Ten Things to Ask Before Hiring a Home Care Agency
By Shirley Cohen
Today’s seniors have more options available to them then ever
before. One option more and more seniors are turning to when their physical
capabilities diminish or while they recover from a short-term disability is
to be treated in the comfort of their own homes by a personal nurses aide or
companion. Home care is considered by many to be one of the most desirable
options because it allows seniors to maintain their independence while
remaining in the one place where they feel most comfortable.
However, as in choosing any type of long-term care, there are many pitfalls
to watch out for when hiring a homecare worker to care for yourself or a
loved one. In any given city, a quick look through the Yellow Pages may
reveal dozens of competing companies offering what appear on the surface to
be the same services. It’s up to you to investigate the differences and find
the one company that best suits your needs.
To help with this task, we’ve provided the following checklist of questions
to ask each home care agency during the initial phone call. If they can’t
answer these questions to your satisfaction, move on to the next agency
until you find one that can.
1) How long has your company been in business?
There are a lot of new companies entering the marketplace, many of which
have little experience or expertise in the special challenges of running a
successful home care company. The office staff cannot be relied upon as much
as those at well-established companies because they themselves experience a
high turnover rate. This puts them at a distinct disadvantage because they
do not have extensive records of caregiver's past performance, and they
often attract those providers who can't get a job at a reputable agency.
2) Are your workers bonded and insured?
Few people like to think about accidents or possible problems at the outset
of retaining help, but the fact is lots of people get into accidents every
day, such as car accidents, sprained backs, twisted ankles, etc. Also, from
time to time, important things in a client's home can be damaged or
disappear through an individual's negligence or dishonesty. The company you
want to work with must have extensive insurance, including Professional and
General Liability, Non-Owned Auto, a Dishonesty Bond, and Worker's
Compensation policies. Believe it or not there are some companies that have
minimal insurance coverage and others who have none at all.
3) How extensive are your criminal and background checks?
As you know, there are lots of unscrupulous people out and about looking for
work. You don't want them in your home or in the home of someone you love or
care about. Therefore you must do business only with companies that provide
a criminal background check of each person they dispatch. Because unsavory
characters drift around from place to place, it's important that they not
only run a check on the last place their candidate worked but also on all
the places they've lived for at least the last five years. Also ask them if
they can provide you with written reference check reports.
4) Does your company have a Licensed Vocational Nurse or RN on staff?
Most reputable agencies have a licensed nurse on staff to assure that proper
protocol is being followed in the care of a client. A trained nurse can help
a caregiver identify safety hazards, recognize symptoms, observe special
diets, familiarize them with infection control procedures and universal
precautions, establish hygiene standards, and more. In most cases, home care
aide agencies that have a licensed nurse on staff are going the extra mile
to provide quality assurance to the services their caregivers provide.
5) How do you select your employees?
Many agencies hire home care aides that have little experience and even less
credentials—not exactly the type of person you want caring for you or your
loved one. Reputable agencies, however, have minimum requirements for years
of experience and levels of certification. The best agencies will even take
into consideration such factors as demeanor and professionalism, weeding out
the unacceptable workers so you don’t have to. Make sure you choose an
agency that sets high standards in its hiring policies.
6) Can you send me information describing your services and fees?
This may seem like a basic question, but a company that has not spent the
time developing important informational materials such as these probably
haven’t done a lot of other important tasks either. Not only will these
materials help you compare their services to those of other agencies, but
they may also provide useful details that you hadn’t thought of earlier.
More than likely, an agency that sends you detailed, carefully considered
materials for your review has also gone the extra mile in other aspects of
7) What is the company's replacement policy or guarantee?
If you want to avoid getting a lemon, ask about the company's replacement or
guarantee policy. In most cases, a good agency will give you as many
replacements as needed whenever needed without limitation. For those people
wanting a caregiver on a referral basis, wherein you handle the payroll and
insurance obligations, you should get at least three months to see if the
individual will be suitable to you. Of course, the more the better, but
certainly no less than three months.
8) What are your financial procedures? Are your rates negotiable?
Most agencies have a lot of fixed costs to incorporate into their quoted
rates. However, they also know that not all clients have the same ability to
pay. Some agencies may be prepared to make a deal. If you're flexible about
the age, number of years of experience of the caregiver, or English speaking
abilities, perhaps you can get reduced rates. Most agencies come in contact
with eager, honest and hardworking people who are anxious to gain experience
and English skills. So if money is an issue, this approach may work for you.
Even if you choose not to negotiate, ask to see written statements
explaining all of the agency’s costs and payment plan options. This will
clear up any discrepancies before they occur.
9) Would you mind providing me with references?
It pays to find out if the Agency's clients are satisfied with the services
they're getting. Sometimes old references don't reflect current management
conditions, so it's best to ask for testimonials from their more recent
jobs. Of course, you want to be able to talk with clients who have had a
long history with the agency so that you can get a good sense for how they
do business and what you might expect from them.
10) Can we set up a time to meet to discuss the details of my care needs?
It's always a good idea to meet the Agency's principal(s) or
representative(s) and to see their setting if possible. It's also good to
have them come over to your place so that you can meet them at your
convenience. Home care can get expensive, so you want to be sure that the
people you'll be dealing with can be relied upon to give you the best
service possible. Also, the advantage of going to their office is that you
can make some assessments about them that you can't just by talking on the
phone. Are they a boiler room operation or are they organized and corporate?
Are they a small company or a large one?
Cohen is the founder and managing director of Home Sweet Home Care,
Inc., a private duty home care agency providing quality services to seniors
and convalescing adults in the San Francisco Bay Area. Shirley founded Home
Sweet Home Care in response to her own urgent need and desire to find the
right home care help for her mother, who had suffered a sudden and
paralyzing stroke. Visit Shirley's website at