Levels of Care

With the increased presence of home care and home health care agencies in South Hampton Roads, it is important for health care consumers to know who and what comes in their doors when disability and/or dementia demand that care can be accessed.

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A home health agency is one that provides skilled care, ordered by a physician for a prescribed reason and usually for a limited length of time. Medicare augmented by a Medigap policy will pay for these services, however there are restrictions imposed on the patient. RN'S, LPN's, CNA's and therapists are usually employed by home health agencies. They are licensed by the state and must adhere to state regulations.

Home care agencies provide personal care and although this care may be Medicaid funded, it is usually a fee-for-services arrangement. There are so many agencies providing this care that choosing one can be confusing.

Licensed, bonded and insured services must follow state regulations that in part can offer more substantial supervision, knowledge and experience benefiting the patient. 


Skilled Home Health Care Nursing

Provides the highest level of home care—physician ordered and covered through through insurance and Medicare.


There are companion, housekeeping and sitter services that are restricted from bathing and transferring a patient. Among the many agencies that are licensed, there are a variety of caregivers. The CNA has had 120 hours of clinical and classroom experience. The PCA has had 40 hrs of direction but it is not certified by the state.

The plan of care must be a reflection of the medical and caregiving needs of the patient and must be designed and written by a Registered Nurse and available in the home. The RN must be the supervising professional and must admit the patient for care. LPN's are not accepted for this role.

Marilyn C. Fall,


For more information or a free home assessment:

Call (757) 454-4800 to see if you would benefit from personal home care.

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