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If you love helping and caring for people, there are many opportunities for you to be gainfully employed in the health care industry. One of these is to work as a Home Care Worker. Home Health Aides provide a lot of assistance to nurses and they are paid good money for their services. If you’re in this industry, having access to and choosing home care rostering software is a great way to manage your colleagues. This allows you to inform your colleagues, with useful information from their monthly rotas, to accessing client’s important information, so staff is able to get an understanding before the visit. The following are tips about making money as a Home Health Care Aide.

Home care workers can make as much as $30,000 every year and some of them even make more. There is an increasing demand for these workers so you will always find a position. The basic criteria for working in this capacity are that you have to be at least 18 years old and must have basic reading level education. The training classes are usually not more than 3 weeks long.

  • How to Make Money as a Home Health Care Aide
  • What is The Difference Between a Home Health Aide And a Personal Care Aide?
  • What is The Difference Between a Home Health Aide And a Home Care Aide?
  • What Are The Duties of a Home Health Care Aide?
  • Is a Home Health Aide a Health Care Worker?
  • What is a Home Health Care Worker?
  • What Does a Home Health Care Aide do?
  • Is Working as a Home Health Care Aide Worth it?
  • What Does a Home Health Aide Make an Hour?
  • How Does Home Health Aide Care Differ From Nursing Assistant Care?
  • What Type of Care is Generally Given by a Home Health Aide?
  • Who Is Part of the Home Health Care Team?
  • How do You Pay For Home Health Care Aide?
  • Where do Home Health Aides Make The Most Money?
  • How Much Does a Home Health Aide Gets Paid?
  • How Many Hours Does a Home Health Aide Work?
  • Who Gets Paid More CNA or HHA?
  • How Much Does 24/7 in-home Care Cost?
  • Do You Have to be Certified to be a Home Health Aide?

How to Make Money as a Home Health Care Aide

Upgrading Your Skills

If you are already making money as a Home Health Care Aide, you should consider upgrading your skills so that you can make more money. A simple C.P.R class or training in the care of Special Needs patients can easily increase your level of income. You can also choose to go for a CNA certification which can really push your career to another level.

Provide Diligent Service

Make sure you are always available for work. The problem with a lot of home health aides is that they do not take their work seriously enough. If you are always available, your coordinator may offer you extra work and this will enable you to make more money. If you have little children, you should make proper arrangements for a babysitter so that you can always be available for work.

Be Professional

Most home care workers do not see themselves as professionals. This is where you can easily distinguish yourself. Professionalism will help you to stand out. You should see yourself as a specially trained and experienced health care professional. If you display professionalism in the discharge of your duties, your coordinators will soon recognize your efforts and you will be given better positions.

Read Also: Make Money As An Information Technology Expert

Also, you do not always have to work for an agency. When you have enough experience, you could consider working on your own. You can market your services by placing classified ads on the internet. Just write a short description of your training and experience. Private clients will enable you to make more money as a Home Health Care Aide.

Don’t Be Limited To One Agency

If you are not getting enough work hours from the home care company that you are with, you should consider expanding your options. You can always apply to other agencies. You should also consider applying to business establishments. A lot of organizations have health care departments and they could need the type of services that you provide.

These jobs might not be strictly ‘health care aide’ descriptions but they are positions that you can easily handle. Making money as a Home Health Care Aide is not difficult. There are a lot of opportunities waiting for you out there.

What is The Difference Between a Home Health Aide And a Personal Care Aide?

Home health aides (HHA) and personal care aides (PCA) perform many similar duties when caring for patients. However, with training, certain responsibilities and work environments, their careers can differ slightly.

Here are the major differences between a home health and personal care aide:

Training

Most often, health care facilities and states require home health aides to pursue extra training and certification courses in order to practice their occupation. This can include completing vocational schools for an HHA career, or becoming certified as an HHA through a certified nursing assistant (CNA) program.

Personal care aides, however, are able to pursue their career right outside of high school. This is because HHAs help some patients with medical needs, such as administering medication and taking vital signs. PCAs do not have the training or certifications necessary to perform those tasks.

Responsibilities

Personal care aides often assist patients more thoroughly as they help them with errands, cooking and housekeeping. Home health aides generally focus more on the health and safety of their patients and their daily tasks, such as bathing and grooming and don’t always assist with errands or housekeeping activities.

Next to taking vital signs and administering medication, home health aides can also perform certain medical procedures under the strict supervision of a registered nurse (RN) or nurse practitioner (NP).

Work environment

Families of patients often hire personal care aides to perform their duties and assist loved ones in their own home. Home health aides can provide the same service, but can also work in nursing homes, retirement homes, transitional housing and more.

Most often, personal care aides will work with one or two patients focusing their care and attention on fewer clients, while home health aides might have an extensive list of patients they’re assisting in care communities.

Salary and job outlook

According to the Bureau of Labor Statistics (BLS), as of May 2019, home health and personal care aides make an average of $12.15 per hour and $25,280 per year. However, the highest 10% of workers often make over $34,000 annually.

The BLS also predicts that the job outlook for HHAs and PCAs will increase greatly by 34% between 2019 and 2029, creating an additional 1,159,500 jobs with 568,800 positions opening every year.

Required skills

Here are a few skills that HHAs and PCAs use throughout their career:

Communication

Both personal care and home health aides require the use of communication to perform their primary duties, including understanding patients’ needs, relaying important information to families and reporting patients’ health statuses to nurses and physicians.

It’s also important for PCAs and HHAs to understand directions from both the patient’s family and crucial medical instructions from doctors on how to care for the patients properly.

Attention to detail

Attention to detail is important for both HHAs and PCAs so they can understand when a patient is in pain or suffering from an ailment, know when to administer care to patients and remember important details, like their dietary restrictions. This often involves the combination of powerful organization techniques and observation skills to ensure they care for patients appropriately.

Compassion

It can be very important for home health and personal care aides to have strong skills of compassion and empathy as they often work with injured, impaired or struggling individuals who require a lot of care and attention.

Ensuring to actively listen to the patient’s needs, practice patience and offer companionship can help HHAs and PCAs develop strong relationships with their clients and display excellent skills of compassion.

Medical knowledge

Though home health aides perform a majority of the medical tasks for their patients. It can be equally important for personal care aides to be equipped with medical knowledge so they can identify certain medical ailments triggered by disease and perform first aid or CPR if necessary.

It’s also important for both professionals to have certain medical knowledge so they can understand information given to them by nurses and physicians.

Physical stamina

Because HHAs and PCAs often perform many occupational duties while on their feet, it can be important for them to build physical stamina. Whether they’re running errands, turning patients in bed or completing rounds in health care facilities, home health and personal care aides are often physically active during their workday.

What is The Difference Between a Home Health Aide And a Home Care Aide?

People often think home health and home care are the same thing. Many agencies use the terms interchangeably, depending on the state you’re in. The terms sound similar and both types of care are delivered in the home. But there are important differences between home care and home health care. Knowing the differences can help you decide which type of care is right for your needs and budget.

Some of the key differences between home health vs. home care are:

Type of Care
  • Home health care provides “clinical” or “skilled” care by licensed nurses and therapists.
  • Home care provides “non-clinical” or “non-skilled” care by professional caregivers.
Services
  • Home health care services are more medical in nature. Home health aides are available to help with things like bathing, grooming and dressing until you are safely able to do them again or have a caregiver who can safely assist you. But the focus of care is skilled nursing and therapy.
  • Home care helps with everyday tasks like bathing, dressing, grooming, cooking, cleaning and transportation. It does not include medical care like nursing or therapy.
Eligibility
  • Home health care requires a doctor’s order. Patients have to meet certain eligibility criteria. For example, they must have limited ability to leave their home and require assistance to do so.
  • Since people usually pay for home care out of pocket, there are no eligibility requirements.
Length of Care
  • Home health care continues as long as your doctor certifies, and you continue to meet eligibility requirements.
  • Home care continues as long as you want, based on your budget and needs.
Payment
  • Home health care is covered by Medicare, Medicaid and most private insurance plans for eligible patients.
  • Home care is typically paid directly by the patient or long-term care insurance. Medicaid may also cover home care.
Care Team
  • The home health team is made up of skilled professionals such as nurses and therapists.
  • Family members and professional caregivers provide home care services.
Frequency
  • Home health care visits are typically a few hours per week, depending on the patient’s needs and doctor’s orders.
  • Home care can help patients 24/7, depending on the patient’s budget and needs.
Location
  • Patients can receive home health care in their place of residence, including assisted living facilities and group homes.
  • Home care is typically provided at home.

When you’re comparing home health care vs. home care, you should know that you can receive both at the same time. Home health provides clinical care to help the patient recover, and home care helps with day-to-day caregiving and tasks. Some agencies provide both home health care and home care.

Although there are many differences between home care and home health care, both types of care can help older adults stay safe and independent in their homes. If you’re struggling with daily tasks or recovering from an illness, injury or surgery, ask your health care provider if home health or home care is an option for you.

What Are The Duties of a Home Health Care Aide?

Home health aides assist with activities of daily living, like bathing, dressing and meal preparation. But perhaps the most meaningful benefits they provide are companionship for the patient and much-needed “time off” for exhausted family caregivers. 

The duties of a home health aide don’t require medical training. They do, however, require state-approved health training, such as in how to take vital signs, provide basic care, infection control and emergency procedures; that’s how a home health aide (HHA) differs from a personal care aide (PCA).

A home health aide’s duties may include:

  • Helping with personal activities, such as bathing, dressing and grooming
  • Light housekeeping, such as doing laundry, washing dishes and changing the bed linens
  • Shopping for groceries
  • Planning, preparing or serving meals
  • Providing transportation to doctor’s appointments
  • Helping with using the toilet
  • Monitoring and documenting a client’s condition, including checking vital signs or recording how much they ate
  • Giving medication reminders

Because older adults who don’t drive or have limited mobility can become isolated and depressed, visits from an aide can also provide an emotional boost. Depression is sadly very common in seniors. Having the companionship of a home health aide can alleviate those symptoms, and help prevent the physical manifestations associated with depression.  

In many instances, home health aides can seem like a member of the family. Providing critical care, along with smiles and laughs, is an incredibly powerful role in the life of another human being. You get to know your patients, but also their families. Our home health aides are blown away by the emotional connections they make as part of their jobs. 

Is a Home Health Aide a Health Care Worker?

Home health aides are considered health care paraprofessionals and must meet state-set training requirements. (Other types of home health workers are sometimes lumped together under the title of home health aides.)

They might live with the care recipient or work regular shifts. Along with doing routine chores the care recipient can no longer manage, such as laundry, cooking and shopping, the aides must be able to:

  • Assist with activities of daily living, including bathing, dressing, eating, grooming, moving from one place to another, toileting and cleaning up afterward.
  • Check vital signs such as blood pressure, respiration and pulse.
  • Monitor a client’s physical and mental condition; level of exercise; and how much they are eating, drinking and going to the bathroom.
  • Handle emergencies such as an accident, heart attack or stroke.

Home health aides do not provide services such as physical and occupational therapy or skilled nursing care. But they often are tasked with observing the care recipient’s physical and mental health, and reporting on conditions to a registered nurse or other health care professional.

Traits to look for in a home health aide include compassion, good communication skills and attention to detail, says Christian Steiner, owner and operator of the Manhattan office of Home Instead Senior Care, a national provider of home health services. Flexibility, honesty, patience, physical stamina and some medical knowledge also are required to do the job well.

Training requirements for home health aides vary by state. Under federal law, home health aides must get at least 75 hours of training through a state-approved program, including at least 16 hours of hands-on practical and clinical training.

Most states follow that standard, but some set a higher bar. As of 2016, 12 states and the District of Columbia required 100 or more hours — up to a high of 180 in Maine — and 11 states and the District mandated at least 30 hours of clinical training, according to PHI, a nonprofit organization that works to improve direct-care services for older and disabled people.

What is a Home Health Care Worker?

Home healthcare is healthcare provided in the client’s home. Home healthcare workers provide hands-on long-term care and personal assistance to clients with disabilities or other chronic conditions.

These workers, who may be home health aides, personal/home care aides, companions, nursing assistants or home health nurses, are employed in patients’ homes and in community-based services such as group homes.

Depending on their training and job duties, they help patients with activities of daily living such as meals, bathing, dressing and housekeeping, and may perform clinical tasks such as medication administration, wound care, blood pressure readings and range of motion exercises.

Home healthcare workers may be employed by a home care agency or may be self-employed independent contractors working directly for patients. They have little control over their work environment which may contain a number of safety and health hazards.

These hazards include bloodborne pathogens and biological hazards, latex sensitivity, ergonomic hazards from patient lifting, violence, hostile animals and unhygienic and dangerous conditions. In addition, if their daily work schedule requires them to provide care for multiple patients, they face hazards on the road as they drive from home to home.

What Does a Home Health Care Aide do?

The job of a home health aide (HHA) is to help someone live independently at home by assisting with activities of daily living, among other responsibilities. It’s rewarding and important work. Not only are you helping someone to stay in the environment in which they’re most comfortable, but home health care is actually more cost-efficient, because the care is tailored to the needs of the individual.

The work is so varied that there’s no “typical week” of being a home health aide. There isn’t a set duration for an HHA shift; you can work as short as two hours, if you’d like, but there are more standard eight-hour shifts and even live-in situations, too, depending on the client’s needs. 

The length of time a client needs an HHA varies, ranging anywhere from a few weeks to a few years or longer. And home health aides can work with a variety of people of different ages, although most clients are aging seniors.

Home health aides help people with activities of daily living (ADLs). The three main duties of a home health aide:

  1. Assistance with personal care
  2. Light housekeeping
  3. Companionship

Is Working as a Home Health Care Aide Worth it?

Working one on one with a client in their home means you get to build a strong and meaningful relationship with each client you see. In addition to your home health aide duties, like personal care and housekeeping tasks, you can spend time listening to your client’s stories about when they were younger, enjoying a joke that the two of you share, or listening to music that reminds your client of happy times. 

Working in-home care not only gives you a meaningful and valuable profession, it also allows you to enjoy a flexible schedule and a career in one of the fastest-growing professions in the United States. The Bureau of Labor Statistics estimates that the number of jobs available for home health aides will increase by 41% by 2026, so there will be plenty of opportunity for ongoing work. 

A career as a home health aide gives you the chance to do important and significant work that makes the world a better place. Now, that’s a powerful job description!

What Does a Home Health Aide Make an Hour?

The average hourly pay for a Home Health Aide in the United States is $12.07 an hour.

While ZipRecruiter is seeing hourly wages as high as $15.87 and as low as $7.93, the majority of Home Health Aide wages currently range between $10.10 (25th percentile) to $12.98 (75th percentile) across the United States.

The average pay range for a Home Health Aide varies greatly (by as much as $2.88), which suggests there may be many opportunities for advancement and increased pay based on skill level, location and years of experience.

How Does Home Health Aide Care Differ From Nursing Assistant Care?

When it comes time to choose the most appropriate senior care service for an aging loved one, knowing your options is important. In-home healthcare for the elderly that includes a medical component can differ between a certified nursing aide (CNA) and a home health aide (HHA). Both involve supplying a certain level of medical assistance, but to varying degrees.

Both the CNA and HHA offer basic healthcare, including changing soiled sheets or bedpans, assisting clients with bathing, dressing and grooming, among other similar, routine services. The primary difference between the two roles is that the HHA contributes more services to help complete basic tasks in which the CNA does not engage.

HHA and CNA Responsibilities

Such activities with which the HHA provides support include grocery shopping, doing laundry for patients as well as accompanying seniors on walks. Depending on the state in which the client resides, an HHA may also give a client medication under the supervision of a nurse or similar healthcare provider.

When it comes to the CNA’s role in a patient’s life, the CNA provides slightly more advanced medical care. The CNA is required to work under a registered nurse or licensed practical nurse, to whom they report their patients’ conditions and progress. CNAs cannot perform certain medical tasks due to liability and legality.

A CNA will monitor oxygen levels and vital signs, administer medications prescribed by a physician, dress sutures and change wound bandages—under the direction of a registered nurse or doctor. The CNA can also help tend to the patient’s living environment, maintain the cleanliness and sanitation of the room or help feed a patient during meals.

CNAs work very closely with patients and are frequently the first point of contact with the medical team. CNAs, through their frequent interactions with patients, are able to observe the fluctuations in the patients’ physical conditions and the subtle changes in their emotional states, thereby allowing them to relay this information to upper levels of the healthcare team and contribute to furthering optimal treatment and healing.

Work Environments

HHAs can work in various capacities. Oftentimes, HHAs are employed by senior care agencies to work in clients’ homes, for instance. HHAs also can work in day programs for the elderly, independent living and retirement communities, assisted living facilities and group homes for seniors.

Many CNAs work in hospitals, day programs, long-term care facilities, rehabilitation centers, clients’ homes and assisted living facilities. The workload of CNAs can be stressful, demanding and fast-paced; however, the opportunity to help those with medical needs and the fulfillment they experience in providing such services to improve the lives of those who are ill offers daily motivation during challenging days.

Training

No formal education is required of HHAs. Normally, however, HHAs possess at least a high school diploma. Aside from formal schooling, HHAs must undergo hands-on training, pass a competency examination plus pass standardized written tests in the presence of a registered nurse before they can be hired by an in-home healthcare agency.

This requirement is the case in every state in the US. Many vocational schools and community colleges offer training to prepare an individual for a career as a home health aide.

Medical schools and community colleges offer certification programs for those who wish to pursue a career path as a certified nursing assistant. All CNAs require a state-issued license to practice in their field. If a CNA has appropriate training, some states may allow the CNA to draw blood, for instance. The level of training a CNA receives can dictate, in some states, certain tasks he or she can undertake.

Whether the patient is a senior, stroke victim, an individual recovering from an injury or illness or an individual with a disability, a home health aide or a certified nursing assistant can provide invaluable in-home assistance to help make daily life as comfortable as possible. Especially if the loved one lives alone, in-home healthcare is essential to helping him or her sustain an optimal quality of life.

In some instances, both a home health aide and a certified nursing assistant can provide a range of services for the same patient, particularly when the senior is recovering from a surgery.

The elderly individual will require a certain level of advanced medical care, which a qualified CNA can provide, in order to recoup at home after hospitalization; at the same time, an HHA will offer basic care, in the form of general housekeeping, transportation and grocery shopping, with which the elderly individual will likely need assistance.

Hiring an elder care service provider to send an HHA to your home can offer immense relief to family caregivers. The constant supervision and compassionate care an HHA offers to elder clients enable these seniors to remain in the comfort of their home and live as independently and safely as possible.

What Type of Care is Generally Given by a Home Health Aide?

Home health aides typically provide assistance to people with every-day tasks so that they can be as independent as possible while remaining in their own homes. Typical tasks include bathing, dressing, and assisting a patient with using a bedpan, urinal, commode, or toilet.

HHAs may also be involved with purchasing and preparing food and assisting a patient with eating during meals. Depending on the state in which they live, HHAs may also participate in health care activities such as taking vital signs (such as checking blood pressure, pulse, respiration rate, and temperature) and assisting with prescribed medications under supervision, by providing reminders to patients. Personal care aides, however, may not perform the above health care activities.

Other tasks, such as light housekeeping duties such as vacuuming, laundry, and washing dishes, help to maintain the home of the person to whom care is being provided. It is important that home health aides and personal care aides keep accurate records of the services they provide and the tasks they complete.

They must document all services provided and those that were unable to be provided due to time constraints or patient refusal. Home health aides and personal care aides also keep records of their patient’s progress and must report any changes in their patient’s condition to their supervisor.

Developing a trusting relationship and providing companionship for the person for whom they are caring for is an important aspect of being a home health aide and personal care aide. This can also be one of the most rewarding aspects of the job.

Since HHAs and PCAs are providing intimate and important care to their patient, they have an opportunity to get to know him or her as a person very well.

Examples of Tasks Performed by HHAs and PCAs:
  • Bathing
  • Dressing
  • Toileting
  • Purchasing and preparing food
  • Eating
  • Monitoring vital signs (for HHAs only)
  • Housekeeping duties (vacuuming, laundry, dishes)
  • Companionship
  • Record keeping

Who Is Part of the Home Health Care Team?

Home health care may be provided by licensed medical personnel such as physicians, registered nurses (RNs), licensed practical nurses (LPNs), physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), registered dieticians (RDs), medical social workers (MSWs), respiratory therapists (RTs), wound care specialists, and unlicensed, but certified workers such as home health aides, nursing assistants, and personal care aides.

Unlicensed personnel such as home health aides and personal care aides are vital members of the home health care team. Every member of the home health care team has a role to play. When all members work together, they can achieve the goal of caring for the patient.

Physician (MD or DO)

While physicians may not often provide direct health care within the home setting, they oversee patient care, diagnose and monitor conditions, and prescribe medications and treatments. Doctors have graduated from a bachelor’s degree program and medical school.

They have passed a licensing exam within their state. All physicians must be licensed within the state they practice. Many doctors also have specialty certifications.

Registered Nurse (RN)

Registered nurses in a home health agency coordinate and manage the patient’s care. RNs perform assessments, monitor test and laboratory results, administer treatments and medications, monitor the patient’s condition, and provide education to the patient and family. Registered nurses supervise LPNs, Home Health Aides, and Personal Care Aides.

Registered nurses have degrees from two- or four-year nursing programs, or have graduated from a diploma program, and have passed a licensing examination in order to practice within their state. RNs may have advanced academic degrees and education/certification in specialty areas.

Licensed Practical Nurse (LPN)

Working under the supervision of an RN, a LPN may administer medications, check vital signs, provide wound care, collect samples for testing such as urine and blood, and assist with patient self-care activities. LPNs must complete a state-approved educational program and apply for a license within their state after passing an examination.

Physical Therapist (PT)

Physical therapists help patients to strengthen and restore their ability to be mobile and to prevent further injury. PTs may teach patients to use special equipment such as walkers and canes, assist patients with specific exercises to help regain mobility and strength, and administer treatments such as massage, heat, or cold to help improve patient circulation, reduce pain, prevent disability, and improve muscle and joint function.

PTs must obtain a Doctor of Physical Therapy (DPT) degree and pass national and state licensure exams to practice. PTs must be licensed within their state.

Occupational Therapist (OT)

Occupational therapists work with patients to help them learn to adapt to a disability so they may function as independently as possible. OTs help patients perform activities of daily living such as dressing, eating, and bathing.

An OT teaches patients how to use assistive and adaptive devices such as special forks, plates, long-handled shoe horns and sponges, and raised toilet seats. OTs usually have a master’s degree in occupational therapy and have passed a national certification exam. OTs must be licensed and/or registered within their state.

Speech-Language Pathologist (SLP)

Speech-Language Pathologists or speech therapists work with patients who have communication or swallowing disorders, who have experienced strokes or accidents, or have a neurological health problem.

The SLPs teach patients exercises to improve speech, to effectively communicate, and to safely swallow. They may suggest special diets to aid in swallowing, such as mechanical diets and thickened liquids. Most SLPs have a master’s degree and depending on the state in which they work, must be licensed.

Registered Dietician (RD)

A registered dietician evaluates a patient’s nutritional intake and orders special diets for the patient to follow. They provide education to patients and families about special diets to manage their illness and to improve their nutrition. RDs must have completed a bachelor’s degree and often have a master’s degree. Most states require certification or license to practice.

Medical Social Worker (MSW)

A medical social worker works with the patient and family to help them get support services such as counseling, financial assistance, and community services. An MSW provides emotional support to the family and works as an advocate to help meet the patient’s needs.

Social workers typically have at least a bachelor’s degree. Clinical social workers must have a master’s degree and two years post-masters supervised clinical experience. MSWs must be licensed within the state they practice.

Home Health Aide (HHA)

Under the supervision of a nurse, a HHA provides supportive care to patients within their homes. They work to increase or maintain independence, health, and well-being of the patient.

HHAs provide or assist with self-care activities such as bathing, dressing, grooming, toileting, feeding, skin care, use of medical supplies and equipment such as walkers and wheelchairs, and assisting with light housework, laundry, and home safety.

Depending on the state in which they live and if they work in a certified home health agency, home health aides (HHAs) must be certified and complete training programs.

Personal Care Aide (PCA)

Under the supervision of a nurse, a PCA provides self-care and companionship to a patient. They assist with self-care activities such as bathing, dressing, grooming, toileting, feeding, skin care, and use of assistive devices such as walkers and wheelchairs. They also assist with housekeeping tasks such as laundry, changing bed linens, washing dishes, and preparing meals.

Personal care aides may not perform any type of medical service or task, as a Home Health Aide may. A PCA may not take vital signs or glucose meter readings. Personal Care Aides are usually trained on the job. There are no educational requirements to become a PCA, but most PCAs have a high school diploma.

Patient/Family

The patient and their family are the most important parts of the health care team. Patients have the right to make decisions about their health care. They have a right to be informed about treatments and the care they receive. They have a right to refuse treatments, medications, and services.

All patients and their families are unique and have various needs, desires, cultures, and traditions. It is important that the health care team respect these individual differences and work to meet each patient’s needs. Without the patient, there can be no health care team.

How do You Pay For Home Health Care Aide?

When you or a loved one needs home health care, the last thing you want to worry about is how you’ll pay for it.

Medicare

Medicare is a federally funded program, primarily for those 65 and older. Medicare may pay for visiting nurses and other home health care services, including part-time skilled nursing care, part-time home health aides, rehabilitative therapy (including speech, physical, and occupational therapies), social services, and medical supplies. It does not cover around-the-clock home care, meal delivery, or assistance with shopping or domestic chores.

In order to qualify for Medicare home health care, a patient must be homebound and in need of part-time skilled nursing care or rehabilitative therapy. Your doctor must order Medicare services, as well as formulate a plan of care for the home health care organization, such as VNSNY, to carry out.

Your doctor and your VNSNY nurse will work closely to determine which services and supplies are needed and how often, as well as what progress should be expected and how long you need home health care.

Before your home health care services can begin, VNSNY will inform you in writing about how much of your bill should be covered by Medicare, as well as which items and services are not included in the coverage and their costs. VNSNY bills Medicare, which pays the full, approved cost of all covered home health care visits. Any remaining costs are the patient’s responsibility (but may be paid for by another form of insurance).

Medicaid

Medicaid is a health insurance program funded by federal and state governments that is available to United States citizens and permanent residents who meet certain requirements for income, resources, age, or disability.

In general, Medicaid covers most skilled nursing care, whether at home or in a facility, and personal care provided by a home health aide. Medicine, supplies, and equipment, as well as transportation to and from medical appointments, may also be covered. (Some services, equipment, and supplies may require prior approval before they can be covered.)

In order to help your family member get the health care required, it is important to plan ahead for Medicaid eligibility and to learn the rules necessary for Medicaid application so that you know what is required and how to comply.

Private Pay

Private pay (paying out of pocket) may be an option if you need home health care services (including skilled nursing care, rehabilitation therapy, or services provided by a home health aide) but don’t qualify for a government insurance program, if you don’t have private insurance, or if you desire more services than these programs cover.

For several reasons, many seniors and their families choose to pay out-of-pocket for private care:

  • Paying out-of-pocket gives you greater flexibility in the type and amount of services you order.
    • In some cases, a patient’s Medicare coverage or other private insurance coverage may not pay for all of the home health care services needed or wanted.
    • It may be that the benefits have been exhausted, or perhaps the patient’s medical needs do not qualify them for covered home care services.
  • You can avoid the restrictions and limits of programs provided by the government or private insurers.
  • Many people find that home health care costs are typically much lower than fees at residential health care facilities such as nursing homes, assisted living, or memory care facilities.

Where do Home Health Aides Make The Most Money?

The average salary of a home health aide worker varies by state, though the patterns that emerge are interesting. A more mundane pattern is that states with higher cost of living tend to have higher home health support incomes, such as California, Massachusetts and Washington.

Another significant correlation with higher salaries is where demand is high for home health aides, which can be influenced by a variety of factors. Here’s a breakdown of the top-10 states in which home health aides and personal care aides earn the most, based on the BLS’s mean annual wage data:

StateAverage Annual Wage – 20172017 Rank
North Dakota$33,9401
Alaska$32,3502
California$31,6103
Massachusetts$30,7404
Delaware$29,2705
Washington$28,6206
Iowa$28,5407
Rhode Island$28,4508
District of Columbia$28,4109
Nevada$28,29010

Supply and demand are especially important to home health aide incomes by state. It’s no coincidence that geographically remote and sparsely populated North Dakota and Alaska ranked as the No. 1 and No. 2 states where home healthcare aides earn the most money. Same with No. 7 Iowa, which is surrounded by higher-income states like No. 6 Washington and No. 8 Rhode Island.

How Much Does a Home Health Aide Gets Paid?

Home Health Aides made a median salary of $25,280 in 2019. The best-paid 25 percent made $29,460 that year, while the lowest-paid 25 percent made $22,680.

The metropolitan areas that pay the highest salary in the home health aide profession are Dover, Fairbanks, Bismarck, Anchorage, and Norwich.

  • Dover, New Hampshire – $32,170
  • Fairbanks, Alaska – $34,390
  • Bismarck, North Dakota – $33,280
  • Anchorage, Alaska – $32,980
  • Norwich, Connecticut – $32,210

How Many Hours Does a Home Health Aide Work?

Most full-time aides work about 40 hours a week, but because patients need care 24 hours a day, some aides work evenings, nights, weekends and holidays, or may “live in.” Many work part time.

Home care aides spend many hours standing and walking, and they often face heavy workloads. They may be trained in how to move and care for patients, and some may have access to mechanical devices that can reduce the risk of injury. Working as a home care aide can also be emotionally demanding because the patients they care for may be disoriented, irritable or uncooperative.

Who Gets Paid More CNA or HHA?

As the table below illustrates, Certified Nursing Assistants are usually paid more than Home Health Aides. The reason for this is related to the types of employers that each position works for.

Whereas the HHA is almost exclusively employed by home care agencies, the CNA may work in a wider range of facilities.

Some of these, such as clinics and private practices, often pay considerably more than one would earn solely working as a home care provider.

CNA vs HHA

How Much Does 24/7 in-home Care Cost?

Regardless of the kind of home care service you choose, you will receive an estimate based on the results of a comprehensive assessment of your individual needs by a licensed care worker or home care agency. Depending on the home care agency you choose, you may or may not be charged a non-refundable assessment fee.

Here Are Several Ways Through Which Your In-Home Care Cost May Be Broken Down:

  • Hourly Rates: This is by far the most common way of determining just how much you will pay as a client. Seniors who generally remain independent in their day to day activities may not need a care worker around the clock. It is not uncommon to find seniors who only need care workers for about 2 hours every day. In this kind of case, the calculated cost will not be so high depending on the home care agency you choose. You should also know that different home care agencies have an established minimum number of hours per day that one of their licensed caregivers can spend at the home of a client. In most cases, it is either 2 or 4 hours minimum. This is mostly for staffing purposes.
  • Daily Rates: This kind of arrangement is given to senior clients who need help or care around the clock. The rates are often calculated on a daily basis with allowances given for the time the caregiver takes off for their breaks and rests. Typically, the daily rate for most home care agencies ranges from $200 to about $350 per day. This, of course, is dependent on the cost of living within your given region as well as the amount of specialized care that you need as a client.
  • Overnight Rates: Overnight rates are slightly different than daily rates in that you could choose to hire overnight help without necessarily choosing the daily Although typically not calculated by the hour, overnight rates are not as expensive as daily rates because of the limited number of hours and activities associated with the service provided by the caregiver. Overnight clients are seniors who need assistance from a professional at night because they either get up too many times to go the bathroom and need help with that or have degenerative conditions such as Alzheimer’s or dementia and may wander off into the night. The care worker is primarily there to offer assistance and to ensure the senior’s safety through the night. This option is often chosen by seniors who have family members acting as the primary caregiver during the day. Since the family members need to sleep as well, there is always a care worker who takes over at night. The rates are fairly affordable with some home care agencies charging between $120 and $200 for every 10–12-hour overnight care.

As mentioned, these estimates vary depending on your location and the cost of living within that state or county. For the most part, you can easily compare and contrast different home care agencies to see which one offer the best value for money.

Do You Have to be Certified to be a Home Health Aide?

According to the US Bureau of Labor Statistics, HHA educational requirements vary depending on the employer.  Aides who work for organizations that receive funds from Medicare or Medicaid must complete formal training, while those who work for private companies are not required to meet these obligations.  

More experienced aides, such as certified nursing assistants (CNAs) and licensed practical or registered nurses, often provide on-the-job training for new aides.

Federal Requirements
Throughout the US any home health agency that accepts Medicare must employ certified home health aides.  Federal law states that HHAs working at a CMS (Centers for Medicare and Medicaid Services), must have 75 hours of training, including 16 hours of on-the-job training.

This is the minimum number of required hours, and states can then choose if they want to license HHAs working in the state and if any additional training is needed.  However, it is important to distinguish facilities that accept CMS and those that do not.  Private companies that do not accept Medicare do not have certification requirements.

State Requirements
As mentioned above, HHA certification requirements vary greatly by state.  In Wyoming, there is no HHA specific training program or designation.  In order to work as an HHA, one must complete an approved CNA program.   

The state of Wyoming then sets standards for how home health agencies train their home health aides. State law requires home health agencies to provide 16 hours of additional training upon being hired in the first two weeks.

In Wisconsin, potential HHAs must complete a CNA training program and then successfully complete an exam and a background check.  To be a CNA in Wisconsin requires a minimum of 120 total hours of training, including 32 clinical hours.

In Vermont, to work as an HHA an applicant must first be a Licensed Nursing Assistant (LNA).  The LNA training program includes 80 hours of total training, with 30 hours of clinical training.  After the training, all LNAs must pass a state exam and register with the state.

Washington, DC Requirements
Washington, DC only requires the bare minimum number of training hours (75), including 16 hours of on-the-job training.  Many states require more than this bare minimum and some states even require formal training such as a CNA or another nursing degree or certification to be an HHA.  

In Washington, DC, in order to be certified, home health aides must successfully complete a training program, pass a competency exam issued by the District of Columbia Board of Nursing, pass a criminal background check, and submit an application along with a fee to the District of Columbia Board of Nursing.  However, for private companies that do not accept Medicare, these certification requirements do not apply.

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The District of Columbia Home Health Aide certification by examination was established in July 2012 with the final publication of the Home Health Aide Regulations.   

The regulations were derived from the revised Health Occupations Revisions Act of 2009, which place Nursing Assistive Personnel under the authority of the Board of Nursing. The District of Columbia Home Health Aide Regulations were last revised and amended in September 29, 2017.

Many HHAs could be “waived in” or “grandfathered in” in the past, meaning they could waive the examination to be certified as an HHA. There are now four ways to be certified as an HHA in Washington, DC: (1) Certification by examination, (2) certification by endorsement, (3) certification by renewal, and (4) reactivation of certification.   The examination has 2 parts: a written section and a skills section.  HHA certifications expire October 31st of every odd numbered year.

There has been a history of fraudulent HHA applications in Washington, DC with HHA applicants submitting certification applications directly to the Board of Nursing themselves.  Many applicants have submitted fraudulent educational certificates and applications.  

Because of this, the Board now requires applications to come directly from the HHA’s employers, and for those applying to take the HHA examination, the HHA schools must send lists of graduates to the processing unit.

Due to the nature of their responsibilities and the Importance of their roles, HHAs should be thoroughly trained and vetted, arguably more than health care workers who work in health care facilities.  However, this is not always the case due to relaxed training and education requirements that vary from state to state across the country. 

This is especially worrisome in the nation’s capital, which has some of the least restrictive requirements for HHAs, and a history of loopholes, such as the grandfather clause, that allowed for unqualified and unverified HHAs to work in the District.

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