McAllen Senior AdvisorWhat is the difference between home health and attendant care?
Home health is skilled care, nursing and therapy visits ordered by a physician for a homebound patient and usually paid by Medicare, while attendant care is non-medical help with bathing, dressing, meals and housekeeping, paid by Medicaid or privately.
In Texas both come from agencies licensed by HHSC as Home and Community Support Services Agencies. The license categories tell you which: licensed home health services, licensed and certified home health services, and personal assistance services.
How long does home health last?
Home health lasts as long as the patient needs intermittent skilled care and remains homebound, often a few weeks after a hospital stay or a new diagnosis, with visits that last under an hour; Medicare does not pay for long-term daily help.
When the nurse or therapist discharges your parent, ask what help will still be needed and who will provide it. That is the moment many Valley families start attendant care.
How many licensed agencies serve Hidalgo County?
HHSC's directory lists 177 home health agencies with offices in Hidalgo County, 87 of them certified so they can bill Medicare or Medicaid; an office's address does not limit where its staff travel.
Hidalgo County has 257 agencies licensed only for personal assistance, besides the home health agencies that also offer it. Many agencies hold more than one category, so one company can sometimes provide both home health visits and attendant hours, but they are still billed and supervised differently.
How do we decide which a parent needs?
If the need is medical, such as a new wound, new insulin, therapy after a fall or monitoring after a hospital stay, ask the doctor for a home health order; if the need is daily help that a family member has been providing, attendant care is the fit.
Many people need both for a time. The home health nurse can also assess whether attendant hours are needed and help start a STAR+PLUS assessment if your parent has Medicaid.
Can attendant care continue in a hospital or nursing home?
Generally no: personal attendant services are delivered in the home or community, so they pause during a hospital stay or a nursing home rehab stay and restart after discharge, sometimes after a new assessment.
Tell the agency and the STAR+PLUS service coordinator as soon as your parent is admitted, so hours are not lost and the schedule restarts on the day your parent comes home.
Side by side
| Home health | Attendant care | |
|---|---|---|
| Care | Skilled nursing and therapy | Personal care and housekeeping |
| Order | Physician's plan of care | Assessment and service plan, or private agreement |
| Payment | Usually Medicare | Medicaid through STAR+PLUS, or private pay |
| Length | Short episodes while homebound | Ongoing, often for years |
Sources: Texas Health and Safety Code ch. 247 and 242; 26 TAC chapters 553, 554, 558 and 559; HHSC directories, TULIP and handbooks; CMS; CareScout; VA rate tables, as cited above. See our editorial standards.
