Home Care Agencies

caregivinghope.org expert advice on caregivingHome care agencies differ in types of services. Agencies offer short-term medical care, long-term personal care and housekeeping. They are all sizes, nonprofit and for-profit, Medicare certified and non-Medicare certified. It is helpful to clarify the type and level of services the agency provides as well as the type of reimbursement it accepts.

Social Service Agencies
In some communities, home care services are available through social service agencies like CJE SeniorLife. Most of these agencies are nonprofit. Many furnish other services in addition to home care. For example, an agency may conduct a preliminary assessment by a nurse or social worker, and/or involve a social worker in order to help with decision-making, counseling and coordination.
Homemaker/Home Care Agencies
These agencies provide a variety of nonmedical home support services. They can provide homemakers, home health aides, chore housekeepers and other workers. The workforce is generally not under the direct supervision of a medical professional and services are not usually Medicare reimbursable.
Home Health Care Agencies
These agencies, some of which are hospital-affiliated, focus on the medical aspects of care. Their professionally-trained personnel (e.g., registered nurses, physical therapists, licensed practical nurses, etc.) can do dressing changes, monitor vital signs and perform other tasks as required by the physician or nurse. Most also offer the services of certified nurse assistants who are supervised by licensed professional nurses. Some agencies do provide nonmedical home care services. Home health care is covered by Medicare but must be ordered by a physician. 
Nurse Agencies
These agencies may be, but are not always, Medicare-certified. In addition to private duty registered nurses, licensed practical nurses, and/or skilled therapists (for physical therapy, occupational therapy, or speech therapy), these agencies often provide certified nurse aides and homemakers.
Finding The Right Agency
Word of mouth is one of the best sources of information about home care agencies. Hospital discharge planners, social workers, and doctors are good resources for finding home care services immediately following hospitalization. There is an extensive national network of state and area agencies on aging that links seniors with services in their communities. For information about these services anywhere in the country, call the Eldercare Locator at 800.677.1116. If you are eligible for government-sponsored services, your Area Agency on Aging can select the home care provider for you. The National Association for Homecare can provide you with a list of Home Health Care Agencies in your state and local area. Many states have Home Care Councils that can also provide resource lists.
Questions For Agency
  • Is your agency licensed or accredited and, if so, by whom?
  • Is your agency Medicare-certified?
  • What is your assessment process?
  • What qualifications do you require of your workers, i.e. certification, working experience?
  • How do you determine what services are needed?
  • Will you have a written plan of care? Will I get a copy of it?
  • Do you work with my doctor in developing a plan of care?
  • What are your minimum/maximum hours of service in a day or week?
  • Are there service limitations in terms of tasks performed?
  • Are there service limitations in terms of times of the day? Hours in a day?
  • What geographic areas do you serve?
  • How do you screen your employees prior to hiring?
  • What kind of training do your employees receive?
  • Do you offer your employees specialized training in caring for individuals with dementias or other chronic disabilities?
  • Is your agency bonded and insured? Are your employees bonded and insured?
  • What is the background of your agency?
  • Do you conduct a home visit before starting home care service?
  • How long have you been in operation?
  • What is your funding source? Are you a for-profit or not-for-profit agency?
  • What are your fees? What do they cover?
  • Do you have a sliding fee scale or subsidized service?
  • Will you pay your employees, or will I?
  • Who supervises your employees? Do they receive any on-site supervision in the home?
  • Who do I call if the worker does not show up?
  • Will the same employee continue with my case?
  • What are your replacement policies?
  • How soon can services begin?
  • Do you provide any other services?
  • Can you provide references from doctors, hospital personnel, or social workers?
  • Do you guarantee customer satisfaction?
The following sections may assist you in finding help for your loved ones: