According to the North Carolina Department of Health and Human Services (NCDHHS), nursing services for home care typically focus on skilled nursing services. Here’s a breakdown of how skilled and unskilled care is defined in the context of home care services:

Skilled Nursing Services

These are services provided by licensed nurses (RNs or LPNs) that require advanced training and clinical judgment.

Examples of Skilled Care:

• Administration of medications (including IV therapy).
• Wound care and management.
• Patient assessments and monitoring of vital signs.
• Chronic disease management.
• Coordination with healthcare providers.

Unskilled Care

Non-medical services that can be provided by home health aides or personal care assistants.
Examples of Unskilled Care:

• Assistance with activities of daily living (ADLs) such as bathing, dressing, grooming, and meal preparation.
• Companionship and supervision.

NCDHHS Guidelines

• Home Health Agencies: In home health settings, skilled nursing services are typically the focus and are eligible for reimbursement by Medicare and Medicaid.
• Personal Care Services: Unskilled care may be provided by separate home care agencies not under the same regulations as skilled nursing agencies.

While both skilled and unskilled care may be part of a comprehensive home care plan, skilled nursing services, as defined by NCDHHS, clinical care provided by registered nurses (RNs) or licensed practical nurses (LPNs), such as wound care, injections, vital sign monitoring, medication administration, and patient assessments—all performed under the direction of a physician.