Home Care FAQs

What is home care?

More than 12 million Americans receive home care each year, with that number projected to climb as our population grows older and people are discharged from hospitals quicker and sicker. So what exactly is home care and who does it serve? Home care is specialized health and social services provided to individuals where they live, keeping them safe and independent in the comfort of their own homes. Recipients often include older Americans, children and adults of any age who are disabled or recuperating from injury, and the chronically or terminally ill. Services can meet a broad scope of needs such as ongoing medical, nursing, social or therapeutic treatments, and assistance with essential daily activities like bathing, toileting, and eating.

Why would somebody use home care?

Home care enables a person to live as independently as possible without having to give up the comforts of their own home. It allows them to be in a familiar environment, sleep in their own bed at night, and stay close to loved ones like family, friends, and pets. It also brings peace of mind to know they have access to skilled, consistent, reliable care when it’s needed, even if those needs change. When compared to other alternatives of care, home care can be significantly more cost effective. According to the Centers for Medicare and Medicaid Services (CMS), at-home care is usually less expensive, more convenient, and effective.

How are these different types of care paid for?

Personal care and companionship 

Usually paid directly by the person receiving care (private pay), or through long-term care insurance or Medicaid.

Private duty nursing care

Private duty nursing can be paid through a variety of sources, including:

  1. Medicaid (with qualifications)

  2. Health insurance

  3. Workers’ compensation

  4. Veterans benefits

  5. Direct payment by person receiving care (private pay).

Home health care

When specific qualifications are met (generally, when services are ordered by a physician and a clinical assessment deems them necessary), these services are typically paid for by Medicare or private insurance.

Can you only get home care in a private residence?

No. Home care services can be provided wherever home is—a private residence, a senior living community, or while staying with a friend or family caregiver.

What is the difference between Medicare and Medicaid?

Medicare

Medicare is federal health insurance for people 65 or older, and some people under 65 with certain disabilities or conditions. A federal agency called the Centers for Medicare & Medicaid Services (CMS) runs Medicare. Because it’s a federal program, Medicare has set standards for costs and coverage. This means a person’s Medicare coverage will be the same no matter what state they live in. People with Medicare pay part of the costs through things like monthly premiums for medical and drug coverage, deductibles and coinsurance.

Medicaid

Medicaid is a joint federal and state program that helps cover medical costs for some people with limited income and resources. The federal government has general rules that all state Medicaid programs must follow, but each state runs its own program. This means eligibility requirements and benefits can vary from state to state. Medicaid offers benefits that Medicare doesn’t normally cover, like nursing home care and personal care services. People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or services.

What types of home care are available?

Personal care and companionship

Help at home with everyday activities like bathing and dressing, meal preparation, and household tasks to enable independence and safety.

Personal Care and Companionship does not need to be prescribed by a doctor unless you are receiving it through a state Medicaid program, such as the Personal Care Assistant (PCA) program in NJ or the Personal Assistant Services (PAS) program in PA. Care is provided on an ongoing basis, on a schedule that meets a client’s needs, up to 24 hours a day, 7 days a week, including possible live-in care.

Private duty nursing care

Long-term, hourly nursing care at home by RNs and LPNs for adults and children with a chronic illness, injury, or disability.

Private Duty Nursing Care needs to be prescribed by a doctor. Care is provided hourly on an ongoing basis by RNs and LPNs based on the client’s needs, up to 24 hours a day, 7 days a week.

Home health care

Short-term, Medicare-certified physician-directed care designed to help a patient prevent or recover from an illness, injury, or hospital stay

Home Health Care needs to be prescribed by a doctor. Care is provided through Medicare certified visits from nurses or therapists that last up to an hour, on a short-term basis until individual goals are met.

For more information visit hcaoa.org.

What are the benefits of in-home vs. institutionalized care?

In-home care has proven to be the patient-preferred method of long-term care, as well as the safer and more cost-effective alternative to institutional care or hospitalization. 

Less Expensive

In 2020, the typical annual cost of in-home care for seniors was about $55,000 for an average of 44 hours of care per week -- about half the annual cost of a private room in a nursing home.

Source: hcaoa.org

Safer

Home health care also promotes the healing process. Research studies have shown that patients can recuperate and heal faster and much more comfortably when they’re at home, compared to staying in a hospital or a nursing home. There’s also less chance of needing the services of the hospital again when their recovery process is at home.

Seniors who stay at home tend to live longer than those who live in nursing homes, and studies have confirmed this fact. In addition, those who stay at home tend to be physically and mentally healthier compared to the residents of nursing homes.

Many seniors report having a greater quality of life and happiness with in-home care, and statistics show that these beneficiaries actually have up to 50% fewer doctor’s visits annually.

Families have become reluctant to put aging parents into congregate living facilities, fearful of the higher health risks from COVID-19 and worried that parents will be quarantined alone there.

Sources: homehelpershomecare.com, seniorliving.org, pbs.org

Patient Preferred

70% of respondents said they would prefer to stay home with support in the future, rather than go to an outside facility like a retirement community or nursing home.

Source:  crosscountry.com

Who should I contact if I need home care for a loved one?

There are many home care agencies in each state. States’ department of health and/or human services websites and County Area Agency on Aging offices will contain lists of all agencies in a particular state or area. Hearts for Home Care is affiliated with BAYADA Home Health Care, which operates in 23 states. If you or your loved one are in need of care, you can contact BAYADA to speak to someone and learn more about home care: bayada.com/contact-services.asp

Who can become an Advocate?

Anyone in the community can become a Hearts for Home Care Advocate, for free! Whether you are a caregiver, a patient, a family member, politician, or simply someone eager to make a difference, H4HC welcomes you! H4HC is a growing movement of like-minded individuals with the mission to improve the home care ecosystem across the U.S. so that more medically fragile populations have access to quality in-home care.

What does an Advocate do?

Advocates can be as active in our program as they want! Meet with your legislators, participate in action alerts, join us for an Advocacy Day, contribute to public affairs outreaches by sharing your home care story. ALL of these efforts help to spread awareness and enact legislative change!

Is there a fee to become an H4HC Advocate?

No! H4HC is a free program open to anyone in the community looking to make a positive difference in the lives of those who rely on this type of care. Sign up today to be a part of our movement!

H4HC 501 (c) (4) FAQs

What is H4HC - Hearts for Home Care?

Hearts for Home Care, Inc. – also sometimes referred to as Hearts for Home Care or H4HC – is a 501(c)(4) non-profit organization that is affiliated with—but separate from—BAYADA Home Health Care, Inc., which is a 501(c)(3) non-profit organization.

Why is H4HC ‘separate but affiliated’ with BAYADA?

Under US federal tax law, section 501(c)(3) organizations like BAYADA are limited in how they can advocate for change. Hearts for Home Care has been formed under section 501(c)(4), which allows for greater flexibility in how one can advocate and the tools available. Other examples of 501(c)(3) organizations with 501(c)(4) affiliates include: The National Hospice and Palliative Care Organization (NHPCO) and the Hospice Action Network (HAN); The Alzheimer’s Association and the Alzheimer’s Impact Movement (AIM); and March for our Lives and the March for our Lives Action Fund.

Why did BAYADA need to create a separate 501 (c) (4) for advocacy purposes?

The 501(c)(4) non-profit organization (H4HC) that is separate from the 501(c)(3) non-profit organization (BAYADA) is necessary to protect and preserve the 501(c)(3) public charity status of BAYADA while permitting maximum governmental affairs and advocacy activities. Development of an affiliated 501(c)(4) non-profit organization aligns with BAYADA's smart growth strategy, as the Government Affairs team works to create a legislative and regulatory environment in which decision-makers recognize home health care as the fiscally and socially responsible solution to the nation’s healthcare needs, thereby supporting BAYADA’s mission of creating a lasting legacy and serving millions of people worldwide.

When did H4HC Launch?

BAYADA’s Government Affairs Office (GAO) began establishing the H4HC brand in 2016 to begin the process of bringing home care advocacy beyond the BAYADA community. While the name, branding images, and other such items have been in developmental use, the 501(c)(4) entity itself has only officially launched as of January 2023. While we have asked BAYADA employees and other members of the home care community at-large to sign up to demonstrate their interest in Hearts for Home Care advocacy before, all who wish to become an official member of the new 501(c)(4) entity must sign up after 1/1/23 and annually thereafter. because under the rules governing the official 501(c)(4) entity, all members must affirmatively establish and renew their membership once a year.

Who runs H4HC?

Currently, BAYADA Hearts for Home Care, Inc. – is governed by a separate 5-member Board of Directors which represents BAYADA’s interests, the interests of individuals who join as action members, and the interests of organizations that join as affiliate members. The President/Executive Director of H4HC is Dave Totaro who also currently serves as BAYADA’s Chief Government Affairs Office.

What’s the difference between H4HC and BAYADA’s Government Affairs Office?

BAYADA’s GAO office staff will continue to be the voice for BAYADA before legislators and regulators to support pricing and access to care, representing BAYADA specifically. BAYADA Hearts for Home Care, Inc. advocates can also be employees—but the H4HC brand will represent home care more widely, as a larger community.

How do I check my membership status at H4HC?

Whether you have previously signed up to demonstrate your interest before, as of 1/1/23, all memberships must be affirmatively claimed. Please be sure to sign up even if you think you may have already done so.

Why should I become an H4HC Advocate?

Members of H4HC are able to participate in advocacy activities that will serve to educate and inform state and federal lawmakers about home care. They will also receive certain benefits, including:

  • Customized communications to your lawmakers: Joining H4HC will allow you to receive email notifications about state and federal proposals that will impact home care, and will help you to reach out to legislators with your thoughts. For example, telling your legislator that you are supportive of better funding for home care, or unsupportive of a policy that would make accessing home care more difficult for those who needed. H4HC’s goal is to make advocacy as easy and accessible to you as possible, so such messages would be pre-drafted and editable to save you time while still enabling you to share your voice.

  • Exclusive advocacy opportunities: H4HC members will be given opportunities to meet with legislators in-person and via Zoom, and to be a part of media opportunities to support home care. We intend to make advocacy an easy but regular part of members’ daily lives.

  • Ongoing learning and education: Hearts for Home Care will share optional training opportunities and resources for members, including advocacy best practices and how-tos. If you are not yet sure about advocating in person, these opportunities are meant to help you feel more comfortable and confident sharing your stories.

  • A say in H4HC leadership:  H4HC action members have the right to nominate individuals to fill one Director position on the H4HC Board of Directors, and the right to vote in the election to fill that Director position.