How to Hire a Private In-Home Nurse (RN/LPN) vs. Home Health Aide (HHA)
1. Defining the Roles: Scope of Practice and Training
A Registered Nurse (RN) holds an associate or bachelor degree in nursing, passed the NCLEX-RN, and is licensed to administer IV medications, manage complex tube feedings, assess acute health declines, and coordinate with attending physicians. A Licensed Practical Nurse (LPN) works under RN or MD supervision, handling medication administration, wound dressings, and catheter care. In contrast, Home Health Aides (HHAs) and Certified Nursing Assistants (CNAs) focus on activities of daily living (ADLs)—transferring, bathing, dressing, and gentle nutrition assistance.
2. Hourly Cost Comparison: Agency Markups vs. Direct Hire
Traditional home health agencies typically charge $85–$120/hour for private duty RNs and $36–$48/hour for HHAs, keeping 40% to 50% as administrative gross margin. On assistedhelp.com, caregivers post their own hourly rates. A booked shift includes a 10% platform fee. The caregiver is paid the posted total minus that fee. Those posted ranges are examples, not a quote.
3. Legal and State Nurse Practice Act Boundaries
By law in all 50 states, HHAs and uncertified companions cannot administer prescription medications, draw blood, or dress open surgical wounds. Attempting to assign medical procedures to an aide exposes families to severe liability and patient risk. If your loved one has a tracheostomy, insulin injections, surgical incisions, or IV therapy, hiring a licensed RN or LPN is legally and clinically mandatory.
4. Checklist Before Hiring an In-Home Nurse
Before you hire, read the profile. A Checkr badge is a Checkr report. A staff review is not. Confirm an RN or LPN license with the state board. Ask about CPR or BLS if the work needs it. An assistedhelp.com visit log is a record of hours and, when the phone shared it, a location. It is not a Medicaid, VA, or insurance approval.
Official Resources & References
- National Council of State Boards of Nursing (NCSBN) — Official standards, Nurse Practice Act guidelines, and nurse licensure compact information.
- Medicare.gov Home Health Services — CMS guidelines defining intermittent skilled nursing eligibility and clinical limitations.
Frequently Asked Questions
Can a Home Health Aide administer oral medications?
In most states, an aide may only provide "medication reminders"—prompting the senior to open pre-poured pill organizer boxes. An aide cannot pour, measure, or administer prescription drugs unless they hold a specific State Medication Aide certification under RN delegation.
Is private duty nursing covered by Medicare?
Original Medicare only covers intermittent, short-term skilled nursing for acute rehabilitation following a qualifying hospital stay. Long-term, continuous private duty nursing is paid out-of-pocket, via Long-Term Care Insurance (LTCI), or through Medicaid Home and Community-Based Services (HCBS) waivers.
How does assistedhelp.com verify an RN or LPN license?
Nurses submit a license number and state. assistedhelp.com staff review that submission before a skilled-nursing profile is shown. That review is not a live Nursys query.
Hire Verified Eldercare Without Agency Markups
Compare RNs, LPNs, CNAs, and senior companions. You hire them directly. assistedhelp.com does not hold payment in escrow.
Find Caregivers Near You →