© 2017 Upward Care, LLC  
  • Black Facebook Icon
  • Black YouTube Icon
  • Black Instagram Icon
1380 Pantheon Way
San Antonio, TX 78232
Jul 29

Are all home care agents certified nurses?


I am wondering about this as my brother brought up that ones who are certified nurses typically cost more because they are medically trained and cleared to perform things an uncertified caregiver can't do. Is there a difference here or has he misunderstood something?

Your brother is correct. Typically, nurses do professional tasks like medication management and administration, wound care, evaluating health status, and medically complex care. They usually work through home health companies. Medicare and health insurance pays for Home Health care. Home care is assistance with activities that are usually performed on our own, but that someone is no longer able to do by themselves like help with bathing, dressing and grooming, meal preparation, housekeeping, and driving. The caregivers sometimes are certified nurses assistants, and sometimes they are caring individuals who have had a lot of experience helping people. They can also alert the agency or family if they observe any changes in the client's condition or anything that they are concerned about. This type of care is considered custodial and is private pay unless the client has a low enough income to qualify for Medicaid.

Kelly - it might also be useful to understand some of the lingo you will likely encounter. When looking at home services, the industry differentiates between Skilled needs and Custodial needs. A Skilled need is usually one in which a RN or LVN is needed - services like Laura mentioned above. Most skilled care is considered short term and IS covered by Medicare and other insurance plans. Custodial needs are most likely long term and ones which do NOT require the level of a nurse, and can be preformed by a caregiver with training. This type of care is designed to meet the ADL's (Activities of Daily Living) - like bathing and dressing. These are by far the most common needs families have as the need is mostly for supportive services: meal prep, light housekeeping, grooming, ect. Custodial needs are NOT covered by Medicare or standard insurances but may be covered through a long term care policy.

Thank you for your responses. I ended up getting a few questions answered here. I am glad I asked because I was under the impression that the bathing and everything like that would be done by all caregivers, not just ones who specify it. I think both will be necessary long term. The custodial care is not covered by insurance which is very unfortunate. I know in nursing homes, this is covered but we do not want to go that route unless we had no other option.

New Posts
  • With all things considered, at the moment my mother-in-law is going well. My husband and I have been talking about getting her more care in the near future. She is currently staying in our guest house so she is closer by. She was previously renting a small trailer home and it was a chore to get her to move. We would like to keep her here with us until her time comes, if possible. Is round the clock care from home an option if/when it comes to this? How much care will be provided?
  • I would like to know how the home care system generally works. Having never known anyone who has been through this process, I want to make sure everything will be done properly as well as what to expect. I don't need every detail but a simple step by step process. Like what I have to do as a daughter, what my mom as to do as a patient, and what the care service will be doing to get everything set up.
  • I have been considering this option with my husband for my mother. My father seems to be on board with it as well. We are considering just having some help for her step in a few hours a day just to make sure she is taking her medication, do a daily check up, and make sure my dad is handling everything okay. How much would something like this cost if the insurance does not cover it?


Russell Gainer, LCSW

Co-Founder - GainWel



  • Mental Health

  • Dealing with Grief

  • Family Dynamics

  • Caregiver Burnout

Marie Hoffman, RN, BSN

Lead Instructor

  • Nursing Skills

  • Personal Care

  • Education and Training

  • Caregiver Skills Training


Tim Montfort

Financial Adviser - Raymond James



  • Retirement Planning

  • Wealth management

  • Estate Issues

  • Longevity Planning

Leanne Chaloupka, OT

Occupational Therapist


  • Home Health/ Hospice

  • Rehabilitation

  • Aging in place

  • Adaptive Care

Laura McGuire

Co-Owner - Griswold Home Care



  • Introducing Home Care

  • Aging in Place

  • Resistance to Care

Carol Bertsch

Elder Law Attorney



  • Advance Directives

  • Power of Attorney

  • Medicaid considerations

  • Estate Planning


Byron Cortes, LCSW, CMC
  • Care Management

  • Needs Assessment

  • Crisis Intervention

  • Placement Management

  • Family Caregiver

  • Estate Planning

  • Advance Directives


Family Caregiver, Elder Law Paralegal


Toni O'brien


The medical, legal and financial information contained on this web site is provided for educational and informational purposes only and is not a substitute for professional advice. 

We love to help, that is why we are here! But... Questions related to specific legal, financial or medical issues can only be be answered in general terms. If more detail is needed you can contact the professional directly for a consultation or meeting. 

Read the full disclaimer HERE