Objective: The purpose of the study is to investigate the awareness and usage of home support services by adults with profound intellectual and multiple disabilities (PIMD) depending on the severity of their disability, and to identify factors related to their current and continuous home environment. Methods: Of the 305 facilities listed by the Office of Daily Activity Assistance for PIMD, 276 facilities were used in the present study. Since the exact number of adults with PIMD was not available, 10 mail questionnaires were sent to each of the 276 facilities. Of those, 626 responses were obtained. The participants were divided into three groups based on their medical care needs and the kind of the medical care they received. The awareness and frequency of using home support services were analyzed. Results: The results revealed that the more severely disabled the adults were, the more frequently they used the services of “visiting medical care,” “visiting nursing care,” “home help service,” and “visiting rehabilitation.” Furthermore, factors related to their current and continuous home environment included their age, the severity of their disability, and the frequency of using visiting nursing care. Conclusion: The implications of this study emphasize the need for increasing the availability of visiting services for individuals with severe PIMD living at home.