Home Care vs. Home Health in North Dakota: What Families Need to Know
Home care and home health sound similar, but they are not the same. Learn the difference between non-medical support at home and skilled medical care so your family can choose the right type of help.
Home care and home health are not the same service. In North Dakota, home care usually means non-medical help with daily life, while home health means skilled nursing, therapy, and related clinical services delivered under a medical plan of care.
The names are easy to confuse, especially because companies and directories use them inconsistently. The practical difference is the kind of help a person needs, who provides it, and how it may be paid for.
ND Home Health currently provides non-medical in-home support. Private-pay services are available. ND Home Health is an approved North Dakota Agency Qualified Service Provider (QSP). We do not currently provide skilled nursing, physical therapy, occupational therapy, speech therapy, or emergency medical care.
The short answer
| Question | Non-medical home care | Skilled home health |
|---|---|---|
| Main purpose | Help a person live safely and independently at home | Treat or manage an illness, injury, or functional decline at home |
| Typical help | Personal care, homemaker help, meals, companionship, respite, supervision, chores, and non-medical transportation | Skilled nursing, wound care, injections, therapy, medical social services, and certain home health aide services |
| Typical workers | Caregivers, personal care workers, homemakers, companions, and approved QSPs | Registered nurses, licensed practical nurses, therapists, medical social workers, and home health aides working under a clinical plan |
| Medical order | Not the Medicare home-health pathway; private-pay support is arranged directly around daily needs | Generally requires a qualified medical provider’s order, medical necessity, and a written plan of care |
| Payment | Often private pay; certain eligible North Dakotans may receive authorized services through public programs and an approved QSP | May be covered by Medicare, Medicaid, or insurance when clinical eligibility and provider requirements are met |
| ND Home Health today | Yes, subject to caregiver availability | No |
What non-medical home care means in North Dakota
Non-medical home care supports activities of daily living and the routines that make it possible to remain at home. It is appropriate when the main problem is not a need for clinical treatment, but difficulty completing personal or household tasks safely and consistently.
Depending on the person’s needs and the provider’s approved scope, services may include:
- Bathing, dressing, grooming, toileting, mobility, and other personal care
- Housekeeping, laundry, shopping, and routine homemaker tasks
- Meal preparation and help with eating
- Companionship and social support
- Safety supervision
- Respite for a family caregiver
- Chore services such as heavier or periodic household tasks
- Non-medical transportation to essential community services
North Dakota Health and Human Services describes Qualified Service Providers, or QSPs, as individuals or agencies that have met required standards to serve eligible clients whose services are funded through state programs. The state’s current QSP materials identify services such as personal care, homemaker, respite, supervision, companionship, chores, and non-medical transportation. Eligibility, authorized tasks, hours, and payment are determined through the applicable public program and care-management process, not by the care agency.
Read North Dakota HHS information about Qualified Service Providers.
What skilled home health means in North Dakota
Skilled home health is clinical care. North Dakota HHS says home health agencies provide nursing and related services in residents’ homes. The state’s April 2026 Medicaid policy defines home health services as part-time or intermittent skilled nursing and related services provided under medical orders and a written plan of care.
Examples include:
- Wound assessment and treatment
- Injections, intravenous therapy, or other skilled nursing tasks
- Monitoring an unstable or serious health condition
- Physical, occupational, or speech therapy
- Patient and caregiver education related to a medical condition
- Home health aide care when it is connected to an eligible skilled home-health plan
Medicare states that a person generally must need part-time or intermittent skilled services, meet its homebound criteria, receive a face-to-face assessment, and have care ordered by a qualified health professional. A Medicare-certified home health agency must provide the covered care.
Review Medicare’s home health coverage rules and North Dakota Medicaid’s current home health policy.
Which type of help fits the situation?
| Situation | Likely starting point | Why |
|---|---|---|
| A person needs help bathing, dressing, preparing meals, or keeping up the home | Non-medical home care | The need centers on daily living and household support |
| A family caregiver needs several hours of relief | Non-medical respite care | The goal is temporary relief and safe supervision |
| A person is lonely, forgetful, or unsafe when left alone but does not need a medical procedure | Companionship or supervision | The need is presence, cueing, observation, and routine support |
| A person has a new wound, injection, unstable condition, or medically necessary therapy need | Skilled home health | The need requires licensed clinical judgment or treatment |
| A person is leaving the hospital and needs therapy plus help with meals and bathing | Possibly both | Home health can address the clinical recovery while non-medical care fills daily-living gaps |
| The person may be in immediate danger or is having an urgent medical problem | Emergency services | Neither routine home care nor scheduled home health replaces 911 or emergency evaluation |
Can someone receive home care and home health at the same time?
Yes, the services can complement each other when each is separately appropriate. A nurse or therapist may visit for skilled treatment, while a non-medical caregiver helps with meals, hygiene, supervision, or household routines between clinical visits.
Coverage is not automatic. Each payer and program applies its own eligibility, authorization, care-plan, and non-duplication rules. Families should ask each provider to state exactly which tasks it will perform, when it will visit, and who is responsible for the remaining care.
How payment differs
Private-pay home care
A family or client may purchase non-medical support directly. The schedule and tasks are based on the agreed care plan, provider scope, staffing, and rate. ND Home Health currently accepts private-pay inquiries across North Dakota, with service dependent on local caregiver availability.
QSP and publicly funded home- and community-based services
Eligible North Dakotans may receive authorized services from an approved QSP. A case manager or applicable state process determines program eligibility and the authorized service plan. A provider cannot decide that a person qualifies, promise a number of hours, or bill as a QSP before its enrollment is approved.
ND Home Health’s ND Home Health is an approved North Dakota Agency Qualified Service Provider (QSP). Until approval is confirmed, our available care is private pay.
Medicare or Medicaid home health
Medicare home health is limited to covered clinical services for people who meet its rules. Medicare specifically says it does not pay for 24-hour care at home, meal delivery, homemaker services unrelated to the clinical care plan, or personal care when that is the only care needed.
North Dakota Medicaid’s home health benefit also has clinical eligibility, provider, order, documentation, and service-authorization requirements. It is distinct from QSP-delivered home- and community-based services.
For a broader breakdown, read How to Pay for Home Care in North Dakota.
Questions families often ask
Does Medicare pay for ordinary non-medical home care?
Usually not when personal care or homemaker help is the only need. Medicare may cover limited home health aide services only when the person is also receiving eligible skilled nursing or therapy under a covered home-health plan.
Is a home health aide the same as a private-duty caregiver?
No. A home health aide works within a clinical home-health plan and under agency supervision. A non-medical caregiver may provide personal care and daily support through a separate private-pay or authorized community-services arrangement.
Do I need a doctor’s order to contact ND Home Health?
No. Families can contact us directly about private-pay non-medical support. We will ask about the person’s daily needs, location, schedule, safety concerns, and caregiver availability. We do not diagnose conditions or replace a medical provider’s assessment.
Does ND Home Health provide skilled nursing or therapy?
Not currently. ND Home Health provides non-medical services. Families needing nursing, wound care, injections, or therapy should contact a licensed home health agency or ask the person’s medical provider for an appropriate referral.
Can QSP funds pay for care from ND Home Health?
ND Home Health’s ND Home Health is an approved North Dakota Agency Qualified Service Provider (QSP). Private-pay services are available now. We cannot determine Medicaid eligibility, approve services or hours, or represent that QSP billing is available before state approval is confirmed.
A practical next step
- Write down the exact tasks the person cannot complete safely.
- Separate medical treatment needs from daily-living and household needs.
- Ask the medical provider about skilled home health when nursing or therapy may be necessary.
- Use the free North Dakota Home Care Roadmap or contact ND Home Health to discuss non-medical support and local availability.
You can also review our non-medical home care services and North Dakota service-area approach.
Source and scope note: This educational guide was reviewed against Medicare, North Dakota HHS home-health, North Dakota Medicaid, and North Dakota QSP materials available on July 28, 2026. Program rules, eligibility, authorization, and coverage can change. ND Home Health does not determine public-benefit eligibility or payment coverage.