request a free in-home care guide electronically or by mail.