Three entirely different legal regimes go by the same name, and most of the confusion in this field comes from that. This article separates Medicare-certified home health, the hospice benefit, and personal care services, and explains why the coverage rules, the appeal rights, the wage law, and the enforcement risk diverge completely across them. It corrects the single most consequential misunderstanding in the field — that services stop when a patient stops improving — and explains what homebound actually requires. It covers what hospice election gives up and what it does not, why living longer than six months is not fraud, and why revocation is always available. It then works through the wage rules that changed for agency-employed caregivers, the consumer-directed programs where those rules produce fewer hours rather than more pay, the fraud patterns that make this sector an enforcement priority, and how a discharge is actually challenged.