AVOID DISASTER - ASK THESE TEN QUESTIONS BEFORE YOU HIRE A HOMECARE COMPANY

So you and your loved ones have come to the conclusion that private duty, non-medical homecare is needed – now what? How do you choose the right company to provide homecare assistance? What are the right questions to ask and the things to look for? Whether it’s you or your loved one that needs homecare services, choosing the right homecare agency to fit your specific needs, schedule, and pocketbook is essential. Here are 10 helpful questions to ask in order to make an informed decision, whether it is an emergency situation or you have the time and ability to plan ahead:

1. What range of home care services does the agency provide?

   Before you start your investigation, be sure to determine the needs and the level of care that is required. Is a hands-on caregiver needed for help with the Activities of Daily Living (ADLs) or is friendly companionship and transportation for errands all that is required? In addition to the ADLs of bathing, dressing, eating, transferring, toileting, and continence will the agency caregivers make meals, handle medication reminders, do light housekeeping, take the client out for errands or food shopping? Walk the dog?

2. What is the background of the homecare agency and its owners?

   Are the license and certifications of the agency current? Find out if the agency owners have a background in elder care, ask how long they have owned the agency, and if it is supported by a nationally recognized brand. Keep in mind that an agency is the preferred choice over a registry - registries refer independent contractors, and do not hire their caregivers as employees. A homecare agency is liable for the caregiver as their employee and you are not.

3. Are the caregivers employees or independent contractors?

   Agencies must hire their caregivers as employees and handle all payroll taxes and arrange for Worker's Compensation Insurance in order to protect the client if any injuries occur during care. Registries only refer independent contractors and do not protect clients from lawsuits in the case of injuries on the job. Registries are not permitted to supervise caregivers or discipline caregivers in cases of misconduct. Not all registries perform thorough criminal background checks on the independent contractors they place. For your protection, hire an agency with caregivers as employees that are properly vetted, insured and bonded. The hourly rates for an agency may be a bit higher than a registry for this reason, but you can’t put a price on peace of mind.

4. What qualifications, certifications, experience, and training do you require of your employees?

   When a caregiver comes into your home, you want to ensure it is someone you can trust. Find out if caregivers’ credentials are investigated, how much hands-on experience they are required to have. Do they undergo a thorough, professional testing and screening process, including criminal background checks? Ask how the agency trains and supervises its employees. You're more likely to get a compassionate and experienced caregiver when choosing an agency. Registries do not supervise, or provide training or education for independent contractors.

5. How do you make sure the caregivers are providing the proper care?

   Ask if the agency makes scheduled quality assurance calls and visits to the home, and if caregivers are regularly and closely supervised by a registered nurse. If cognitive or physical impairment is involved, can they provide consistency of care, and guarantee a caregiver with the proper skills? It is difficult to receive good care if different contractors show up every week. A good home care agency whose caregivers and companions are employees will be concerned with continuity of care. Find out who to call with questions or complaints and how the agency resolves problems. If you are dissatisfied with your caregiver, may you request a replacement?

6. How is the plan of care developed?

   Does a full time, registered nurse conduct a home visit to evaluate the client's home care needs? Are the client and the physician, as well as the family members, involved in developing the plan of care? Does the agency update the plan as changes occur? Does the agency take time to educate family members and document the services being performed?

7. What financial info can be shared regarding hourly rates, billing practices and payment options?

   Rates may vary depending on the level of care needed. Is a long term contract required or can you cancel at any time? Can you pay by check or credit card? Are Long Term Care Insurance benefits accepted? Will the agency assist in dealing with the insurance companies’ paperwork, and managing the LTC benefits wisely if they are in a “pool?” Are there minimums, over time, or holiday rates? When you're first comparing prices, it might seem cheaper to hire from a registry. But don't forget the hidden costs—and potential problems—of working with independent contractors vs agency employees.

8. What procedures does the agency have in place to handle emergencies?

   Are its caregivers available 24 hours a day, seven days a week? Is the office staff on call when the office is closed? Continuity of care is vital, will the agency guarantee replacement coverage if the regularly assigned caregiver is unable to come? Is a disaster response plan in place in case of a hurricane? Can the agency help if the client has special needs?

9. How well does the agency communicate with the significant other or family members?

   If you do not live nearby, then status updates on a loved one are even more important to you. Ask how often the agency can check in with you by phone or email to keep you posted on their care. Be sure that the agency is HIPAA compliant and your loved one’s private medical information is protected at all times.

10. Are there references available from agency clients?

Ask for the names and contact information of individual clients who have a situation similar to yours. Be sure to ask if they would use the company again if there was a need. Check online ratings as well and see if the agency has won any awards for client satisfaction.

In conclusion, homecare services from an agency are a helpful solution when a family member is unable or unavailable to assist with a loved one’s needs. Due diligence is essential when it comes to agency background checks, client references, and reliability. The choice you make will affect everyone involved emotionally, as well as financially. Make sure it is the right choice.

Till Next Time!

Irv Seldin, JD, President and Owner, Visiting Angels of the Palm Beaches

This article is not intended as medical, legal, or financial advice.