Who supervises a home health aide after they start working?
A registered nurse, or another appropriate skilled professional, is responsible for checking in on a home health aide after they start providing care. How often that check-in happens depends on whether the patient is also receiving skilled nursing or therapy services at the same time.
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When skilled services are also involved
If a patient is getting skilled nursing, physical therapy, occupational therapy, or speech-language pathology services alongside aide care, a registered nurse or other qualified professional must complete a supervisory assessment of the aide at least every 14 days. That check is usually done in person, though it can rarely be done by two-way video, limited to one virtual check per patient within any 60-day stretch.
When aide services stand alone
If the patient is only getting aide services, a registered nurse still has to make an in-person visit every 60 days to check the quality of care, and twice a year, the nurse must specifically observe the aide while they are doing hands-on, non-skilled care.
If the aide is also serving a patient who gets skilled care, a nurse or qualified professional separately has to make an annual in-person visit focused on watching that aide perform care.
Why oversight does not stop after training
These checkpoints exist on top of, not instead of, the earlier training and competency evaluation, which is why an aide can expect ongoing visits from a nurse long after they have already qualified for the role.
Connecticut's own licensing rule points the same direction at the agency level: a home health aide agency may only be licensed to provide aide services with the oversight of those services handled by a registered nurse.
- Every 14 days, if skilled care is also being provided.
- An in-person visit every 60 days, if only aide services are provided.
- A semi-annual visit focused on non-skilled care.
- An annual visit when skilled care is also part of the case.
More questions
Can the 14-day check always be done remotely?
No, it is normally done in person, with remote video allowed only rarely and capped at one virtual check per patient in a 60-day period.
What happens if a patient only receives aide services, with no skilled nursing or therapy?
A registered nurse must still visit in person every 60 days to assess the quality of the aide's care.
Does supervision end once an aide is fully trained?
No, these visit schedules continue for as long as the aide is actively providing care, separate from the earlier training and competency steps.
Sources
- § 484.80 Condition of participation: Home health aide services., Centers for Medicare & Medicaid Services
- Home Health Unit, Connecticut Department of Public Health
Checked against these sources on November 6, 2026. Rules change, so confirm with the source before you rely on a detail. This page is general information, not legal advice.