“Home care” and “home health” sound almost interchangeable, but they are not the same thing. The difference matters when a family is trying to figure out whether an older adult needs help with everyday routines, skilled clinical care, or both.
In Texas, the regulatory lines are specific. Personal Assistance Services, or PAS, are one HCSSA service category. Licensed Home Health Services are another. Medicare also uses its own rules for when certain home health services are covered.
The easiest way to sort through the terminology is to start with the actual need. Is the problem bathing, dressing, meal preparation, errands, companionship, or caregiver relief? Or does the person need nursing, therapy, wound care, injections, or another skilled health service?
The short version
Nonmedical home care generally focuses on everyday living support. In Texas, PAS is defined around routine ongoing care or services that help a person engage in activities of daily living or perform physical functions needed for independent living, including respite services.
Home health is a different service category. Texas describes home health services as including health services such as nursing, physical, occupational, speech or respiratory therapy, medical social services, intravenous therapy, dialysis, certain services provided under professional delegation or supervision, medical equipment and supplies, and nutritional counseling.
That means a family may need one, the other, or both at different points.
| Question | Nonmedical home care / PAS | Home health |
|---|---|---|
| Main purpose | Help with everyday routines and independent living | Provide qualifying health or skilled services at home |
| Examples | Bathing, dressing, meal preparation, light household routines, errands, companionship, caregiver relief | Nursing, therapy, wound-related skilled care, certain injections or other clinical services when ordered and appropriate |
| Texas license category | Personal Assistance Services is a HCSSA category | Licensed Home Health Services is a separate HCSSA category |
| Medicare | Medicare generally does not pay for personal or custodial care when that is the only care needed | Medicare may cover qualifying home health services when eligibility requirements are met |
What nonmedical home care is designed to help with
For many families, the first problem is not a medical procedure. It is that ordinary life has become harder to manage.
An older adult may be able to remain at home but need help getting dressed in the morning, preparing meals, keeping up with laundry, getting to routine errands, or staying connected during long stretches alone. A family caregiver may also need a predictable break from a demanding weekly schedule.
Those are the kinds of needs that fit the everyday-support lane. Families can review Valiynt’s planned Personal Assistance, Companion Care, and Respite Care pages to see how Valiynt is organizing its future nonmedical services.
Importantly, “companion care” is a useful consumer term, but it is not a separate Texas HCSSA license category. Valiynt’s planned companion-focused support is being developed within its nonmedical PAS model.
What home health is designed to help with
Home health belongs in the clinical lane. Depending on the person’s needs, provider, orders, and coverage requirements, home health may involve skilled nursing, physical therapy, occupational therapy, speech-language pathology, medical social services, or other qualifying health services delivered in the home.
A person might receive home health after a hospitalization, surgery, illness, or functional decline when skilled care is needed and the eligibility requirements are met.
That does not automatically mean the person has enough help with the rest of the day. A nurse or therapist may visit for a specific skilled purpose, while the family still has to solve meals, bathing, household routines, companionship, transportation, or long gaps between visits.
Can someone have home health and nonmedical help at the same time?
Yes. The two types of support can address different needs.
For example, a person might receive qualifying physical therapy through a home health agency while also relying on family or nonmedical support for meal preparation, dressing, companionship, or routine errands. The important part is keeping the roles clear so nobody assumes that one service automatically replaces the other.
A useful family plan names each need separately:
- What requires a licensed or skilled healthcare professional?
- What requires hands-on help with everyday living?
- What can family members reasonably cover?
- Where are the uncovered hours or tasks?
- Who should be contacted if the person’s health changes?
What Medicare may cover at home
Medicare can cover certain home health services for eligible beneficiaries when its requirements are met. Medicare lists medically necessary part-time or intermittent skilled nursing, qualifying therapy services, medical social services, and certain part-time or intermittent home health aide care among covered services.
There is an important limit. Medicare says it does not pay for 24-hour-a-day care at home, home meal delivery, homemaker services unrelated to a covered care plan, or custodial/personal care such as bathing or dressing when that is the only care a person needs.
So “Medicare covers home health” should not be translated into “Medicare pays for whatever help someone needs at home.” Coverage depends on the service, eligibility, and the specific Medicare rules.
How to decide which lane fits the current need
Start with a one-week record of what is actually happening. Write down where the person needs help and when.
If the notes mostly say things like “needs help showering,” “not preparing dinner,” “cannot get groceries,” “daughter has to stay every evening,” or “spends most days alone,” the family is looking primarily at everyday support needs.
If the notes say “new wound,” “needs therapy after surgery,” “requires skilled assessment,” “new injection,” or another health issue, involve the appropriate healthcare professional and ask whether home health or another clinical service is appropriate.
Some situations will show both columns. That is normal.
Questions to ask before choosing a provider
- What exact services are included?
- Which Texas license category applies to the services being offered?
- Who supervises the service?
- What happens if a scheduled worker is unavailable?
- Are there minimum visit lengths or schedule requirements?
- How are changes in the person’s needs communicated?
- What is private pay, what may be insurance-covered, and what requires separate eligibility?
- Which tasks are outside the provider’s scope?
Valiynt’s Resources page can help families organize questions before contacting providers.
Keep the decision tied to the person, not the label
Families do not need to become experts in agency terminology before they can make a good plan. They need a clear picture of what the person can do independently, what has become difficult, what requires clinical attention, and where the weekly schedule has gaps.
Valiynt Health Group is completing the Texas HCSSA licensing process for planned nonmedical Personal Assistance Services in Southeast Texas. Valiynt is not currently providing services or accepting clients or referrals. Families may use the website’s educational material while the licensing process is underway and review Contact for future updates.
Frequently Asked Questions
Is nonmedical home care the same as home health in Texas?
No. Personal Assistance Services and Licensed Home Health Services are distinct Texas HCSSA service categories with different scopes.
Does Medicare pay for help with bathing and dressing at home?
Medicare may cover certain home health aide services when a person is also receiving qualifying skilled home health services, but Medicare does not pay for custodial or personal care when that is the only care needed.
Can a person receive home health and nonmedical home care at the same time?
Yes. They can address different needs. One may handle qualifying clinical services while the other helps with everyday routines and schedule gaps.
Is companion care a separate Texas HCSSA license category?
No. “Companion care” is a consumer-facing description rather than a separate HCSSA license category.