Who provides home health versus home care?

Home health providers are Medicare-certified — a specific federal designation with its own survey, staffing, and quality-reporting requirements. Every visit is by a licensed clinician: RN, LPN, physical therapist, occupational therapist, speech therapist, medical social worker, or home health aide working under an RN’s supervision. All visits are documented against the OASIS assessment and a physician-signed plan.

Home care providers are state-licensed (in Michigan, through LARA) but are not Medicare-certified because they do not deliver skilled clinical care. The workforce is caregivers — trained in ADLs, transfers, dementia response, safe medication reminders — vetted through background checks and reference checks, and verified in real time by a Registered Nurse before the first shift.

The distinction shows up in what the visit looks like. A home health visit is short and task-specific: wound dressing, gait training, blood pressure check, teaching. A home care shift is long and holistic: the whole morning routine, or the whole afternoon block, executed as a continuous stretch in the person’s home.

For families in Southeast Michigan, both services are widely available, and the two workforces do not overlap — a Medicare-certified RN does not do the daily shift, and a home care caregiver does not administer injections. That is the design.

For the full breakdown, see the cornerstone: Home Health vs. Home Care guide.