How to Choose a Home Health Care Agency

Copyright © 2014 AARP. All rights reserved.

Many people do not investigate long-term home care agencies until they have a crisis. Often the crisis involves a hospitalization. The hospital discharge plan may include a referral to home care, and you may get a list of agencies that accept your insurance.

In such a situation, you don't have a lot of time to investigate the options. But even so, you should ask questions about the agency before you sign an agreement. Be especially careful to find out how the agency screens, trains, and supervises home care workers. If you are not in crisis mode, you have more time and should do a thorough search.

A hospital discharge planner may not refer you to home care services. If you think you or your parent needs these services, ask the discharge planner to make a referral. A referral can also be made by a doctor in the community.

Although there are federal guidelines for training home health aides, each state has its own system of education and certifications. Most states require the federal minimum of 75 hours of training and 16 hours of clinical experience. Some states exceed these requirements. Most states have no training requirements for personal care attendants.

Here are some questions to ask the agency, whether you're paying privately or expect insurance to cover the services:

  • What types of services do you provide? (Be sure to ask about special kinds of care, such as ventilator assistance or wound care. Some agencies contract these services to specialized agencies.)

  • Do you provide back-up help if the assigned worker is not available?

  • Do your aides have special training to deal with medical conditions like dementia, paralysis, or stroke?

  • What kind of supervision do your aides receive? Does a nurse review the case regularly and ask for their observations about the person's care?

  • Do you screen aides before you hire them? Do you do a background check and what does it include? Is the criminal background check for your state only, or is it nationwide?

  • How much do you charge per hour?

  • Can your agency arrange for medical equipment when needed?

  • How do you handle complaints?

  • Do you provide 24-hour access in case of emergencies?

If your family member does not speak English, has cognitive problems, or follows certain religious or cultural routines, you should inform the agency.

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