Home health or private duty nursing? How to tell which one you need

Our intake line gets this question more than any other, usually from an adult child trying to arrange care for a parent who is about to leave the hospital. The two services sound alike and both bring a nurse to the house, but almost everything else about them is different.

Home health is visits

Home health is intermittent: a nurse or therapist comes for a visit of about an hour, does something that needs a licensed professional, and leaves. A physician orders it, the plan of care has goals, and it ends when those goals are met, typically after a few weeks. Medicare covers it at no cost to the patient for people who are homebound and need skilled care.

Private duty is shifts

Private duty nursing is continuous: a nurse stays in the home for a shift, anywhere from four hours to around the clock. It is for people who need a nurse nearby for long stretches, such as someone on a ventilator or a child with a tracheostomy. Medicare does not cover it. Medicaid often does for children, and for adults it is usually paid by long-term care insurance, a waiver program, the VA or the family.

Many families use both

The two are not either-or. A patient on home health for wound care might also have a private duty nurse overnight. When we set up both, the home health nurse and the private duty team share one chart so nothing falls between them. If you are not sure which you need, call intake and describe the situation; that conversation is free and usually takes ten minutes.