Do I need home health or home care after a fall?
Key facts
- Home health payer
- Medicare (when criteria met)
- Home care payer
- Private pay, LTC insurance, VA, Medicaid waivers
- Home health role after a fall
- PT/OT gait & balance, nurse clinical follow-up
- Home care role after a fall
- Transfers, bathing, meals, meds, daily observation
- Personal Care rate, SE MI
- $29–$37/hr (2026 agency rate)
These are two different services with two different payors, and after a fall most families need both at the same time. Home health, ordered by the doctor and delivered by a Medicare-certified agency, sends a physical therapist or occupational therapist 2 to 3 times per week for short visits to evaluate gait, prescribe balance exercises, and adjust the home for safety. A nurse may also visit if there are clinical needs.
Home care fills the other 165 hours of the week. A non-medical caregiver handles safe transfers, bathing, dressing, meal preparation, medication reminders on the exact schedule, bathroom safety, and daily observation. Personal Care in Southeast Michigan runs $29–$37/hr at 2026 agency rates.
The typical Southeast Michigan pattern after a fall: home health starts within a few days of the doctor’s order, home care starts within 24–48 hours of the family’s call, and both run in parallel for the covered home-health window (usually 30 to 60 days). When the Medicare skilled window ends, home care usually continues at reduced hours as strength and confidence rebuild.
Home care is not a substitute for the skilled evaluation. A PT can prescribe the exact gait pattern; the home care caregiver reinforces it every day. That combination is what actually reduces recurrent falls.
For the full breakdown, see the cornerstone: Parent Just Fell playbook.
Related questions
- Can the same agency provide both?
- Usually not. Home health agencies are Medicare-certified clinical providers. Home care agencies are non-medical and private-pay. They coordinate together.
- How do I get home health started?
- Ask the discharging or primary care doctor for a home-health referral. Medicare will only cover it with a physician order.
- Does home care require a physician order?
- No. A family can start home care directly with a licensed agency — no physician order needed.
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