Home Care & Home Health

Home health care is a rapidly growing business as more elderly persons and their families turn to home care as a means of allowing seniors to remain safely in their own homes. As a Senior’s Advocate, the first thing I want you to know about home care companies here in Colorado is that they are required to be licensed.

Types of Home Care Companies

In Colorado, all agencies that provide Home Care services must be either licensed or registered with the Colorado Department of Public Health and Environment. Agencies which directly employ their caregivers must be licensed, either for Skilled Care (Class A) or Non-Medical Care (Class B), as well as certified by Medicare and Medicaid if they accept them. The fact that home care companies need to be licensed should make you feel a bit more confident about hiring one.

There is another class of Home Care Companies, Independent Home Care Agencies that do not directly employ their caregivers, but instead provide referrals and then the caregiver independently contracts with the individual. As result, these agencies are only required to register with the state, and their scope of liability is very limited.

Home Health (Skilled) Care versus Home Care (Non-Skilled)

Now, I mentioned above that there is a difference between home health care and home care. It is important to grasp the distinction between skilled and non-skilled care, as doing so helps families to better understand and utilize their health insurance benefits and find financial assistance to care for a loved one.

Let’s review those differences in a bit more detail here:

Home Health Care – Skilled Home Care – Class A

Skilled home health care is considered medical which means that these agencies provide services by licensed or certified health care practitioners, such as nurses, occupational therapists, respiratory therapists and Certified Nursing Assistants (CNA). They also will do medication reminders as well as order the prescriptions for you. They will help only with the medical side. The CNA’s who come in are for assisting with bathing, transferring and other Activities of Daily Living. Some of these companies are also full service and hold a Class B license as well. Which means that they can provide the non-medical services as well.

Home Care – Non-Medical Care – Class B

Providing non-medical home care generally means assisting elderly or disabled persons in performing their activities of daily living, such as eating, maintaining personal hygiene, mobility as well as the other ADL’S. They also will do smaller activities such as cleaning, laundry, grocery shopping, running errands and transporting you to the doctors’ appointments. If you are on Medicaid, the transportation will not be included as per Medicaid rules.

The main distinction here is that these caregivers do not have to be licensed or certified. These companies also hire CNA’s but for the most part they are personal caregivers. Assistance with medication is an area that toes the line between medical and non-medical care. Medication reminders for taking pills is considered non-medical, but they can’t distribute them. If you need other forms of medication, shots, wound care, use a nebulizer and need to change it, use a catheter, etc… is considered medical care.

These home care agencies specifically provide personal care services such as bathing, going to the toilet, eating, transferring, dressing, and continence. In some, but not all cases, these providers also can assist with light housekeeping.

The Non-Medical home care sector is the one that is used the most for seniors. It allows seniors to stay home as long as possible or can provide a companion to assist them with some activities. This is why currently there are over 600 home care companies in the Denver Metro Area and that number is continuing to grow rapidly.
For this reason, when you consider using one of these home care companies, you should take a hard look at what the company is offering, and how stable they are. We all have heard horror stories about home care.

Here are some questions you should ask before hiring a home care company. These same questions could be used to evaluate Class A providers as well:

  1. How long has the home care company been in business?
  2. How long has a caregiver been with the home care company?
  3. What type of training do the caregivers get prior to working with a client?
  4. Does the home care company and the caregiver have liability coverage?
  5. What is the turnover rate for caregivers?
  6. What are the qualifications of the caregiver?
  7. Is your caregiver an independent contractor or an employee of the home care company?
  8. What is the likelihood that you will get the same caregiver for the foreseeable future?
  9. What type of insurance coverage does the home care company and or the caregivers carry?
  10. Are the caregivers bonded?
  11. Is there a minimum number of hours that are required?
  12. Do the services include assisting with all of the Assistance with Daily Living (ADL)?
  13. How do they handle emergencies and if one of the caregivers fails to show will they send another caregiver or will someone from the office cover?


What does HIPAA stand for? The Health Insurance Portability and Accountability Act.

It is a law designed to provide privacy standard to protect patients’ medical records as well as other health information that is provided to Doctors, hospitals other health care providers, and family members, and others.

In today’s world protection and privacy are very important and with this law in place, it helps some of who can gain access to your records.

HIPPA laws today are very strict. If you don’t have the proper forms, updated and/or signed, and upon something happening to you or your loved one, and they

Please make sure that you talk with your Attorney regarding this matter and make sure that you get everything updated.

What to expect from the Home Care Caregiver?

Since you are the one who is hiring the company; you should and are entitled to set what your expectations are. For instance, you should expect that they provide you with consistency, timelessness, experienced, and that they are insured.

Most of them should be able to do daily tasks without having to be told, making you meals, snacks, laundry, cleaning, companionship, assisting with your ADL’s, even take you to your doctors’ appointments, grocery shopping, out to eat, or just running errands among others. If you want, you can even make your own list aside from the one that the companies provide.

What insurance do home care companies accept?

You will need to ask the companies as they are all different in what insurance companies they will take. Most accept a majority of them. Long Term Care policies are a great way to pay for home care for both private pay and ones that accept Insurances.

Medicaid is another way to pay and there are some companies that accept Medicaid as a pay or source, but you will need to be qualified first.

What are the top 5 mistakes clients make when hiring and working with a home care company?

  1. Don’t understand when Long-term care insurance will “kick-in” and pay for home care
  2. Expect too little from the caregiver
  3. Expect too much caregiver.
  4. Continue to settle for sub-par performance from a company just because you don’t know what to do next

Final Note: How a Seniors Advocate can support and help you in this area.

Senior Advocates will be able to assist in navigating the systems for you as they know what is expected from the home care companies and have the experience to talk with your insurance companies to deterrent your qualifications and the benefits you are entitled to. We also advocate for you so that you get the right assistance you need and if there is any non-performance from the companies, we talk with them to get the situation back to your liking or if need to be find another company who will perform for you.