In short
Home care brings help into your parent's home for set hours, from companionship to hands-on personal care, with nursing visits when a doctor orders them. A nursing home provides nursing care, 24-hour supervision, meals and help with daily activities in one place. Home care fits until needs require skilled care or supervision around the clock.
Side by side
^ Home care and nursing homes compared
| Home care | Nursing home | |
|---|---|---|
| --- | --- | --- |
| What it provides | Personal care, homemaking and companionship for set hours; skilled visits when ordered | Nursing care, 24-hour supervision, three meals, help with daily activities, therapy |
| Best fit | Needs that fit into scheduled hours, with family or others covering the rest | Daily skilled nursing, or care needs that run day and night |
| National median cost, 2025 | $35 an hour for a non-medical caregiver | $9,581 a month semi-private; $10,798 private |
| Medicare | Covers part-time skilled home health for homebound people; not custodial care | Covers short-term skilled care after a qualifying hospital stay; not long-term care |
| Medicaid | Many state programs pay for care at home | Pays for long-term care for people who qualify |
Signs home may no longer be enough
- Your parent needs help at night as well as during the day
- Needs include daily nursing tasks family can't safely do
- Falls are happening even with help in place
- The family caregiver is exhausted or their own health is slipping
- The cost of the hours needed is more than a nursing home
Our Is home care enough? self-check walks through these.
The cost crossover
Home care is billed by the hour, so cost rises with need. At the national median of $35 an hour, about 274 hours of home care a month equals the $9,581 median for a semi-private nursing home room. That is about nine hours a day. Check local rates, which vary widely.
Questions families ask
Is home care cheaper than a nursing home?
For part-time help, yes. For round-the-clock care, often not: at 2025 national medians, about nine hours a day of home care costs as much as a semi-private nursing home room.
Does Medicare pay for home care?
Medicare covers part-time or intermittent skilled home health for people who are homebound and under a doctor's care. It does not pay for custodial care alone, such as help with bathing and dressing.
Can a person on hospice stay home instead of a nursing home?
Yes. Hospice is usually given at home, though the family still provides or pays for most day-to-day care.
Who decides if my parent needs a nursing home?
Your parent, if able, together with family and the doctor. Medicaid programs also assess whether a person meets a nursing facility level of care.
Sources
- National Institute on Aging: Long-term care facilities, assisted living, nursing homes and other residential care
- National Institute on Aging: What is long-term care?
- Medicare.gov: Home health services coverage
- Medicare.gov: Long-term care coverage
- CareScout Cost of Care Survey 2025 (national and state medians)