Home Care Service Terms to Clarify Before Choosing a Provider

Words like home health aide, personal care, homemaker and companion can describe different work, different training expectations and different payers. New York law defines several of these terms, but “companion” and “caregiver” are often used loosely in marketing. Before you choose a provider, ask them to list the tasks they would actually perform, who would perform them, and who supervises that person. A task list is far more useful than a job title.

The table below explains the common terms and who can confirm them. It does not assess anyone’s care needs, and CaringNYC is not a home care provider.

Service terms and who should confirm them

Term	What it can mean	Ask this	Who confirms
Home care	A broad term. The state says it may include nursing, therapy, home health aide and personal care services.	Which of these do you provide directly?	The agency; state profiles
Home health aide services	Under Public Health Law § 3602: simple health care tasks, personal hygiene, housekeeping tasks essential to the patient’s health, and related support.	Which health-related tasks can this aide do, and under whose direction?	The agency’s nurse or supervisor
Personal care services	Help with hygiene, dressing, feeding and household tasks essential to health, prescribed by a physician under a plan supervised by a registered nurse. A nurse practitioner may also prescribe or order them to the extent the law allows (§ 3602).	Who is the supervising nurse, and how often do they review the plan?	The agency, or the plan or HRA if Medicaid pays
Homemaker	Help and instruction in running a household, plus dressing, feeding and incidental household tasks (§ 3602).	Does this include hands-on personal care, or household tasks only?	The agency
Housekeeper or chore services	Light work or household tasks that do not need a trained homemaker (§ 3602).	Will this person touch or physically assist the client at all?	The agency
Companion	Not one of the service types listed in § 3602. Providers often use it for social visits, supervision or errands, but the meaning varies.	What exact tasks are included and excluded? Is the worker employed by a licensed agency?	The provider, in writing
Home attendant	A common NYC term. NYC 311 uses it when describing Medicaid home care through CASA.	Is this a home health aide or a personal care aide on your records?	HRA, the plan, or the agency
Personal assistant (CDPAP)	A worker chosen and directed by a Medicaid consumer or their representative under the consumer directed program.	Who acts as the employer-side contact, and who handles payroll?	The Medicaid plan or local Medicaid office
Skilled nursing or therapy	Clinical services such as nursing, physical therapy or speech pathology, which certified agencies may offer.	Who ordered this, and how many visits are planned?	The clinician and the agency

Medicaid’s Level I and Level II language

If Medicaid pays for personal care, you may see a split into two levels. Under 18 NYCRR 505.14:

Level I covers nutritional and environmental support, such as making beds, light cleaning, laundry, shopping and preparing meals. Authorization for Level I is capped at eight hours a week.
Level II includes those tasks plus personal care such as bathing, dressing, grooming, toileting, walking, transferring and turning and positioning.

A Level II task list does not by itself establish eligibility. Ask NYIA, your Medicaid plan or HRA which current minimum needs requirements and any legacy protections apply to your case.

The regulation also says supervision and cueing are not standalone services, so a request for “someone to keep an eye on Mom” may not translate into paid hours by itself. Describe the specific daily tasks where that supervision matters.

These levels are Medicaid terms. Private-pay agencies may not use them.

Terms that describe the hours

In Medicaid personal care, live-in 24-hour care means one aide, who must be likely to get five hours of uninterrupted sleep during an eight-hour sleep period. Continuous care means more than one aide providing uninterrupted care for more than 16 hours in a calendar day (18 NYCRR 505.14). Private providers may use the same words differently, so ask how many workers are involved and what happens overnight.

Hourly limits matter for Medicare as well. Medicare describes covered aide care as part-time or intermittent, and only alongside skilled care.

Medication: pin down the wording

“Medication help” is one of the vaguest phrases in home care. The Medicaid regulation lists assistance with the patient’s own administration of medication, including prompting them about the time and identifying the medication. That is different from a nurse managing or giving medication. Ask exactly what the worker may do if the person cannot take medication on their own. If the answer is “it depends,” ask who decides and whether a nurse’s review is needed.

Agency labels are a separate question

The job title tells you who comes to the home. The agency label tells you how the organization is regulated.

Certified Home Health Agency (CHHA): provides part-time, intermittent skilled services and may be paid by Medicare, Medicaid, private payment and commercial insurers, according to the state’s CHHA page.
Licensed Home Care Services Agency (LHCSA): serves people who pay privately or have private insurance, and may contract to serve Medicare or Medicaid beneficiaries whose cases are managed by another entity, per the state’s LHCSA page.

A license requirement applies to agencies providing nursing, home health aide or personal care services, directly or by contract (Public Health Law § 3605). That sentence does not name housekeeping or companion services, so a business offering only those may describe itself differently. If a “companion” will also help with bathing or toileting, ask how the business is licensed, then check the answer in the state profiles.

One agency’s credentials do not transfer to another. If a website says “licensed,” confirm that the license belongs to the exact legal entity you would sign with.

A quick way to use this

Write down the tasks you expect help with, one per line. Next to each, have the provider mark “included,” “not included,” or “needs nurse review,” and ask them to send that list in writing. Then compare providers line by line.

For more background, see our Home Care Services overview and the pages on home attendants, nursing services and CDPAP. If you are still deciding who to call first, begin at Home Care & Senior Services.

Sources

Checked November 5, 2026. The Department of Health minimum needs page could not be opened directly on that date, so it was confirmed only through the state’s search listings.