The Difference Between a Home Health Agency and a Registery

There has been a long-standing debate in the realm of home health in Florida: agency or registry? Florida provides licensure for both home health agencies and nurse registries. At its core the concept is very similar – caregivers providing care to elderly and/or disabled individuals in the comfort of their own homes. The two business models however, have some significant differences. These differences are often heavily debated and it is probably not surprising there are strong opponents to each.

VIP America wants to preface this article with the thought that neither home health agencies nor nurse registries are a detriment to the clients they service when run properly. We believe there to be a true benefit and value to both.

Source of Payment

Let’s get the financial talk out of the way first:

Home Health Agencies can bill a patient’s Medicare benefits. Certification periods for this usually last around 9 weeks or so and must have an episode or event to qualify the need for care. Also a physician will need to sign orders necessitating care. Agencies can also accept private pay and insurance as well.

Nurse Registries will primarily accept Long Term Care insurance assignment of benefits and private pay. VIP America, LLC also holds contracts with several government agencies who contract services for Medicaid and Medicare diversion programs.

Skill Levels and Services

Home Health Agencies have a broader range of services they will provide for their clients. Many employ home health aides and certified nursing assistants for personal care services/bath visits. Nurses for skilled nursing services, supervisory visits and medication management. Therapists and therapist assistants for physical, occupational and speech therapies. Social workers for counseling and intervention services.

Nurse Registries have a more narrow focus in the skill level they can refer. Because a nurse registry tends to have a more long term relationship versus episodic (although we can handle PRN situations,) we only register and refer home health aides, certified nursing assistants and nurses. The services provided by those aides can be anything from homemaking, personal care, shopping assistance, transportation, respite and skilled nursing.


Home Health Agencies and Nurse Registries can both work with the client’s and their families to determine what type of schedule will benefit the client best. However, Medicare will only pay for a certain amount of services and there must be medical necessity that meets a set of criteria. So you will want to inquire about the companies’ private pay rates regarding specific services and their minimums. It is a common misconception that Medicare will cover all the services an individual might need the most like homemaking and transportation to doctor’s appointments, etc.


Another grave misconception in the home health arena is the status of caregivers referred through a nurse registry. Nurse registries often have to endure slander campaigns whose focus is the fact that caregivers are independent contractors versus employees as they would be through a home health agency.

Sadly the companies that employ these tactics often spread the fear that a nurse registry would carelessly throw out the referral to whatever warm body on the referral list would accept the case. Thus leading consumers to believe that the individual knocking on your door might be some rogue CNA left completely to themselves when caring for your precious loved-ones.

This simply is not true. Home health agencies and nurse registries have many of the same standards when it comes to the caregivers employed/registered with their respective companies. Nurse registries Health Care Administration just like an agency would.

Some agencies will also choose to highlight the fact that they carry worker’s comp insurance for their aides while we cannot because they are independent contractors. Those companies have completely ignored the fact that all caregivers referred to client’s homes carry their own professional liability insurance policy.


What does all of this mean to the consumer? We have the ability to work in coordination with each other. Most agencies and nurse registries will work together to supplement the care from each company. A caregiver referred by VIP America can assist the client’s family by keeping an eye out for red flags or indicators that an individual could benefit from additional services that Medicare may cover. We then work to alert the client’s home health agency on any changes with the client thus ensuring continuation of care.

For example: Mrs. Smith had a fall and injured her hip, after hospitalization and surgery she was released home with a Medicare agency to follow up for bath visits and some physical therapy. After 8 weeks it was ascertained that she had achieved her maximum level of improvement with the services provided and the services were discontinued. Mrs. Smith’s daughter was uncomfortable with the thought of her mother having to resume all the household chores so soon after her injury and procured assistance from a nurse registry for homemaking services and shopping assistance 3 times a week for 4 hours a day. While there the aide notices Mrs. Smith goes through periods in the afternoon where she seems very groggy and slightly disoriented. One day she notices Mrs. Smith attempts to retake medication she has already taken for the day. The caregiver notifies the client service supervisor at VIP America and they call the Medicare agency whom had been with Mrs. Smith previously. The agency comes back in to assist the medication management for the client. Mrs. Smith’s family is pleased as they did not know this was a qualifying event or service the client would be able to take advantage of.

In home health care we believe transparency is key. Do your homework. Schedule assessments with the companies you might use. VIP America, LLC will happily meet you in the comfort of your own home to discuss any home health services in Melbourne, and surrounding areas, that you might need.

Need assistance in the comfort of your own home? We can find help.

VIP America takes care of the guess work and helps you identify the right type of caregiver for you or your loved one. Discover the difference today.