Hi Michele, elderly people who receive medical care under their medicare insurance are receiving services directly related to their acute medical condition. Acute medical conditions need the supervision of medical personnel. Once the client is somewhat stable, their medical condition may prevent them from performing the activities of daily living such as showering/bathing, going to bathroom, getting to the grocery store, preparing meals, doing laundry or light housekeeping. Medicare does not cover these services because they are of a non-medical nature so most clients end up hiring a Comfort Keeper to assist them. Comfort Keepers provides alot of training for its staff and many of the offices hire certified nursing assistants who have worked in assisted living, nursing homes and hospitals. Comfort Keepers does provide companion care but it also provides hands on assistance to those elderly clients that cannot rise from a chair, needs assistance in shower or toileting. Economically speaking it is much cheaper to hire a Comfort Keeper to assist a person in home one on one than to spend hundreds of dollars a day in a facility where the person cannot get to the bathroom without help and have to wait for staff that might be helping another patient on the floor.