Ten Tips for Finding Good Homecare

Most people using homecare services are with the same agency for more than one year. Patients may have services ranging from one hour a day to 24 hours a day. A good homecare agency becomes the safety net for the patient. It is important to make a well-informed decision before choosing a homecare agency, which is why it is best to research local homecare agencies when you see subtle changes caused by aging or disease, rather than waiting until the patient’s condition or supportive environment is deteriorating rapidly. Here are ten tips to ensure that you find the most suitable homecare agency for your needs:

  1. Call your local state agency. You can find out who your local state agency is by inquiring at your local senior center or by searching online for senior services. Make a referral to them and have a professional case manager come into your home, where they will be able to physically see you and document your health and disability issues. Find out what the case manager thinks you need for home care assistance. Know how much you make every year, whether it is income from working, pension(s), Social Security, or any other documented income to the IRS. Be comfortable telling a case manager working for a state agency how munch you make, and inquire about any benefits which you may be eligible for based on your yearly income. The case manager will work with you to inform you of what your home care options are. You may also call your state homecare association or closest town senior center and get their list of homecare agencies in your immediate area. In addition, most hospitals’ social service departments and nursing home discharge planners have local listings of homecare agencies. Ask them if they can recommend at least two or three agencies you can inquire upon and investigate.
    • If you are a veteran, the VA has its own homecare program
    • Ask about opening your long-term care contract if you have one
  2. Call at least two homecare agencies, although three is better to compare how differently they respond to you and your questions. Compare the agencies for the following:
    • Does the agency carry worker compensation insurance, liability insurance, or auto insurance for its workers?
    • Is the agency licensed by the state or federal government, meaning do they accepts Medicare and Medicaid?
    • Is the agency bonded?
    • Does the agency do a free on-site consultation?
    • Does the BBB give the agency a good rating? Many agencies are franchises or satellites of national companies and the local owners and management run each one differently. Make sure you have the address of the agency you are directly working with for the BBB.
    • Does the agency have three¬†references they can provide you with?

    Here are some other things to think about when calling different agencies:

    • Some agencies may just want your demographic information and some may even suggest you pay up front without an interview. This is not the type of agency that you would want to use for your homecare.
    • Some franchises are owned by people who have no medical background. A good agency will want to have a dialogue with you about why you are looking for services and what is currently in place now. A good agency will inquire if there have been any recent medical or physical changes or other issues with the patent. They will inquire about the current condition of the client and current residence (home, hospital, nursing home, hospice, etc).
    • Sometimes an agency will want to know how many family and friends are involved and welcome them to the initial consultation so everyone understands how to work together. I suggest, in this case, the family decides on a spokesperson for the meeting. This is a good opportunity for the family members to clarify, understand, and agree on who will be in charge of different jobs for the client (medication management, bill paying, and transportation to the doctors’ appointments).
  3. Discuss the clients’ diagnosis with the intake person you speak with at each agency
    • Ask whether they have had other clients with this disease or condition and whether they are familiar with it.
    • Explain your situation to the intake specialist and ask how many aides they have working for them at this time in yoiur area
    • Ask how long it will take them to see the client and how much time they will need to start services with a new client.
    • Is this agency contracted with any state or federal programs? Does the client’s income make him eligible for services through any programs that may help pay for some or all of the services being requested at the time? Can this agency give the client a phone number for a referral to this program?
    • Ask whether the agency does a criminal investigation on all of their workers and whether they do at least two professional reference checks. What credentials are they requiring be in place before hiring a worker? Homecare aides are licensed with some record of 40-60 hours of class and hands-on training (from the Red Cross license or a school known to graduate appropriate aides).

    Ask if a registered nurse is responsible for a detailed care plan, taking into consideration these issues:

    • Medication management
    • Bathing and personal care
    • Disease management
    • Ambulation
    • Housekeeping, laundry, grocery shopping
    • Diet guidelines and meal preparation
    • Transportation
  4. Along with this information, an agency should inquire about the client’s usual activities of daily living (what time do they wake up, what do they like for breakfast, are they kosher, do they take an afternoon nap, etc.). Does the care plan manage the homecare aide’s routines so the client reaches and maintains a maximum potential level of physical and mental well-being?
  5. Ask if the agency has 24-hour on-call service and always has a nurse available to be on-call in case of emergencies.
  6. Ask about the scheduling system. It should be made available to the client so they are aware of when and who will be coming to care for their needs. Clients should sign a time sheet showing the date an the hours of service each day. A time sheet requires the signature of the client, family member, caretaker, or other aide after each shift.
  7. A paymen agreement, contract, and service plan (including the anticipated number of days and hours per day of service decided on) should be signed so the client and/or family member/Power of Attorney are aware of the charges for all services at all times. A charge for a homemaker two hours a day may be at a different rate than a charge for a nurse filling meds once a week. These charges should be defined. Also, know how much is charged for transportation (errands, grocery shopping, doctor’s appointments, etc).
  8. Clients rights are always an agency’s priority!
  9. The client is entitled to certain rights and it is important to ensure that the agency you’re working with respects these rights. They are as follows:
    • The client should always have the option to request a different worker if they are uncomfortable with someone the agency provides.
    • The client can cancel service at any time.
    • The client can review billed time sheets at any time.
    • The client should expect the agency to follow all state and federal privacy laws.
    • The client should be made aware that abuse is never tolerated and all avenues of reporting to local agencies should be understood.
  10. If you are still looking for professional information about homecare and hospice call your local homecare association. Homecare, more often than not, can be a part of someone’s life for a long time, and a good working relationship with an agency makes things easier for everyone.

For more tips on disease management and home care call Cheryl Rumley, RN, President & CEO of Apex Healthcare Services at 413.746.4663.