Hiring a home caregiver

The best place to receive ongoing care may be in the comfort of your own home. But to receive quality assistance, it's important to know what questions to ask so that you hire the home care agency that's right for you. Home care agencies provide services ranging from medically licensed professional care, such as nurses and therapists, to general home support such as cleaning, cooking and running errands.

To help you sort through your options, ask questions to help you evaluate their services. Asking the right questions can help you choose the best agency for your needs.

Agency qualifications

  • How long has the agency been in business?
  • Is the agency evaluated and accredited by a governing agency such as The Joint Commission's Home Care Accreditation Program?
  • Is the agency certified by Medicare? Medicare certification means that it meets federal requirements for health and safety. An agency's Medicare survey report is public information. If the agency isn't certified, ask why.
  • Is the agency licensed by the state? Most states — but not all — require agencies to be licensed and reviewed regularly. These reviews may be available upon request and can be valuable for determining the quality of an agency. To obtain a report, contact your state health department.
  • Can the agency provide references? Ask for a list of doctors, hospital discharge planners and former clients who have experience with the agency.
  • How does the agency protect client confidentiality?
  • What are the credentials of the providers?

Quality of care

  • What is the professional training of the nursing staff?
  • Will the agency provide you with the services of nurses or therapists? Will they work directly with you, your family members or your doctor?
  • Are the caregivers bonded and insured?
  • Does the agency provide a supervisor to evaluate the quality of home care on a regular basis?
  • Does the agency have references on file for home care staff?
  • Do employees seem friendly and helpful?


  • How does the agency handle expenses and billing? Does the agency provide literature explaining its services and fees? Does it provide detailed explanations of all the costs associated with home care?
  • Is the agency approved or accepted by your health maintenance organization (HMO) or supplemental insurance?
  • What resources does the agency provide to help you get financial assistance, if needed?
  • Are there copays or deductibles?
  • How does the coverage interact with Medicare hospice benefits?
  • Are there days of exclusion which must be met before coverage begins?

Understanding services

  • Is there a written plan that details services to be provided by each caregiver? Documents — including financial arrangements — should be given to you before service begins so that there's no misunderstanding about the service to be provided.
  • Does the agency provide a brochure that outlines fees, eligibility requirements and services provided? Many agencies provide a "patient's bill of rights" that outlines the rights and responsibilities of all parties involved.
  • Will you be involved in planning for care or making changes to the care plan?
  • Who will be working in your home, and what are his or her specific duties?
  • What procedures does the agency have for emergencies? Are caregivers available round-the-clock? Is someone on call?
  • How does the agency address and resolve problems? Who can you or another family member contact with requests, questions or complaints?
  • Does the home care agency require that you have a primary family caregiver as a condition of admission? If so, what will be required of that person?
  • If you need equipment such as oxygen, a respirator or a dialysis machine, will the agency instruct you in its use? Do they provide a 24-hour contact you can call for service?
  • How many hours of coverage a week are allocated?

Monitor your home care service

After you've found a home health care provider, it's up to you to monitor the care you or your loved one receives to make sure it's what the doctor ordered. That's where having a detailed, written care plan can help. Make sure the care you're receiving follows what's detailed in the plan. Record the number of visits from the agency. If you have any questions about the care you're receiving, ask your doctor.