How to choose a home care agency

You don’t need to be an expert to choose well. Work through these steps, talk to two or three agencies, and pay attention to what you notice on the phone and at the first visit.

Step 1: Write down what help is needed

List the tasks (for example: help with showering, medication reminders, meals, wound care, therapy after surgery), the days and hours, and any must-haves such as experience with memory loss, a caregiver who speaks a particular language, or someone comfortable with pets.

Step 2: Confirm the right kind of agency

Skilled medical care billed to Medicare requires a Medicare-certified home health agency. Help with daily living is usually provided by a licensed non-medical home care agency. See home health vs. in-home care.

Step 3: Check credentials

• Medicare-certified agencies: look them up on Medicare Care Compare to confirm certification, services offered, and quality and patient-survey star ratings.
• State license: many states license home health and home care agencies. Ask for the license number and verify it with your state’s health department or licensing agency.

Step 4: Call and interview

Use our list of questions to ask a home care agency. Note how quickly they respond and how clearly they explain things.

Step 5: Meet in person and get it in writing

Ask for an in-home assessment, a written care plan, and a written service agreement that explains rates, minimum hours, billing, and how to cancel.

Agency checklist

Tip: print this page (Ctrl/Cmd + P) and take notes for each agency.

• The agency offers the type of care we need (skilled home health, non-medical, or both)
• Medicare certification confirmed on Care Compare (if we need Medicare-covered home health)
• State license number provided and verified
• Caregivers are employees of the agency (or the agency explained its model clearly)
• Background checks, references, and training for caregivers are explained
• The agency is bonded and insured, and explained what that covers
• A nurse or care manager does an assessment and writes a care plan
• The care plan is reviewed on a set schedule and when needs change
• Someone supervises caregivers and checks the quality of care
• Backup coverage if the regular caregiver is sick or on vacation
• A clear way to reach the agency after hours and on weekends
• Written rates, minimum visit lengths, and billing terms (for private-pay care)
• A clear process to raise a concern, request a different caregiver, or end service
• For Medicare home health: they explained what Medicare covers and will give an ABN for anything it doesn’t
• We felt respected, listened to, and not rushed