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Gentiva Health Services is a gentle giant. As one of the nation's largest home health care services firms, the company provides home nursing care through a network of more than 300 agency locations in about 40 states. Gentiva's home care nurses provide services ranging from acute-care treatment to housekeeping for the elderly or disabled. The company also offers consulting services to the home care industry to help with regulatory and reimbursement issues, and it provides hospice care services in about 30 states. Gentiva expanded its hospice operations greatly through the 2010 acquisition of Odyssey HealthCare.

Girling Healthcare is a subsidiary of another Austin-based health care company, privately held Harden Healthcare. Girling Health Care offers home health, personal care, and homemaker services for grown up girls and boys who need living assistance. The company serves customers in nine states in the midwestern, northeastern, and southern US. Girling provides services including skilled nursing, rehabilitation therapy, condition monitoring, social services, living assistance, and respite care. Texas is the health care firm's largest market.

Guardian Home Care Holdings provides medical and non-medical home health care services to private patients -- as well as through contracts with health insurers, hospitals, and nursing homes -- in Georgia, Tennessee, and Texas. Primarily working under Medicare and Medicaid funding programs, Guardian's health care personnel provide skilled nursing services, physical and speech therapy, social work services, and assistance with daily activities such as cleaning and bathing. The company also provides hospice services in Nashville, Tennessee. It operates as Texas Home Health in Texas and under the Guardian name in its other markets.

Home Instead has a network of some 900 franchises operating throughout the US and in more than a dozen countries internationally. Employees known as CAREGivers provide the elderly with one-on-one assistance in the home and at assisted living or nursing care facilities. Home Instead helps keep the elderly at home instead of in assisted living or nursing homes. The company -- operating under the name Home Instead Senior Care -- provides non-medical home care assistance for seniors. Its services are designed for people who are capable of managing their physical needs but require assistance, supervision, light housework, meals, errands, or simply companionship in order to remain in their homes.

Hospice of Michigan provides specialized health care services for people with a terminal illness and support for their loved ones. These services focus on comfort measures and pain control, or palliative care. Palliative care is directed by the patient and family along with the patient's physician or hospice medical director. Nurses, social workers, home health aides, spiritual advisors and trained volunteers work as an expert team to provide palliative care. The team focuses on providing comfort and pain relief when a cure is not possible. The goal is to help each person live as fully as possible and to help the family and loved ones participate in the person's care.

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