Last Updated: October 15, 2013
The first step to finding the right kind of home care agency is
determining what level of care is needed. There are two main
categories of in-home care services: skilled care, which provides
for medical needs, and custodial care. Custodial care may include
environmental assistance-help with housekeeping, shopping, meal
preparation and the like-or personal care, such as bathing,
dressing, and feeding. Some agencies only provide one type of care;
others may include both types. Different types of home care
companies may work together to provide an integrated system of
services for a care recipient
Types of Home Care Organizations
- Home health agencies
- Homemaker and home care aide (HCA) agencies
- Staffing and private-duty agencies
Top Questions to Ask Home Care Agencies
Once you have determined the type of home care services your
loved one needs and have a list of appropriate agencies, it's a
good idea to interview and evaluate the agencies to compare them.
Use the following checklist to help you choose the right home care
agency for your loved one.
- Does the home care provider supply literature explaining its
services, eligibility requirements, fees, and funding sources? Many
agencies furnish care recipients with a detailed "Patient Bill of
Rights" that outlines the rights and responsibilities of the
providers, care recipients, and caregivers alike. An annual report
and other educational materials also can provide helpful
information about the provider.
- How long has this agency been providing home care
- Is the agency Medicare certified?
- Is the agency licensed by the state?
- Can the agency explain what Medicare or insurance will cover
and what the client must pay? The agency should have an established
track record and be able to provide references.
- What range of home care services does the agency provide?
- Do they offer the specific services you need (e.g. physical
therapy, occupational therapy, etc.)?
- Can they meet any special needs you may have (e.g. language or
- How does this provider select and train its employees?
- Does it perform background checks on staff?
- Does it have written personnel policies, benefits packages, and
malpractice insurance? You're more likely to get a committed and
dedicated aide when the company selects its staff carefully and
supports them with the proper policies, protections, and
incentives. The extent of the background check varies state to
- Are nurses or therapists required to evaluate your loved one's
home care needs? If so, would they consult with his or her
physicians and family members? The various care-givers serving your
loved one need to communicate effectively with each other; for
example, if a doctor prescribes physical therapy, all the home-care
aides should be working together to further this goal.
Medicare-certified agencies are required to have this sort of
- Does this provider include the client and his or her family
members in developing the plan of care?
- Are they involved in making care plan changes?
- Is the client's course of treatment documented, detailing the
specific tasks to be carried out by each professional
- Does the provider assign supervisors to oversee the quality of
care that clients are receiving in their homes? If so, how often do
these individuals make visits?
- Who can the care recipient and his or her family members call
with questions or complaints?
- How does the agency follow up on and resolve problems? This
helps ensure that the caregivers are performing the services
correctly, and responding to the care recipient's changing
- What are the financial procedures of the agency?
- Do they furnish written statements explaining all of the costs
and payment plan options associated with the home care services it
- What procedures does the provider have in place to handle
- Are its caregivers available 24 hours a day, seven days a week?
Not all home care agencies are available 24 hours a day, or
guarantee replacement coverage if the assigned aide is unable to
Finally, ask the home care agency to supply you with a list of
references, such as doctors, discharge planners, clients or their
family members, and community leaders who are familiar with the
provider's quality of service. Contact these references and ask:Do
you frequently refer clients to this agency? Do you have a
contractual relationship with this agency? If so, do you require
the agency to meet special standards for quality care? What sort of
feedback have you gotten from clients receiving care from this
agency, either on an informal basis or through a formal