Home Care vs Assisted Living vs Home Health in Georgia

When a parent starts needing help, families run into a tangle of similar-sounding terms. In-home care, home health, personal care homes, assisted living and nursing homes are different services with different rules, and they're paid for in different ways. This guide explains each one in Georgia terms, who pays for what and how to check that a provider is licensed.

What's the difference between in-home care and home health?

The two names sound alike, but they cover different kinds of help.

In-home care (Georgia's rules call it "private home care") is help with daily living in the person's own home. Georgia's licensing rules describe three kinds of service a private home care provider can offer:

Personal care tasks, such as help with bathing, toileting, grooming, dressing and eating, along with walking and transfers
Companion or sitter tasks, such as transportation and escort, meal preparation and household tasks "essential to cleanliness and safety"
Nursing services, which only a licensed registered nurse (RN) or licensed practical nurse (LPN) may provide

In-home care is usually scheduled by the hour, from a few hours a week to around the clock, and it can go on for as long as it's needed.

Home health is skilled care that a doctor orders, usually for a limited time after an illness, injury or hospital stay. Under Medicare, it includes skilled nursing, physical, occupational and speech therapy, medical social services and home health aide services alongside that skilled care. Georgia licenses home health agencies under a separate set of rules (Chapter 111-8-31), and Medicare pays only Medicare-certified agencies.

Many families use both at once. A nurse and therapist might visit a few times a week after a stroke, for example, while an in-home caregiver helps with showers, meals and getting around the house in between.

What's the difference between assisted living and a personal care home in Georgia?

Georgia licenses residential care in two sizes, both overseen by the Department of Community Health (DCH).

A personal care home provides housing, meals and one or more personal services for two or more adults not related to the owner. DCH describes these as serving 2 to 24 residents, under Chapter 111-8-62.
An assisted living community is a personal care home serving 25 or more residents that holds a separate license to provide assisted living care, under Chapter 111-8-63. Assisted living care can include medication administration by a certified medication aide and limited nursing services.

So "assisted living" in Georgia is a specific license. Under the rules, only a licensed assisted living community may hold itself out as offering assisted living care.

What does a nursing home provide?

A nursing home offers round-the-clock supervision, personal care, meals, therapy and on-site nursing care 24 hours a day. Georgia licenses nursing homes under Chapter 111-8-56. Nursing homes are for people whose medical and care needs are too heavy to meet safely at home or in assisted living, and for short-term rehab after a hospital stay.

Home care vs assisted living vs home health at a glance

	In-home care	Home health	Assisted living or personal care home	Nursing home
Where	Your home	Your home	A residence	A facility
What	Help with daily living, companionship, errands	Skilled nursing and therapy, ordered by a doctor	Housing, meals and personal care	24-hour nursing care, personal care, rehab
How long	As long as needed	Usually short term	Ongoing	Short-term rehab or long-term stay
Usually paid by	Private pay, long-term care insurance, VA benefits, Medicaid waiver programs for those eligible	Medicare, if conditions are met	Mostly private pay or long-term care insurance	Medicare for short skilled stays, then private pay or Medicaid
Georgia rules	Chapter 111-8-65	Chapter 111-8-31	Chapters 111-8-62 and 111-8-63	Chapter 111-8-56

For current prices in metro Atlanta, including the CareScout 2025 medians for each setting, see how much in-home care costs in Atlanta.

Does Medicare pay for home care or assisted living?

This is the question that surprises families most. Medicare.gov says plainly that "Medicare doesn't pay for long-term care," and that most health insurance, including Medigap, doesn't either.

Home health is covered under specific conditions. According to Medicare.gov, the person must be homebound (leaving home takes a lot of effort), must need part-time or intermittent skilled services and must be seen in person by a doctor or other provider who orders the care. Care has to come from a Medicare-certified home health agency. "Part-time or intermittent" usually means skilled nursing and aide services combined of up to 8 hours a day, up to 28 hours a week.

Custodial care isn't covered. Medicare's home health benefit excludes 24-hour care at home, homemaker services and "custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need." That's exactly the help most in-home caregivers give.

Nursing home coverage is short and conditional. Medicare covers skilled nursing facility care after a qualifying inpatient hospital stay of at least three days in a row. In 2026 it pays in full for days 1 to 20 after the Part A deductible ($1,736), charges $217 a day for days 21 to 100 and stops after day 100. It covers only daily skilled care, not a long-term stay for help with daily living.

The other payers are private funds, long-term care insurance, VA Aid and Attendance for eligible veterans and survivors and Georgia Medicaid. Georgia's Elderly and Disabled Waiver (the CCSP and SOURCE programs) can pay for personal care at home for people who qualify for nursing home level of care and meet income and asset limits. In metro Atlanta, apply through Empowerline at 404-463-3333. The cost guide linked above goes through each of these in more detail.

How does Georgia license in-home care agencies?

Georgia requires a license. The rules (Chapter 111-8-65, Rules and Regulations for Private Home Care Providers) say no private home care provider may operate without a license or provisional license from DCH. The Healthcare Facility Regulation Division runs the program. A few narrow exemptions exist, such as a person who provides care directly without employees or contractors.

The rules set minimum standards that are useful to know when you're comparing agencies.

Background checks. Owners and staff with direct access to clients must have a satisfactory fingerprint-based criminal records check.
Training. Personal care aides must complete approved training, such as nurse aide training or a 40-hour program covering bathing, transfers, first aid and CPR, infection control and more. Companions must show competency in areas like meal preparation, home safety and handling medical emergencies.
Health screening. Staff need a TB screening when hired and every year after.
A written service plan. A supervisor completes it within seven working days of the first visit. It covers the person's limitations, the services, how often and how long visits happen and the goals.
Supervisory visits. A supervisor visits the home at least every 92 days for personal care clients and at least every 122 days for companion clients.
Client rights. Clients have the right to be fully informed of charges, a complaint process free from retaliation and written notice of how to reach DCH.

How do I check that a home care agency is licensed in Georgia?

Use GaMap2Care, the DCH search tool for licensed facilities and providers. It lists facilities, inspection reports and license verification, and links to complaint forms. You can reach it from the DCH Healthcare Facility Regulation website. Search by the agency's name or by county and choose the private home care provider category.

If you have a concern about a licensed provider, DCH takes complaints online or through its Complaint Intake Unit at 1-800-878-6442. For Medicare home health agencies and nursing homes, Medicare's Care Compare tool also shows quality information.

What questions should I ask a home care agency?

Bring this list to your first call.

What is your Georgia license, and may I see it?
How do you screen caregivers, and what training do they have?
Who writes the care plan, and how often is it reviewed?
Who supervises caregivers, and how often does a supervisor visit?
What happens if our regular caregiver is sick? Who fills in?
What tasks won't your caregivers do? (Ask about medication, lifts and clinical tasks.)
How do you arrange a nurse if care needs one?
How will you keep the family updated, and who do we call with a problem?
What are your rates, minimum hours and charges for nights, weekends and holidays?
How much notice do you need to change or stop service?

A good agency answers these plainly. Clear answers about what caregivers don't do are a good sign. If you're still deciding whether help is needed yet, see signs a parent needs help at home.

When in-home care is the right fit

In-home care suits people who want to stay at home and need help with the routine of the day more than round-the-clock nursing. Tale Circle Care's caregivers help with bathing and dressing, mobility and transfers, meals, medication reminders, light housekeeping, companionship, dementia support, errands and rides to appointments. They also cover help after a hospital stay, overnight and extended hours and respite for family caregivers. They report changes to the family, and when care calls for a nurse, we can arrange a licensed one. We serve communities across metro Atlanta, including Marietta, Roswell and Johns Creek. Call (346) 278-3018 to talk it through.

Common questions

Is home care cheaper than assisted living?

For part-time help, usually yes. At full-time hours or more it often costs more. The Atlanta cost guide shows the break-even math.

Can someone get home health and in-home care at the same time?

Yes. Medicare home health covers the skilled visits, and families often pay privately for daily help in between.

Is a personal care home the same as assisted living in Georgia?

Not quite. Both are licensed by DCH, but only a community with 25 or more residents and an assisted living license can offer assisted living care.

Does Medicaid pay for in-home care in Georgia?

It can, through the CCSP and SOURCE waiver programs for people who qualify. Contact your local Aging and Disability Resource Connection (1-866-552-4464 statewide) to apply.

Sources

This guide is general information for families, not medical advice. Ask the person's doctor about their care, and call 911 in an emergency.