If you've been told to look into both
Home health vs home care in Tennessee
Home health and home care are two different services that share a name. Home health is short-term medical care provided in your home after a hospital stay or significant medical event — skilled nursing visits, physical therapy, occupational therapy — and it's typically covered by Medicare for limited periods. Home care is ongoing non-medical support — bathing, dressing, meal preparation, supervision, companionship — that helps someone live independently at home, paid privately or through long-term care insurance, TennCare, or VA benefits.
Most Tennessee families need home care, not home health. But the terms get used interchangeably, the licensing is different, and choosing the wrong one means waiting weeks for a service that doesn't exist or paying out of pocket for something insurance might have covered.
Key takeaways
- Home health = short-term medical care (skilled nursing, PT, OT) after a hospital stay, doctor-ordered, Medicare-covered.
- Home care = ongoing non-medical support (personal care, companion care, supervision), paid privately or through LTC insurance, TennCare, VA, or OPTIONS.
- Home health agencies in Tennessee require a Certificate of Need (CON) license. Home care agencies require a PSSA license.
- Most older adults need home care, not home health — Medicare home health rarely covers ongoing daily support.
- Many West Tennessee families need both: home health for medical recovery, home care for the everyday support home health doesn't cover.
The quick comparison
Both come to your home. Both can be billed through insurance. Both involve people in your loved one's life. Beyond that, they're almost completely different.
- Home health is medical. Home care is non-medical.
- Home health is short-term. Home care is ongoing.
- Home health is doctor-ordered. Home care is family-chosen.
- Home health is mostly Medicare. Home care is mostly private pay or long-term care insurance.
- Home health staff are nurses and therapists. Home care staff are caregivers, CNAs, and DSPs.
- Home health agencies in Tennessee are CON-licensed. Home care agencies are PSSA-licensed.
What home health is
Home health (sometimes called "skilled home health") is medical care delivered in your home, usually after a hospitalization, surgery, or new diagnosis. It's ordered by a physician, delivered by a CON-holding agency, and time-limited.
A typical home health episode lasts 30 to 60 days and includes:
- Skilled nursing visits — a nurse comes to your home one to three times a week to assess vitals, manage wounds, monitor a new diagnosis, or train you to manage complex medications.
- Physical therapy — a therapist works with the patient on mobility, balance, and recovery exercises after surgery, a stroke, or a fall.
- Occupational therapy — focused on activities of daily living, adapting the home environment, recovering hand and arm function.
- Speech therapy — for stroke recovery, swallowing concerns, or cognitive impairments.
- Medical social work — limited support for connecting with community resources.
- Home health aide visits — short visits for personal care, but only as part of a skilled nursing or therapy plan, not as standalone help.
Critical detail: Medicare home health does NOT cover ongoing non-medical home care. The home health aide visits are limited, short, and only available alongside skilled nursing or therapy. Once the medical care ends, the home health aide visits end. This is the most common point of confusion for families.
What home care is
Home care (sometimes called "non-medical home care," "private duty home care," or just "in-home care") is ongoing non-medical support. It's not doctor-ordered. It's not time-limited by Medicare. It's the everyday help that keeps someone safe at home.
A typical home care assignment includes:
- Personal care — bathing, dressing, mobility, toileting, transfers.
- Companion care — conversation, supervision, light engagement, errands.
- Medication reminders (not administration).
- Light housekeeping, laundry, meal preparation.
- Transportation and escort to appointments and errands.
- Respite for family caregivers.
- 24-hour care when needed.
In Tennessee, home care agencies operate under a Personal Support Services Agency (PSSA) license. PSSA agencies cannot provide skilled nursing direct to private-pay families — that requires a CON. Resource One is PSSA-licensed.
When you need home health
You need home health when:
- You're discharging from a hospital, rehab, or skilled nursing facility and your physician orders home health follow-up.
- You have a new wound, surgical incision, or chronic condition that needs nursing assessment.
- You're recovering from surgery, a stroke, or a fall and need physical therapy, occupational therapy, or speech therapy.
- You have a complex new medication regimen and need a nurse to train you or family on managing it.
Home health is started by a physician. It's covered by Medicare Part A or Part B for eligible patients, usually 100% with no copay if all criteria are met. The episode runs about 30 to 60 days, sometimes recertified for additional 60-day cycles if medical need continues. When the medical need resolves, home health discharges you.
When you need home care
You need home care when:
- An aging parent or spouse needs help with bathing, dressing, meals, or supervision — and that need isn't going away.
- A family caregiver is burning out and needs respite or relief.
- Someone discharged from home health still needs daily support after the medical care ends.
- Someone with early dementia needs supervision and engagement, but doesn't need skilled nursing.
- A spouse or adult child needs to work, travel, or simply rest, and someone trusted needs to be in the home.
Home care is chosen by the family, not ordered by a doctor. It's paid through private pay, long-term care insurance, TennCare CHOICES (Medicaid), VA Community Care, OPTIONS for Community Living (state-funded), or DIDD waivers — depending on eligibility. Medicare does NOT cover ongoing home care.
When you need both
Many West Tennessee families need both at the same time, especially after a hospitalization. Home health covers the medical recovery — the nurse visit, the PT exercises, the wound check. Home care covers everything else — the morning shower, the meals, the supervision when home health isn't there.
The two services don't conflict. They cover different needs and bill different payers. A coordinated plan typically has the home health agency providing the medical care for 30 to 60 days, with home care providing the personal support before, during, and after. When home health discharges, home care continues.
If your discharge planner only mentions home health, ask about home care too. They are separate services and you may need both.
How to choose the right one in Tennessee
If your physician has ordered home health and the agency is calling to schedule, you have home health and you don't need to do anything else immediately. Use the home health visits and watch what gets covered and what doesn't.
If your loved one is struggling at home and there's no recent hospital stay or surgery, you probably need home care. Call a PSSA-licensed home care agency for a free in-home assessment. Resource One serves Memphis, Jackson, and the surrounding West Tennessee counties — see our private duty home care or private pay home care pages.
If your loved one is being discharged from a hospital, ask the discharge planner specifically about both home health and home care. Insist on getting both started before discharge if needed — it's the single most effective way to prevent a readmission.
Frequently asked
Will Medicare pay for home care?
Generally no. Medicare covers home health (medical care after a hospital stay) for limited periods. It does not cover ongoing non-medical home care. Some Medicare Advantage plans now offer limited supplemental home care benefits — check your plan, but assume Medicare won't cover ongoing home care.
Can the same agency provide both home health and home care?
Sometimes, but in Tennessee they're separate licenses. CON-holding agencies can provide home health (skilled nursing, therapy). PSSA-licensed agencies provide home care. Some larger organizations hold both licenses. Resource One is PSSA-licensed and partners with CON-holding home health agencies through our agency-staffing line for skilled care needs.
What's the difference between home health aide visits and home care?
Medicare home health includes limited home health aide visits — but only when there's an active skilled nursing or therapy need. The aide visits are short (often an hour) and stop when the skilled need stops. Home care is standalone, longer, and continues as long as you need it.
How do I know if I qualify for Medicare home health?
Medicare home health requires that you're under a doctor's care, the doctor certifies you need at least one skilled service (nursing, PT, OT, or speech therapy), you're considered "homebound" (leaving home is a major effort), and the agency is Medicare-certified. Your physician or hospital discharge planner can confirm eligibility.
We were told we don't qualify for home health. Now what?
Most West Tennessee families don't qualify for ongoing home health — and that's the moment they discover home care exists. Home care has no Medicare eligibility requirements. It can start within days under private pay or long-term care insurance. If you have TennCare or VA benefits, those pathways may also cover home care.
Is home care more expensive than home health?
Home health costs you nothing if Medicare covers it (most eligible patients have zero out-of-pocket cost). Home care is paid privately or through LTC insurance, TennCare, or VA. So in raw dollars, home health appears cheaper. But the comparison is misleading — they cover different needs. Home health covers the 30-60 day medical recovery. Home care covers the months and years of daily support that follow.