Questions for In-Home Care Agencies
- Will you take care of all required payroll paperwork for my parent's worker?

A significant amount of paperwork is involved when employing someone, covering such matters as taxes, Social Security, and disability. One plus to hiring from an agency (and the reason it's usually more expensive than hiring independently) is that it normally does this for you. Still, it never hurts to double-check.

- Are you Medicare certified?

Medicare certified agencies are eligible to be paid through Medicare, the government's health coverage for people over 65. To become Medicare certified, an agency must meet federal standards for patient care.

- Can my parent and I interview candidates and give input on the choice?

The more control you and your parent have over choosing a home health worker, the better you'll feel about the person. Agencies approach this differently, so you'll need to ask.

- What kind of background check do you do on your workers?

It's increasingly common for employers to do criminal background checks on potential employees. Since trust is critical when hiring someone to help your parent in a home setting, these checks are valuable screening tools.

- Do you check your workers' driving record and driver's license?

If you need someone to drive your parent, even occasionally, it's important to know what kind of driver you're getting. Car insurance requirements, by the way, differ state by state. Check with your local Department of Motor Vehicles (DMV) to see what's required in your state. And if the worker will be driving your parent's or your car, check with the insurance company to find out how to include new drivers.

- Are your workers bonded?

If someone is bonded, her work is basically insured, and your parents will be covered if she breaks the washing machine or steals something. Bonding coverage varies, so ask for details. It's a level of reassurance that can make a difference but isn't essential.

- Do you provide any training for your workers?

If so, ask the agency whether training is done once or on an ongoing basis.

- Are the healthcare workers your employees or independent contractors?

Some agencies function more like job referral services, linking independent workers with jobs rather than managing their own employees. With independent contractors, you'll likely be required to do more paperwork and supervision. It's a good idea to be clear about this from the start.

- What kind of supervision do you provide?

Does the agency check in with its workers daily or weekly? Is someone available to provide expertise or extra assistance if needed?

- How do you handle a worker's sick days, vacation days, and holidays? Will you automatically send a replacement worker?

Will you automatically send a replacement worker? Everyone needs breaks and time off, especially home health workers, whose work is physically and emotionally demanding. Find out how agencies cover for worker absences and what's required from your end.

- What's the turnover rate of your workers?

Do you think they like their jobs? Do you offer benefits? It's always hard to know if you'll get an honest answer, but it never hurts to ask. A simple truth prevails: People who are happy with their work make better employees. See if you can get a reading on this.

- How do you handle conflict between a client and worker?

It helps to know how much support you'll get from an agency should a conflict arise -- and it probably will. Does the agency mediate conflicts, and if so, how? Is it flexible about changing workers if things don't improve?

- Do you have customers I can talk to about their experiences?

Ask for several references. This is one of the best ways to get a sense of how an agency performs over time.

- Do you accept payment from insurance companies?

If your parent has, say, long-term care insurance that pays for the cost of in-home care, you'll want to make sure the agency accepts this kind of payment. If not, you're probably better off using one that does.

- What kind of service agreement is required?

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