Home Health Aides

The four rungs, in plain terms

Nobody explains this at the point of inquiry, so here it is in the order of what each person can do.

• Companion or homemaker: Company, conversation, meals, errands, laundry, driving, keeping an eye on things. No hands-on personal care. If someone needs help getting into the shower, this is the wrong rung. See companion care.
• Home health aide (HHA): Hands-on personal care: bathing, dressing, grooming, toileting, transfers, mobility, feeding. Completes a state-approved training program and works under the supervision of a registered nurse. This is the rung most families actually need and the one they are usually quoted.
• Certified nursing assistant (CNA): Certified through the Florida Board of Nursing and listed on the state registry, with more clinical training than an HHA. CNAs are the standard in nursing homes and hospitals, and plenty also work in private homes. Everything an HHA does, with a broader clinical grounding behind it.
• Licensed nurse (LPN or RN): Medication administration, injections, wound care, catheters, tube feeding, assessment. A different category of worker entirely, at a different rate. See skilled nursing at home.

What an aide is not permitted to do

At Focus Family Care, every aide and assistant on any of these rungs is Level 2 background screened before entering a home, and works under a plan of care written by a registered nurse.

This is where placements go wrong, and it goes wrong in the same way every time.

An aide can remind someone to take their medication and can help with self-administration. An aide cannot administer medication, give an injection, dress a wound, change a sterile dressing, manage a catheter or a feeding tube, or make a clinical judgment about whether something is serious.

Those are nursing tasks. They stay nursing tasks regardless of how experienced the aide is, how long they have known the family, or how willing they are to help.

So the decision is not really HHA versus CNA. It is this: does the daily routine include anything on that list? If it does, you need nursing hours in the plan, even a short visit, and the aide covers everything else. If it does not, an aide is the right and considerably cheaper answer.

Families who get this wrong tend to get it wrong in the expensive direction, booking a nurse for a job an aide could do. But the dangerous direction is the other one, booking an aide for a household where somebody is quietly hoping they will handle the insulin.

So does HHA or CNA matter for my mother?

Honestly, less than people expect, and less than the person you match with.

For ordinary personal care at home, a good HHA and a good CNA will do the same work to the same standard. A CNA's extra training shows up in clinical settings and in reading a deteriorating situation. If the person is medically complex, unstable, or recently discharged, that experience is worth asking for by name.

For most households, the things that determine whether the arrangement works are not on anybody's certificate: does this person turn up, do they turn up on time, do they get on with your mother, and do they notice when something has changed.

Ask us for the rung you need. Then ask about the person.

Observing and reporting is the underrated part

An aide in the house four mornings a week sees deterioration weeks before a monthly appointment does. What they ate, how they moved, what was different today.

That is the part families undervalue and the part a supervising nurse relies on. It is also what separates a care service from someone simply being present.

What it costs, and what moves the number

Aide care is billed hourly and quoted in writing before anything begins. Two things move the rate: how many hours a week you need, and how physically involved the care is. There are no evening or weekend differentials, so a Saturday morning costs what a Tuesday morning costs.

One practical point reduces the bill and is routinely missed. Where some nursing is genuinely required, putting nurse hours only against the tasks that demand a license and aide hours everywhere else nearly always lands below a single higher-rate booking covering both. Tell us the routine and we will mark up which is which.

A long-term care policy, if one exists anywhere in the family paperwork, pays for aide hours far more often than households expect. Send it over and a coordinator will go through the wording with you at no cost.

Medicare covers aide services only as part of a skilled home health episode a physician has ordered, alongside nursing or therapy rather than on its own. Florida's Medicaid Long-Term Care program may pay for aide hours for those who qualify, and eligibility is screened by the Area Agency on Aging covering your county. Beyond those two routes, aide care is privately paid.

What we can tell you about staffing

The smallest booking we accept is four hours.

When your regular aide is unavailable, a backup aide covers the shift. We keep backups available rather than leaving a household to find its own cover, which is the question worth asking any agency before you sign.

Where we place home health aides

Home health aides across Palm Beach, Broward, Miami-Dade, Martin, St. Lucie, Indian River and Okeechobee counties. See also personal care for the service itself, and non-medical home care for how the services fit together.