Questions to Ask a Home Care Agency Before You Hire
A practical interview checklist covering screening, employment, care plans, scheduling, rates and what to do when a caregiver does not work out.
Once you have confirmed that an agency is licensed, the real evaluation starts. Two licensed agencies can differ a great deal in how they screen and supervise caregivers, how quickly they respond, and how they write their contracts. Use these questions on the phone, then repeat the important ones at the in-home assessment.
Licensing and employment
- What is your license number, and which office will serve me? Compare the answer with the state record. In Texas, check that Personal Assistance Services is listed. In California, look up the Home Care Organization license.
- Are your caregivers employees? An agency that employs its caregivers handles payroll taxes and workers' compensation. Some businesses only match families with independent contractors; then the family may bear those duties.
- How long has the agency been licensed? The first license date is on many state records and on the listings here. A newer agency is not necessarily worse, but ask about the owner's and manager's experience.
Screening and training
- What screening do you do before a caregiver enters a client's home? Ask about criminal background checks, reference checks and the state registry checks that the state requires. In California, aides must be on the Home Care Aide Registry; in Texas, agencies must search the Nurse Aide Registry and the Employee Misconduct Registry.
- What training do caregivers get, and is there dementia-specific training? Ask what happens on a caregiver's first day and how the agency supervises new hires.
- Do you carry liability insurance and a fidelity bond? Ask for the certificate. These protect against accidents and theft.
The care plan
- Who does the assessment, and is it in my home? A good agency sends someone to see the home and meet the person before setting a schedule.
- Will there be a written care plan, and who updates it? It should list tasks, preferences, allergies and emergency contacts, and be changed when needs change.
- What can caregivers not do? Non-medical caregivers usually cannot give injections or perform nursing tasks. Ask how medication is handled beyond reminders.
- Who supervises the caregiver, and how often do they check in?
Scheduling and continuity
- Will I have a regular caregiver? Continuity matters, especially with dementia.
- What happens when the caregiver is sick or late? Ask how quickly a replacement is found and whether you are told in advance.
- How do I reach someone at night or on a weekend? Call the after-hours number during your search and see who answers.
- Can I request a change if the fit is wrong? The answer should be yes, without penalty.
Rates and contract
- What is the hourly rate, and are there different rates for nights, weekends, holidays, or live-in care?
- Is there a minimum number of hours per visit or per week? Some agencies require a minimum shift of several hours.
- What are the terms for cancelling a shift or ending service? Look for the notice period and any fees.
- How are you paid, and how often will I be billed? Ask for a sample invoice and for how rate increases are notified.
- Do you bill long-term care insurance directly? If the person has a policy, ask whether the agency will provide the documentation the insurer asks for.
Red flags
- Reluctance to give a license number or a written agreement.
- Pressure to sign a long contract before the assessment.
- Asking for large prepayment, or payment by cash, gift card or wire.
- Caregivers described as "independent" but supervised and scheduled by the agency, with no explanation of who is the employer.
- No answer about backup caregivers.
After you start
Drop in during the first weeks, ask the person how they are feeling about the caregiver, and keep a simple log of visits. If you have a concern about safety or conduct, talk to the agency's manager first, and use the state licensing agency's complaint process if it is not resolved. In an emergency call 911.
You can find the license number and state record for every agency listed on this site, and compare agencies in your city, before you make the first call.