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At Home Care: Differences Between Skilled Nursing & Home Health Aide Care

Updated: Dec 9, 2020


Home Health Aide

Since more seniors are choosing to receive care at home, the home health care service industry has been growing at an unprecedented pace. In order to meet the specific goals of different individuals seeking in-home care, home care agencies have broadened the scope of services offered over time. Whether you are looking for short or long term care, or require temporary medical assistance, you now have a handful of options to choose from at home.


While the services offered from the comfort of home are broad and highly convenient, it’s easy for people trying to find care to get confused with what types of service or health care professional to look for. For instance, skilled nursing care and home health aide care are two different in-home care services that most people may initially think are same. The cost and type of care is very different, so it’s worth having a general understanding of the two so your research goes into finding the appropriate type of home health care agency. Don’t get overly concerned with this however, as an agency should guide you to the appropriate care types and advise on whether or not they can provide those services.


Below we’ll discuss some differences with skilled nursing and home health aide services to help you understand the differences between the two:


  • How you end up receiving care: One basic difference in how the search for care is initiated. Skilled nursing care has to be prescribed by a physician, physician assistant, or nurse practitioner to patients. So if you think you need care but it’s not something contrived from visits to your doctor’s office, a hospital, or a planned medical procedure, it’s more than likely that your search wouldn’t be for skilled nursing care.

On the other hand, people who can benefit from a home health aide are the ones, who just require personal care and need support to carry out their activities of daily living. This is a voluntary service and can be initiated without any visit or prescription from a Doctor. Home health caregivers prove to be a great option for seniors who want to retire at home and are experiencing age related decline in their health and functioning. Services offered by a home health aide can also be temporary and beneficial to those requiring general support during recovery from an illness, just as an example.


  • Services offered under each type of care: The second major difference lies in the kind of services that are offered under skilled nursing and home health aide care. So again, in home skilled nursing services are generally medical in nature and ordered by a physician, physician assistant, or nurse practitioner. The types of required care can vary greatly from: wound or pain management, medication supervision, IV administration, ostomy and catheter care, post surgical supervision, and much more. As the cost of health care has increased dramatically over time, there has been a much larger push towards recovery at home once it’s deemed medically safe to do so. With that in mind, there’s a good chance that one will find themselves seeking skilled nursing care at least on a temporary basis at some point during their life.

As far as home health aide services are concerned, these are more personal and non-medical in nature. Personal care offered by a home health caregiver may include assisting the client with personal hygiene, ambulation, eating, dressing, shaving, physical transfer and so on. They can also record and conduct some tests such as: urine tests for sugar, acetone or albumin; measuring intake and output of fluids; measuring temperature, pulse, respiration, or blood pressure, etc.


  • Professionals providing each type of care: The third difference is with respect to the type of care providers, offering each type of services. Skilled nursing care is always provided by Registered Nurses (RNs) and Licensed Practical Nurses (LPNs), who are authorized to practice under their respective states laws. LPNs provide nursing care assigned by and under the direction of a registered nurse who provides on-site supervision as needed, based on the severity of the client’s medical condition and the nurse's training and experience. This is critical to ensuring that the medical care has been provided exactly as it was prescribed by a physician.

On the other hand, home health aide services are offered by a home health aide (HHA) or certified nursing assistants (CNA) with proper training, experience, and certificate required to conduct this type of care. There will always be a registered nurse that writes the plan of care and supervises the HHA or CNA.


When choosing in home skilled nursing or home health aide care, it is always wise to choose a licensed home health care agency. They supervise the staff, can have coverage in the event of a caregiver calling out, and handle everything related to employee payroll and taxes, health insurance benefit processing, and more. United Pledge Home Health offers a FREE consultation, including in-home assessment and care plan estimate to provide the most personalized care plan for you or your loved one.

So that you or your family member concentrates solely on their health, recovery, and quality of life, Unified Pledge offers the following benefits to its clients:

  • Level II FBI background checks of all staff

  • Driving history checks

  • Companions, health aides, LPNs are our direct employees and not independent contractors

  • Constant communication to patients, family, and care team

  • Registered Nurse supervision is ongoing with every care plan

As a trustworthy home health aide service provider and skilled nursing agency in Palm Beach County, we are always ready to answer all your questions, even if you don’t require the care now. Click Here to reach out to us at

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