Home care in Montgomery County, MD covers five broad options: non-medical companion care, hands-on personal care, skilled home health, adult day programs and assisted living. The right fit depends on what your parent actually needs help with: company and household tasks, help with bathing and dressing, or nursing and therapy. If you are not sure where to begin, the county’s Aging and Disability Resource Unit at 240-777-3000 is a free first call.
This guide explains each option in plain language, who oversees it in Maryland, and how to start narrowing things down. It is general information, not medical, legal or financial advice.
The five main options at a glance
The words “home care” get used loosely. Agencies, hospitals and insurers often mean different things by it, so it helps to separate the options by the kind of help involved.
| Option | What it covers | Where it happens | Who oversees it in Maryland |
|---|---|---|---|
| Companion care | Company, conversation, meal preparation, light housekeeping, a steady presence during the day or overnight | At home | Depends on the tasks: an agency offering only household support needs no state license; one offering more is licensed as a Residential Service Agency by the Office of Health Care Quality (OHCQ) |
| Hands-on personal care | Hands-on help with bathing, dressing, toileting and moving around | At home | Residential Service Agencies licensed by OHCQ |
| Home health | Skilled nursing and therapy under the supervision of a physician or registered nurse | At home, usually for a set period | Home Health Agencies licensed by OHCQ; many are also Medicare-certified |
| Adult day programs | Daytime activities, meals and supervision; medical day care adds health services | At a center, returning home each evening | Adult Medical Day Care Centers are licensed by OHCQ |
| Assisted living | Housing plus daily support and services | In a residence or community | Assisted Living Programs licensed by OHCQ |
These options are not either-or. A person might attend an adult day program three days a week and have a companion at home on the other days, or receive short-term home health after an illness while family covers evenings.
Companion care: company and help around the house
Companion care is non-medical. A companion spends time with your parent, shares conversation and activities, prepares meals, tidies the kitchen, does laundry and keeps an eye on how the day is going. It suits someone who is largely independent but lonely, a little unsteady with household routines, or not safe to leave alone for long stretches.
Companion care is also one of the most common forms of respite. A family caregiver who covers most of the week can use a few hours of companionship to go to work, see a doctor of their own or simply rest. Overnight companionship can help when nights are the hardest part.
What companion care does not include matters just as much. Companions do not give medication, change dressings or provide hands-on help with bathing or toileting. If those needs exist, you are looking at personal care or home health. Licensing follows the same line. Under Maryland regulation COMAR 10.07.05.03, an agency that provides only household support (light housekeeping, meal planning and preparation, shopping and errands) does not need a license, so an agency offering only these services may not appear in the state directory. If a provider says it is licensed, you can confirm that with OHCQ. You can read how Bradley Home Care defines its planned non-medical services on our services page.
Hands-on personal care and home health: when help becomes hands-on or clinical
Hands-on personal care means a trained aide helps with the activities of daily living: bathing, dressing, grooming, toileting and getting in and out of a bed or chair. In Maryland, agencies that send aides into the home to provide services like these are licensed by the Office of Health Care Quality as Residential Service Agencies.
Home health is skilled care. Maryland describes a home health agency as one that provides skilled nursing and other therapeutic services under the supervision of a physician or registered nurse. Think of a nurse checking a wound, or a physical therapist helping someone regain strength after surgery. Home health is usually ordered by a clinician and lasts for a defined period.
Payment rules differ sharply between these categories. Medicare’s home health benefit has specific eligibility requirements, and Medicare.gov lists what it does not cover, including 24-hour care at home, homemaker services unrelated to the care plan, and personal care when that is the only care a person needs. Check the Medicare home health coverage page or call 1-800-MEDICARE for your own situation rather than relying on general rules of thumb.
Care outside the home: adult day and assisted living
Adult day programs give a parent a structured day with other people, activities and meals, and give family caregivers predictable time off. Maryland licenses Adult Medical Day Care Centers for adults who do not need 24-hour inpatient care but are not able to live fully independently; these centers add health services to the day. Some programs are social rather than medical, so ask each center which type it is.
Assisted living combines housing with daily support. In Maryland, Assisted Living Programs are licensed and inspected by the Office of Health Care Quality. It can make sense when someone needs help at many points across the day and night, or when living alone has become isolating.
Moving is a large decision, and it is reasonable to try in-home support first, or to combine home care with a day program, before deciding. A clear picture of the needs makes either path easier to choose.
How to work out which option fits
Before you call anyone, spend a few days noting what actually happens. A simple checklist helps:
- List the tasks. Write down what your parent needs help with, and whether each is company, household, hands-on or clinical.
- Note the timing. Is the hard part mornings, evenings, nights or weekends? A few hours a week is a different plan from daily coverage.
- Ask your parent. What would they find helpful, and what would feel intrusive? Their preferences shape what will work.
- Talk to their clinicians. Questions about health, safety or memory belong with their doctor, who can also say whether skilled home health is appropriate.
- Check the license. Look up any agency, adult day center or assisted living program in the Office of Health Care Quality licensee directories before you sign anything.
- Ask direct questions. How are caregivers screened and supervised? Is the agency insured? Who do you call if a shift is missed?
- Plan for change. Needs often grow. Ask how a provider adjusts hours or services over time.
Where to start this week
If you only do one thing, call the ADRU and describe the situation. Staff can explain county programs, caregiver support and options you may not know exist. Then use the checklist above to decide whether you need company and household help, hands-on care, clinical care, or a setting outside the home.
Home care options also depend on where your parent lives within the county. You can see the communities Bradley Home Care plans to cover, from Bethesda to Clarksburg, on our areas page, and read how the process is set up to work on how it works.
Common questions
What is the difference between companion care and home health?
Companion care is non-medical: company, meals and light household help. Home health is skilled nursing or therapy provided under the supervision of a physician or registered nurse, usually for a set period.
Who licenses home care agencies in Maryland?
The Maryland Department of Health’s Office of Health Care Quality (OHCQ) licenses Residential Service Agencies (agencies offering only household support such as meals, light housekeeping and errands are exempt), home health agencies, adult medical day care centers and assisted living programs. Its licensee directories are on health.maryland.gov.
Who can I call in Montgomery County for free advice about senior care?
The county’s Aging and Disability Resource Unit offers free information, assistance and referrals at 240-777-3000 (Maryland Relay 711).
Sources
- Montgomery County Aging and Disability Services
- Maryland OHCQ: Residential Service Agencies
- Maryland OHCQ: Home Health Agencies
- Maryland OHCQ: Adult Medical Day Care
- COMAR 10.07.05.03: Residential service agency license required
- Maryland OHCQ: Licensee Directories
- Medicare.gov: Home health services
This guide is general information, not medical, legal or financial advice. Phone numbers and programs were checked on the date shown above; confirm details with the agency before you rely on them.