Why it matters: Families must match services to need and stay within California’s strict licensing rules and payer requirements.
One-Minute Snapshot
| Home Health | Non-Medical Home Care | |
|---|---|---|
| Care Type | Physician-ordered, clinical | Personal support with daily living |
| Regulator | CDPH – Home Health Agency license + Medicare Conditions of Participation | DSS – Home Care Organization license; aides on HCA Registry |
| Staff | RNs, LVNs, PT/OT/ST, MSW | Registered Home Care Aides |
| Payer | Medicare, Medi-Cal, VA, private insurance (if skilled & intermittent) | Primarily private pay or long-term-care insurance; some VA or IHSS support |
| Goal & Duration | Recovery, clinical monitoring – usually short-term | Safety, independence – often long-term/ongoing |
Home Health (Skilled Care)
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Requires MD order & plan of care.
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Services: wound care, IV/IM meds, disease management, therapy, medical social work.
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Compliance: Agencies must maintain CDPH license, nurse/therapist credentials, infectioncontrol program, and submit OASIS quality data.
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Billing: Medicare/MediCal pay per 30day episode; private insurers follow similar rules. Patient must be “homebound” for Medicare.
NonMedical Home Care (HCO)
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Supports ADLs/IADLs: bathing, dressing, meals, meds reminders, errands, companionship.
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Compliance: DSS licenses HCOs; every aide must pass DOJ fingerprinting, TB screening, 5 hrs entry training + 5 hrs annual CE, and be listed on the state HCA Registry.
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Billing: No Medicare coverage; costs paid by family, longtermcare insurance, VA Aid & Attendance, or county IHSS (for lowincome).
Choosing & Combining Services
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Use Home Health after surgery, new diagnosis, or medication change that needs a clinician.
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Layer in Home Care when chronic support or supervision is required beyond the skilled episode.
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Verify: CDPH license (HHA), DSS license + HCA Registry (HCO).
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Confirm payers: Medicare/MediCal for skilled needs; private pay/LTCI for personal care.
Bottom line: In California, the right mix of licensed care + compliant aides + correct payer source ensures both quality and affordability while keeping loved ones safe at home.