8 Questions to ask When Choosing a Home Care Provider

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8 Questions to ask When Choosing a Home Care Provider

1. Is the agency Medicare certified?
If you want to access Medicare-covered home health care services, you must select a Medicare certified agency to provide them. Some Medicare certified agencies also provide services not covered by Medicare, such as assistance with daily living activities or supervision. They refer to these services as "private pay." Choosing a Medicare certified agency to provide non-medical services may result in higher rates or less flexible hours.

2. Does the home care provider use its own employees or contract staff?
Home health providers may not always be able to find adequate nursing, rehabilitation or home health aide staff to meet all of their patients' needs. These providers may need to contract with other providers or staffing agencies to employ full-time and part-time professional staff. Contracted staff can raise a concern for two reasons. First, any liability insurance the provider may own may not cover the actions of contracted staff. Second, the oversight of staff may not be provided directly from an employee of the agency's local office.

3. What are the home care provider's hiring standards?
In general, each home care provider uses hiring standards that match their services. Some requirements to look for would be:

  • Verification of professional licensure or certification for staff, minimum educational requirements and prior home health experience
  • Verification of prior employment and employee references
  • Criminal background checks (Federal and State)
  • Levels of liability insurance and bonding that cover the in-home service provider

4. What is the home health provider's process for scheduling visits?
Planning for, and scheduling, the in-home visits is an important part of your relationship with the agency. Ask about the following procedures to see how easy, or difficult, it will be for you to manage the in-home visits. Some questions you can ask would be:

  • How far in advance can schedules be confirmed?
  • How much notice does the agency need for a cancellation or change?
  • How will the agency handle illness or vacation for your usual caregiver?
  • Can the agency handle emergency situations when a caregiver is needed immediately (during a previously unscheduled time)?

5. How does the agreement provide for rate changes?
Your written agreement with the home care provider should address one or more of the following, if applicable:

  • A period of time for which the quoted rate is guaranteed
  • Advance notice of rate increases
  • Higher rates for holidays, night shifts or emergencies
  • Lower rates for an increase in weekly hours

6. What payment sources do home health providers accept?
If you believe that the services provided to you will be covered by your Medicare insurance, make sure that you are working with a Medicare certified provider. If you believe that your long-term care policy will cover the services provided, ask about "Assignment of Benefits," a process where the insurance company (if they agree) can make payments directly to the agency. If you will be paying the agency directly, make sure you understand the payment terms. Ask questions such as: What is the grace period from the end of the billing cycle? And, is there a late fee if you don't pay within that period?

7. How does the agency monitor my loved one's daily activities, health condition or concerns?
Most agencies will ask the home health aide to keep a daily log of activities and episodes. The aide will usually make comments about mood, energy and appetite. Ask the agency if these logs are ever reviewed by a clinical staff person. Ask the agency what to do if you have a concern with what you read in the log.

8. What documentation can the agency provide about customer service and quality assurance?
Most agencies have some form of a "Patient's Bill of Rights" and a complaint resolution process. Ask the agency how you should voice any concerns and whether it is always possible to speak with the manager or owner, especially if you have a concern about your home health aide.

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