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Important Questions When Hiring In-Home Health Services

A variety of home health care services are available, ranging from taking care of daily household tasks to medical care. Before identifying a health care provider for information, get a clear idea of what you need, whether you are recovering from surgery or require long-term care for a chronic illness. The first step is determining the type of service and how often you need help. Then assess your budget to figure out which financial resources you will use to pay for home health care services. Get the specific information together about the types of insurance you will be relying on for payment.

Discuss the Transition to Care

Determine your loved one’s comfort level with the process of securing in-home health care. If a loved one denies or refuses the need for care, it’s going to make for misery all around. Have open and non-threatening discussions and listen to their concerns. Your loved one may prefer a specific type of individual as their home health aide, such as a non-smoker, early riser, card player, tidy person, experience with a specific chronic disease, or someone who is multi-lingual.

Finding a Reputable Service

Once you have identified your needs, though they may change or need to be scaled back, the search for a provider begins. The Mayo Clinic recommends finding a qualified home care service agency. Only deal with properly licensed agencies. Most states require agencies to be licensed and regularly reviewed, so check with your state health department. Be sure the agency is Medicare-certified for federal health and safety requirements. If it’s not, inquire why. Ask about employee screening and if the agency can provide references and follow up on them. Request a list of the doctors, hospital discharge planners, and other medical and administrative workers who have experience with the agency.

The individual home health aide should have proper credentials. Check to see that they are appropriately licensed by directly checking with the licensing body itself. Does the aide have a track record, and can they provide references from at least two employers? Follow up on any references given. Also, check with your loved one’s medical team to see if they have specific individuals who would qualify as a good fit for your home health aide.

Check the quality and characteristics of the agency by asking these questions:

  • How do they monitor and train caregivers?
  • Are caregivers licensed, accredited, and insured through the agency and proper licensing bodies?
  • Is continuing education provided to health aides?
  • Is the overall attitude of your potential home health aide positive and patient?
  • Can scheduled hours be consistent with your loved one’s needs? The same aide should reliably and routinely show up.

Considering Your Health Care Budget

Once you have a few qualified home health care options available, it’s time to identify which agencies are affordable. Learning about specific services you can’t afford makes no sense, so pricing is one of the first considerations beyond qualifications. Ask the agency how it handles billing and expenses and get literature that explains services and fees. What levels of care do they provide? Get detailed, written information about all of the costs associated with home care services. If it’s not in writing, be wary and walk away.

Make Sure the Services are Covered by Medicare

Does the agency allow fees to be covered by health insurance or Medicare? Not every agency does. Talk with their billing personnel to ensure your health insurance is accepted and understand Medicare’s requirements for covered services. Don’t forget to ask about financial assistance or payment plans, and again, request that all the information is in writing. Once you understand the payment set-up, reconfirm the services included in those fees. Often staff in the front office doesn’t map out the details of fee-for-service in the accounting department.

  • How much will the aide charge for home health services, and what services are included?
  • Does this information mirror the data provided by the agency?
  • What happens if your aide is out sick or schedules a vacation?
  • Does your aide receive standard holidays off as defined by federal guidelines; are they paid holidays, and who pays?
  • Who is responsible for payroll, social security, and other taxes associated with the aide?

Creating a Detailed Care Plan

Before an aide enters your loved one’s home, there should be a written care plan that includes details about medical equipment, specific care needs, and the responsibilities of the aide and the agency. This plan is usually in the form of a 3-ring binder where an aide tracks hours of care provided and can reference doctor’s notes and relevant medical information, which should be frequently updated. The book should list responsibilities and rights for everyone involved, often referred to as the patient’s bill of rights. This document varies widely, but provides a detailed example of what they include.

Inquire if the agency will continue to work directly with you and other family members after the aide is identified and hired for service.

  • What is the process for elevating concerns and complaints?
  • If there are problems, what is the protocol to resolve them?
  • What are the emergency plans for power failure or a natural disaster that can create safety hazards, particularly with medical equipment?
  • What are the response times during a medical emergency?
  • Is your aide instructed to dial 911 first?

Check for a backup plan in the event the home health aide has an emergency, car trouble, or inclement weather prevents them from showing up.

Due Diligence

According to, the average agency health care worker has between one and two years of experience, so implement the 3 R’s and get resumes, references, and reviews. Ensure the credentialing process through your identified agency includes the home health aide’s social security number and trace verification. Be sure it checks federal and state criminal records, sex offender registry, and valid driver’s license checks through the licensing department in your state. The aide’s license and credential verification need to be vetted. Finally, there should be contact with the Fraud and Abuse Control Information Systems (FACIS), which checks for bad actors in the health care field.

To hire the best home health care services possible for your loved one, thoroughly research before moving forward. Once you are engaging agencies and individual aides, ask questions, get literature, take notes and then follow up on references, license verifications, and credentialing. The research and care you put into the process upfront can prevent complaints or problems with your home health aide selection. You will create the best outcome for the patient by identifying the most qualified and affordable candidate for your situation.

Elder law attorneys help families create comprehensive estate plans for anyone needing long-term care. Contact our office to discuss care needs, and we can help you determine the best resources to pay for it, who will make medical and financial decisions, and much more. Prepare for the future of your family by scheduling a consultation. To discuss planning for the future of your family, contact our office by calling (630) 568-6656.

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