Everything You Never Knew You Needed to Ask About Home Care

Finding the right care provider for a family member can be a daunting task. If you are not familiar with industry lingo, you just aren’t sure if you are comparing apples to apples or if your research is creating fruit salad!!

What questions do I ask?? What’s the difference between certified vs. accredited vs. licensed. And how do I know if I am receiving accurate information or an evasive redirection?

Be sure to do your own investigation, talk to your physician, and to the Doctor’s office practice manager, in most cases the practice manager will have significant experience dealing with home care agencies and may know what local provider will best suite the needs of your loved one. The hospital’s discharge planning team, private geriatric care managers, local elder care attorneys, your health insurance provider and your county’s Area Agency on Aging are good resources as well…

It will be helpful to draw up an agency comparison spreadsheet.

Know what services the company provides:

• Skilled Services include care provided by Licensed Registered Nurses, Licensed Practical Nurses, Physical, Occupational, or Speech Therapists, Medical Social Worker, or limited Home Health Aide care. These services must be medically necessary and ordered by a physician. Services are provided based on authorization from your health care insurance provider.
• Private duty care; Home Health Aide, Home Support Aide, Personal Care Aide, C.N.A.(Certified Nursing Assistant) are most often out of pocket expenses but may be reimbursed by Long Term Care Insurance
• The CHC Waiver in PA is the state’s subsidized waiver program for person’s qualifying for Medicaid services.
• The VA or Vet Assist programs provide for Aid and Attendant Care Services

?Know what you will be paying for

• What does my traditional Medical Insurance cover?
• How are services provided under Medicare or Medicaid
• Are there co-pays for any services received?
• If I have Long Tern Care Insurance, what will that cover??

If you are contracting privately for Personal Care Assistance by a Home Health Aide or Companion Aide, be sure to ask if the company is a structured as an Agency or a Registry.

• Registries typically hire people as Independent Contractors, Caregivers may meet varying degrees of prescreening because as their name indicates, they register caregivers, referring them to families looking for care. ?The caregivers referred are NOT employees of the Registry. They become YOUR employee.. This arrangement can be cheaper, but be wary, be sure to weigh the cost vs. benefit of care provided through registries. Pennsylvania requires Agencies or Registries to provide a disclosure document informing the patient of their employees status.
• Non-Medical Agencies provide caregivers that ARE their employees and are covered with Liability insurance, worker’s compensation and unemployment insurance. Thorough background checks are done, both criminal background screenings, previous employment and experience reference checks as well as and clinical skills evaluations. All aides must meet the state’s licensure training requirements.

Know the agency’s mission.

• Ask… The agency’s employee should know!
• By all means check it out their website!
• Are there ancillary products or services provided by this company?

Who has authorized this agency to operate, (who issued their license?)

• Who audits their provision of care?
• Does this agency carry a certification from a National Home Health Accreditation Agency; (either JCAHO or CHAP)?

Know who to contact in case of an emergency

• Who do I contact after Business hours?
• Is there 24 hr a day on call service for emergencies?
• How do I reach a nurse?
• What is the company’s policy for call back time frames, if I have to leave a voice mail message?
• What do I do if the care partner doesn’t show up?
• How long has this agency provided care in my area?
• Does the agency have a Home Care Concierge, who will allow you the time to ask all of your questions and if you need a more in depth or more researched answer, will get back to you with information in an agreed upon time frame?
• Does this agency offer a free, no obligation, in home family consultation??

The only foolish question is the one unasked. And remember the choice of provider is always YOURS!?