A Family Guide from Apex Home Nursing Services
Additional Services and Care Coordination
Written by Halston Juracka, RN-BSN, CBIS, Co-Owner of Apex Home Nursing Services · Las Vegas, Nevada · Updated June 2026
Most home care companies hand you a caregiver and call it a day. That is a fraction of what your family actually needs. The hard part of caring for an aging loved one is rarely the bathing or the meals. It is the medical chaos around it: the discharge nobody explained, the six medications nobody reconciled, the specialist who never talked to the primary, the hospice team operating in a silo. This guide lays out the full scope of what Apex provides, and why the coordination is the part that changes everything.
Personal care, delivered at a level you have not seen
The foundation is expert, dignified personal care from a caregiver who is among the best in the state. Not a rotating stranger, a dedicated professional who learns your loved one and stays. Personal care with Apex is billed at $65 an hour, and it includes the daily support that keeps someone safe and comfortable at home.
Activities of daily living
Bathing, dressing, grooming, toileting, and hygiene, handled with skill and dignity.
Meal preparation and nutrition
Cooking, hydration, and an eye on the appetite changes that signal trouble.
Companionship and engagement
The human connection that protects against the isolation that accelerates decline.
Mobility and transfers
Safe movement, fall-risk awareness, and steady assistance for the unsteady.
Medication reminders
Keeping the routine on track and flagging missed or doubled doses to the nurse.
Light homemaking
Tidiness, laundry, and a safe, clutter-free environment that prevents falls.
Registered nursing support, from the owner-nurses themselves
This is what sets Apex apart from every staffing service in the valley. When an Apex client needs registered-nursing involvement, it is delivered by my wife Kayla or me, personally, under our own Nevada RN licenses. Not a nurse who signed a chart once. Owners with our names and reputations on the line. Registered nursing care is billed at $200 an hour and underpins everything we do.
Initial RN home visit and safety assessment
A clinical read of the home, the risks, and the real needs before anything else.
RN review of every visit note
A nurse reads what happened at every visit, hunting for the early signs of decline.
Direct nurse line
A real clinician to call when something changes, instead of waiting and worrying.
Personalized care plan
A living clinical document, built and updated by a nurse, not a one-page intake form.
Medication review
Reconciling the full list to catch interactions, duplications, and the errors that cause hospitalizations.
Condition and nutrition guidance
Plain-English education on what your loved one's diagnoses actually mean day to day.
Private-duty skilled nursing, provided by the RN owners themselves
This is the part that genuinely sets Apex apart, and it is worth understanding clearly. Beyond personal care, your loved one has access to real, skilled registered-nursing care delivered personally by the owners, Halston Juracka, RN-BSN, CBIS and Kayla Juracka, RN-BSN. This skilled nursing is provided by Halston and Kayla under their own Nevada registered-nurse licenses as private-duty nursing, coordinated by, not provided by, Apex. In plain terms: the nurse at your loved one's side is an owner of this company, personally accountable for the outcome, not an employee assigned to a file. When you have a registered nurse who is also an owner, you have someone whose name, license, and reputation are all on the line for your family.
The kinds of skilled nursing care our RN owners can provide and coordinate include:
Skilled assessment and monitoring
Ongoing clinical evaluation and early detection of decline before it becomes a crisis.
Wound care
Skilled wound assessment and dressing changes to promote healing and prevent infection.
Chronic disease management
Monitoring and support for heart failure, COPD, diabetes, hypertension, and more.
Catheter, ostomy, and feeding support
Skilled, dignified management of catheters, ostomies, and feeding tubes.
Pain and symptom support
Clinical guidance to keep your loved one comfortable as needs change.
Medication administration
Hands-on medication management and injections such as insulin or B12, plus reconciliation of complex regimens.
Post-hospital and post-surgical care
Close clinical follow-through during the fragile days after a discharge or procedure.
Stroke and brain-injury recovery
Specialized support from a Certified Brain Injury Specialist who has built a career around it.
Diabetic and glucose care
Blood glucose monitoring and steady day-to-day diabetic management.
Patient and family teaching
Plain-English education on conditions, medications, and equipment so nobody feels lost.
And if something ever falls outside what we provide directly, you are still covered. We maintain a trusted network of physicians, specialists, therapists, pharmacists, and other professionals we can refer to and coordinate with, so no matter what comes up, the right person is on it and we are making sure every piece connects. Our long-term dream is to build a complete, in-house healthcare ecosystem that manages every one of your loved one's needs under one roof, and we are always expanding what we offer to get there. Until that day arrives, our network and our coordination deliver the same promise to you right now: no matter what you need, we have you covered.
Care coordination, the part nobody else does well
Here is where families drown, and where Apex does its most valuable work. The modern medical system is fragmented, and the job of stitching it together usually falls on an exhausted adult child with no clinical training. We take that entire burden off your plate.
Hospital discharge coordination
We manage the handoff so the transition home is safe, not a scramble.
Physician communication
We talk to the doctors, relay what matters, and send monthly physician update letters.
Transportation coordination
We arrange safe, reliable transport so a missed ride never means a missed appointment.
Advance care planning
We guide the hard conversations before they become emergencies.
Hospice and home health coordination
We work alongside existing services without interfering, filling the hours and gaps they cannot.
Appointment accompaniment
We go to appointments, with a pre-appointment clinical brief so nothing important gets missed.
Care community coordination
We coordinate with facility staff when a loved one is in a community setting.
Family briefings and conferences
We keep near and far family informed, including long-distance monthly briefings.
~1 in 5
Older adults are readmitted to the hospital within 30 days of discharge, and a large share of those readmissions are preventable with proper care coordination and medication management. That coordination is exactly what we provide.
Source: NCBI / StatPearls, Reducing Hospital Readmissions, 2024
How it deepens as needs grow: the Apex membership tiers
Every client starts with a nurse-led foundation, and the level of RN involvement scales up as the situation calls for it. Here is how it works, in plain terms. The personal care is provided by Apex, the dedicated caregivers and hands-on daily support. The membership tiers below and all registered nursing are provided and billed by Halston and Kayla as licensed registered nurses, under their own Nevada licenses, and coordinated by Apex, not charged or provided by the agency itself. It is the same two nurse-owners either way. You get one seamless team, with the clinical work handled personally by the nurses whose names are on the door.
Care Continuity
The nurse-led baseline every client receives.
-
Initial RN home visit and safety assessment
-
Personalized care plan and family education session
-
RN review of every caregiver visit note
-
Secure 24-hour family portal
$99 / month
Premium
Deeper clinical involvement for families who want a nurse closer to the case.
-
Weekly RN calls and direct nurse line access
-
Monthly clinical summary and quarterly medication review
-
Personalized condition guide and nutrition guidance
$449 / month
Concierge
Full coordination for families navigating an active, complex situation.
-
Dedicated caregiver assignment
-
Hospital discharge, hospice, home health, and care community coordination
-
Quarterly care plan review and pre-appointment clinical briefs
-
Monthly physician update letter and annual post-hospitalization reassessment
$799 / month
Apex Private
A named RN owner personally responsible for the case, with limited availability.
-
Named RN owner accountable for the case, with after-hours direct access
-
Unlimited RN consultation and unannounced quality visits
-
Advance care planning and quarterly family care conferences
-
Monthly long-distance family briefing and formal welcome package
$2,999 / month · invitation only
Why our coordination is the whole ball game
Anyone can send a caregiver. What no staffing service in this market can do is what Kayla and I do every day: get on the phone and argue with the hospitalist, the discharge planner, the facility, and the hospice team like family, then turn around and translate every order, every medication change, and every frightening word from a doctor into plain English you can actually act on.
That is the difference between a family barely surviving a health event and a family sailing through one. You stop being the case manager, the medical translator, and the 2 a.m. crisis responder. We become that, so you can go back to being a son, a daughter, a husband, or a wife.
It is basically having a team of professionals in the family: a nurse, an advocate, and an elite caregiver, all personally invested in your loved one. You cannot put a price on that, and once you have it, you will never go back.
See the difference for your own family
Talk it through with one of the RN owners. An honest, no-pressure read on what your loved one actually needs and what premium support would look like.
Halston Juracka, RN-BSN · (702) 843-7402
Kayla Juracka, RN-BSN · (702) 280-4348
Email: admin@apexhomenursing.com
BOOK YOUR 15-MINUTE NURSE CALL FOR MORE INFORMATION
Frequently asked questions
- 01
- 02
- 03
HJ
About the owners
Halston Juracka, RN-BSN, CBIS and Kayla Juracka, RN-BSN are the registered-nurse owners of Apex Home Nursing Services, a premium private-pay home care agency serving Summerlin, Henderson, and the greater Las Vegas valley. Halston is a Certified Brain Injury Specialist and nurse educator. They founded Apex to give referral partners a clinically serious, reliable resource and to give families nurse-led care that actually keeps people safe at home.
References
-
Reducing Hospital Readmissions, StatPearls, NCBI Bookshelf, 2024. ncbi.nlm.nih.gov
-
Medication-related hospital readmissions in older adults. ncbi.nlm.nih.gov
-
Genworth and CareScout 2024 Cost of Care Survey; Nevada data. payingforseniorcare.com/nevada
This guide is general educational information, not medical, legal, or financial advice. Apex Home Nursing Services is an RN-owned, private-pay personal care agency in Las Vegas, Nevada. Registered nursing services, where applicable, are provided by the RN owners under their own Nevada licenses, coordinated by, not provided by, the agency.