This list can help you ask the right questions before you select a home health agency.
- What services does the agency provide?
- Who is on the home care team – physicians, nurses, therapists, dietitians, social workers, home health aides, homemakers, companions, volunteers?
- What is the cost? Is there a minimum number of hours per week or for each visit? Are there extra charges that might arise unexpectedly? If there any maximum to how much care will be provided? (Ask to have all agreements, including services to be provided and financial arrangements, put in writing.)
- Is the agency certified to receive Medicare and Medicaid reimbursement?
- Can it subsidize care for people who cannot pay for themselves? (Government and voluntary agencies, such as a Visiting Nurse Association, often have public or private money to cover some care.)
- Can the staff meet the special needs of my parent, whether religious, cultural or medical (Alzheimer’s, dialysis, diabetes, etc.)?
- How does the agency determine what services my parent needs? Will a nurse evaluate him? Will he or she consult with my parent’s doctor and my family? (Ask to have a plan of care drawn up and updated as your parent’s condition changes.)
- How will his care be coordinated? Who oversees workers? Will a supervisor visit regularly? How do I each a supervisor if there is a problem?
- Is someone available 24/7 in case of emergency? Are backups provided when workers cancel or don’t show up? (Again, get this in writing.)
- Will the same person care for my parent consistently, or will the guards [sic] change regularly (which is less desirable, but often unavoidable). If my parent doesn’t get along with a particular worker, can someone else be assigned to him? Can we interview two or three aides and select one?
- What sorts of training does staff receive, aside from general geriatric care (care for patients with dementia, first aid, communicating with someone who has trouble communicating, caring for a blind person, caring for someone who is incontinent, etc.)? Do you do background checks on workers (such as a criminal check)?
- How much say does the family have in the plan of care? How does the client or family file complaints?
- Is the agency licensed by the state and in compliance with all state regulations? (Agencies that provide nursing and therapeutic care must be licensed.)
- Is the agency accredited by a trade association, such as the National League for Nursing, which sets standards for the industry? (Accreditation means that an agency has met certain requirements with regard to staffing, training, and supervision, but not all agencies choose to take part even if they meet the requirements, so don’t rule out an agency simply because it is not accredited.)
- Is the agency insured and bonded (which protects your parent in case of theft or accidents)? Does it provide worker’s compensation so you are not liable if an employee is injured while caring for your parents?
- Under what conditions can the client or the agency terminate services?
- Can the agency provide references? Be specific when you ask for references so you don’t talk to a few selected people who were happy with the service. For example, get the names of two clients who live within five miles of your parent, or two clients with dementia who received care within the past month. Then ask these references (clients or their families) specific questions: Did the agency respond quickly to the client’s changing needs? Did workers arrive for work on time? Were workers courteous and police? Was there a need to change workers? And so on.
Virginia Morris, How to Care for Aging Parents (New York: Workman Publishing, 1996, 2004), pp. 158 and 160.
Elder law attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is an Approved Guardianship Attorney. She assists people in elder law, estate and special needs planning, guardianship and settling estates. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.