Choosing a Home Care Agency According to Best Practices

Choosing a home care agency isn’t something you generally think about on a daily basis. But, when a loved one falls or gets seriously hurt, it’s something you can’t stop thinking about. Your thoughts are consumed by, How can I find a home care agency near me?

After contracting with the first home care agency they find, some families quickly realize that all home care agencies aren’t the same. To get the best home health care, you won’t want to make the mistake of rushing into choosing a home care provider just to find that you’re disappointed and dissatisfied later on.

To get the best care, here are a few things to consider when looking for the best home care agency:

  • Give yourself the time you need to make the best choice.
  • Research the major health agencies in your area.
  • Have conversations with your loved one about their home care preferences.

In your quest to choose home care for your loved one, best practices for choosing a home care agency should be your guide. Here’s what you need to know.

What Level of Home Care Do You Need?

In your pursuit of local home care agencies, you’ll find that they offer many different types of services at different levels of care. Having so many choices can be confusing and overwhelming. Let your loved one’s caregiving preferences and best practices be your guide to finding the right caregiver and the right services to meet your loved ones needs. As you educate yourself about the home care industry, you’ll learn that they provide medical care and non-medical care.

It’s to your benefit to get better acquainted with some of the terms in non-medical care. You may hear it being referred to as:

  • In-home care
  • Personal care
  • Senior care
  • Custodial care
  • Companion care
  • Homemaker caregiving

These are some of the services that skilled nursing care agencies offer:

  • Hospice care
  • Physical therapy
  • Pharmaceutical therapy
  • Infusion therapy
  • Home medical equipment

Companionship care and supervision are especially important for seniors living with Alzheimer’s disease or other mental impairments. Professional in-home caregivers assist seniors with activities of daily living (ADLs).

Local home care agencies in your area also provide non-medical caregiving services like the ones listed below:

  • Bathing and showering
  • Personal hygiene, shaving
  • Dressing
  • Transferring
  • Toileting
  • Eating or feeding
  • Walking

Still another term that you’ll want to get familiar with is instrumental activities of daily living (IADL). This term refers to tasks that allow seniors to continue living in their homes independently.

See the following list of activities that seniors often need help with. The best local home health care agencies offer the following types of services:

  • Assistance with managing personal finances
  • Transportation or errand services
  • Shopping for food, clothing, and other needs
  • Preparing meals
  • Home maintenance
  • Housework
  • Helping with technology and communication
  • Taking medications

Now that you know what local home care agencies offer, you’ll be better able to take the next step of hiring the best caregiver.

Hiring a Caregiver

Another issue that can be quite confusing for people looking for home health caregivers is understanding the various medical certifications.

Here’s what you need to know:

  • CNA-Certified nursing assistant
  • HHA-home health aide
  • PCA-personal care aide

You can hire a caregiver directly if you choose. You also have the option of going through a referral agency or using a full-service in-home care agency in your area. Each option comes with its own set of pros and cons. Let’s take them one by one:

  1. Hiring a caregiver directlyWhen choosing this option, you’re taking on the responsibility for checking a caregiver’s background. You’ll also be responsible for employment-related paperwork including setting up worker’s compensation, payroll taxes, and insurance. It will be up to you to set up a backup system in case your regular caregiver is unavailable for any reason.
  2. Using a referral home care agencyThese types of agencies are also called home care registries. They exist to help you match your loved one’s needs to an independent contractor. Be aware that these agencies don’t employ caregivers directly. If you hire someone from their registry, they receive a referral fee. You can’t assume they’ll screen caregivers well. You’ll want to do that yourself. Just as when you hire a caregiver directly, you become their employer and you’re responsible for insurance, payroll taxes, etc.
  3. Hiring through a licensed home care agencyLicensed home care agencies specialize in hiring quality caregivers. They typically provide training and supervision of the caregivers they employ. They also generally provide substitute caregivers when your regular caregiver is not available. They take on the responsibility for background checks, payroll taxes, and other necessary paperwork for compliance.

Choosing a Home Care Agency

In your quest to find the best home care agency in your area, you may find that some agencies operate better than others.

There are a couple of ways to narrow down your options for the best caregiver:

  1. Do the proper research.Talk to your loved one first about the type of assistance they need to live in their home safely. Inform them about the type of services they can use such as:
  • In-home caregiving
  • Skilled nursing care
  • Personal care
  • Skilled Alzheimer’s or dementia care
  • Transportation services

Respect their wishes for pursuing the type of care they feel they need. When searching online for home caregiving, avoid clicking only on the first link. Choose several agencies to get the information you need.

  1. Ask for recommendations.Your family members and friends may have had good success with a local home care agency. They can alleviate many of your concerns as you pursue the right home care agency. Customer satisfaction counts for a lot. Also, medical professionals can often connect you with home care agencies or professionals they’ve had success with in the past.

What Questions Should I Ask Prospective Home Care Agencies?

At this point, you’ve probably narrowed your choices down to the top three or four agencies. The next step is to call each agency and set up interviews. You and your loved one will have the greatest comfort level in your caregiver when you ask all the right questions.

Develop a list of questions about the agency for cost, the management, the caregivers, and the quality of services. Here’s a helpful list to get you started:

What You Need to Know About the Agency

  • Does your agency provide non-medical home care?
  • Are you currently licensed by this state?
  • What types of services does your agency provide?
  • Are there any services your agency doesn’t provide?
  • Are your services available 24 hours, seven days a week?
  • How do I reach someone during off-hours if I have a problem?
  • How many years has your agency been in business?
  • What is the process to get services started?
  • What is the soonest availability to get care started?
  • Is your agency insured and bonded?
  • Are your caregivers insured and bonded?
  • Are there any minimum requirements for the length of the contract I should be aware of?

What You Need to Know About Costs

  • How much do your services cost?
  • Will I have to pay a deposit to set up services?
  • How often can I expect a bill?
  • Can you build my long-term care insurance company directly?

What You Need to Know About Management

  • Who owns your agency?
  • How many owners has this agency had?
  • Who is the manager in charge and what are their qualifications?
  • How do I escalate a concern to a higher level of management if I have a problem?

What You Need to Know About Agency Caregivers

  • What are the certifications of the caregivers your agency provides?
  • How do you select and screen your caregivers?
  • What is the average level of experience for your caregivers?
  • What kind of background checks do you conduct?
  • How do you check caregiver credentials?
  • Do you test your caregivers for drug abuse?
  • Can you describe a typical caregiver to me?
  • Can you describe how you train and support your caregivers?
  • How can you assure me that your caregivers are competent in their duties?
  • If I contract with your agency, are you their legal employer, or am I?
  • Are your caregivers bonded and insured against theft or damages through your agency?
  • What is your process for matching caregivers with my loved one?
  • Can we expect the same caregiver every time, or will different people be coming to my loved one’s home?
  • What should I do if the regular caregiver doesn’t show up on time?
  • Can I request a different caregiver if we aren’t happy with the one we have?
  • How many caregivers do you employ?
  • Can I interview the caregivers before we schedule services?

What You Need to Know About Quality Care

  • Can you give me references for your caregivers?
  • How do you monitor the quality of your caregiver services?
  • Has your agency been reviewed by any outside organizations?
  • When was your agency’s last compliance review and do you make the results available to your clients?
  • Do you have an established process for resolving problems or complaints? How does that work?
  • Can I expect to get a written care plan for my left one?
  • Will I be allowed to be involved in putting together an appropriate care plan for my loved one?

Bear in mind, most states mandate home care agencies to be licensed. It’s completely appropriate to ask to see a copy of their state license. The appropriate state department should also be able to tell you if a specific home health care agency has had any complaints or negative results from inspections.

Checklist for Hiring a Home Care Agency

The following checklist is designed to streamline the process of hiring a home care agency:

  • The agency I chose offers the types of services and caregivers that my loved one needs now, and it offers additional services that my loved one might need later on.
  • The agency is willing to send a nurse or social worker out to my loved one’s home at a convenient time to conduct an initial assessment.
  • The agency is willing to help with arrangements for the necessary supplies and equipment to be delivered to the home.
  • The agency is willing to make recommendations for home modifications such as installing grab bars, adding ramps, and rearranging the furniture to help my loved one live more independently.
  • The home care agency I selected is familiar with community resources for seniors such as Meals on Wheels, transportation services, and adult daycare.
  • The home care agency is willing to involve family members in planning care and communicating about on-going changes in my loved one’s care.
  • The written care plan clearly describes the services we expect to receive.
  • I understand the written plan about care costs and billing procedures.
  • I have the assurance that the caregivers work directly for the agency, and I know they’re taking care of employment tax withholding and worker’s compensation for any caregiver providing services to my loved one.
  • I have written assurance that caregivers are licensed and bonded and that caregivers will go through a background check and be tested for drugs.
  • The agency has assured me that my loved one and I have a say in caregiving services, and if we are unsatisfied with a caregiver, we can request a change in caregiver.
  • The agency will provide the same caregiver on a regular basis and provide an emergency substitute if needed.
  • The agency provided me with a copy of Patient’s Rights and Responsibilities.

Choosing the right home healthcare agency is one of the most important decisions you’ll make in your lifetime. For this reason, it’s important to take all the time you need to select the best option for quality caregiving. Don’t be afraid to ask questions or ask for more information if you’re not getting the answers you need.

Your loved one deserves the best quality of care possible. At Home Care Services is happy to speak with you about the right caregiving services for your loved one.

Mike Miller

Mike Miller

Mike Miller is the CEO and Founder of At Home Care Service, a Home Care agency located in San Diego, California. Senior Caring Solutions was the previous name of the business. He has been involved with senior care for over 15 years. Mike knows the ins and outs of the home care industry, and he is a great resource for people looking for elderly care services. Mike is well-known in California as an expert in the industry.


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