This guide is for primary care physicians, care coordinators, and discharge planners in the Charlotte and Raleigh metro areas. It covers who should be referred for in-home care, what services are available, how care gets funded, and exactly how to make a referral.
Which Patients Should Be Referred for Home Care?
Consider a home care referral when your patient presents with any of the following:
- ADL limitations: Needs help with 2 or more activities of daily living (bathing, dressing, toileting, transfers, eating)
- Fall risk: History of falls, unsteady gait, fear of falling, or home safety concerns
- Post-surgical/post-discharge: Returning home without adequate support for recovery
- Cognitive decline: Progressive dementia or Alzheimer's with wandering, missed meals, or safety issues
- Medication non-adherence: Missed doses, confusion about regimen, or ER visits from mismanagement
- Nutritional decline: Unintended weight loss, dehydration, inability to prepare meals
- Caregiver burnout: Family caregiver showing signs of exhaustion, missed work, or health decline
- Veterans: Any veteran patient declining at home who may be eligible for VA-funded care at no cost
Services We Provide
| Service | What's Included |
|---|---|
| Personal Care | Bathing, dressing, grooming, toileting, transfers, mobility assistance |
| RN Care Supervision | In-home assessment, written care plan, and ongoing supervision of aides by a registered nurse (skilled nursing is not provided) |
| Companion / Sitter | Supervision, conversation, activities, accompaniment to appointments |
| Respite Care | Temporary relief for family caregivers (VA covers 720 hrs/year) |
| Dementia / Memory Care | Specialized supervision, structured routine, safety monitoring, wandering prevention |
| 24-Hour / Live-In | Round-the-clock care for high-acuity needs — shifted or live-in models |
| Meal Prep & Nutrition | Grocery shopping, cooking, feeding assistance, hydration monitoring |
| Fall Prevention | Mobility support, safe transfers, home safety assessment |
How Home Care Gets Paid — Patient Eligibility
Most patients have at least one funding option. Here's a quick reference:
| Funding Source | Who Qualifies | Patient Cost | Start Time |
|---|---|---|---|
| VA Benefits | Veterans (any era) enrolled in VA healthcare | $0 | 24–48 hours |
| NC Medicaid | Income-eligible NC residents (PCS / CAP-DA) | $0 | 2–4 weeks |
| Long-Term Care Insurance | Patients with active LTCI policy, needs 2+ ADLs | Per policy | 1–2 weeks |
| Private Pay | Anyone — no eligibility requirements | Hourly rate | 24–48 hours |
For NC Medicaid patients specifically, PCS eligibility starts with the DHB-3051 referral form — and the correct form and fax number depend on the patient's health plan. See our DHB-3051 PCS Referral Guide for the plan-by-plan breakdown, expedited assessment triggers, and common reasons requests get returned.
How to Make a Referral
Call or Fax Us
Contact our referral coordinator by phone or fax. Provide the patient's name, contact information, diagnosis, and care needs. No special forms required.
We Schedule a Free Assessment
A care coordinator conducts a free in-home assessment within 24–48 hours. We evaluate the patient's needs, home environment, and determine the best care plan and funding options.
Care Begins
We match a caregiver to the patient based on needs, personality, and location. For private pay, care can start the same week. For VA and Medicaid, we coordinate the authorization process and begin as soon as approved.
Referral Contact Information
Charlotte Office: (704) 548-8949 | Fax: (704) 594-9670
Raleigh Office: (919) 751-4837 | Fax: (919) 921-8017
Email: info@carolinahomehealthcare.com
Web: www.carolinahomehealthcare.com
For VA Patients Specifically
We are an authorized provider in the VA Community Care Network (CCN). For veteran patients:
- The veteran's VA primary care provider writes a CCN referral for home care services
- The VA authorizes the referral through the CCN system
- We receive the authorization and begin scheduling care
- The veteran pays $0 — the VA pays us directly
If your patient is a veteran who hasn't explored VA home care, we can help them navigate the process. Many veterans — including those without service-connected disabilities — qualify for no-cost home care through the Homemaker/HHA program.
For Discharge Planners
If you're coordinating post-discharge home care, see our comprehensive Home Care Funding Guide for Discharge Planners, which covers all funding pathways in detail with specific documentation requirements for each.
Frequently Asked Questions
How do I refer a patient for home care?
Call Charlotte at (704) 548-8949 or Raleigh at (919) 751-4837, or fax a referral to (704) 594-9670 (Charlotte) or (919) 921-8017 (Raleigh). No special forms needed — just the patient's name, contact info, diagnosis, and care needs.
Does the patient need a physician order?
VA care requires a VA PCP referral. Medicaid PCS requires a physician order. For private pay and most LTCI, no physician order is needed.
How quickly can care start?
Private pay: 24-48 hours. VA: 24-48 hours after CCN authorization. Medicaid: 2-4 weeks. LTCI: 1-2 weeks after claim approval.
What types of home care do you provide?
Non-medical home care: personal care, medication reminders, companion/sitter, respite, dementia care, fall prevention, 24-hour care, and meal preparation.
Do you accept VA benefits?
Yes. We're a VA Community Care Network provider. Veterans receive care at $0 cost through VA referral.
Carolina Home Health Care is a licensed, CHAP-certified home care agency serving Charlotte, Raleigh, and 25+ NC counties since 2004. We are an independent provider and are not the Department of Veterans Affairs or any government agency. For clinical questions, contact our Director of Nursing.