Everything You Never Knew You
Needed to Ask About Home Care
Finding the right home 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 redirect?
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 suit 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. (County AAA resource offices can be found in the yellow pages or on the web).
It will be helpful to draw up an agency comparison spreadsheet, an easy task for those with Excel computer skills. If excel eludes you … a piece of paper and a ruler will do.
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 Workers, 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) or Medical Escort are most often out-of-pocket expenses but may be provided by Long Term Care Insurance, under a stats, or subsidized waiver program or through other providers representing National Organizations, such as Alzheimer’s Association, Multiple Sclerosis Society or the U. S. Veterans Administration. If your or your loved one falls into one of these categories, call the appropriate organization/plan immediately to find out what services, compensation, or reimbursement they may offer.
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 do not provide worker’s compensation, liability insurance, or unemployment insurance. 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. You are accountable for the employer’s tax burden share (you will have to file tax returns as an employer) as well as being responsible for the aide if he/she is injured while in your employ. The registry has no liability to you or to the referred caregiver. Pennsylvania requires Agencies or Registries to provide a disclosure document informing the patient of their employer responsibilities.
- 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.
- Some non-medical agencies have regular RN supervision of their team of caregivers as well as free RN patient assessments and care plan development. (Be sure to ask!)
- Non medical agencies that are part of a corporate network that includes a skilled care agency as well as the non-medical agency can offer services across the home care continuum.
Know the agency’s mission.
- Ask… The agency’s employee should know! If they have a website, by all means check it out.
- Are there ancillary products or services provided by this company?
- Who has authorized this agency to operate (i.e. who issued the license?)?
- Who audits their provision of care?
- Does this agency carry a certification from a National Home Health Accreditation Agency (e.g. JCAHO or CHAP)?
Know whom 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 aide, nurse or therapist 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!