10 Questions You Should Ask Before Hiring a Home Care Agency

When you hire someone to take care of your loved ones, it's important to know a few things about the agency and caregiver you choose. So you'll want to ask these key questions when you're choosing anyone to provide in-home care. You want to know who is coming into your home and that you are getting quality care.

1. Do you perform national criminal and sex offender background checks for all of your employees before they start work? In the state of North Carolina, agencies are only required to perform a state background check, and the agency must complete the background check within five days of the employee starting. That means that there are cases in which caregivers with criminal backgrounds, such as theft, abuse and other crimes, could be sent into your home for up to five days. Since only a state background check is required, an agency could possibly hire someone who committed a crime in another state.

2. Do you do periodic background checks after the employee is hired? In one instance, we had a caregiver for my mom who was picked up for shoplifting after she started working for the home care agency she was with at the time. We discovered this with a simple google search - after she had conned my mother out of hundreds of dollars worth of items.

3. Do you verify that employees' licenses are clear from the state? The agency should always verify that a caregiver's license is clear and that they have not had any reports of neglect or abuse prior to employment.

4. Do you conduct a 10-panel drug screen to check for prescription and illegal drug use? Unfortunately, drug abuse, particularly prescription drug abuse, can run rampant among caregivers. Since many seniors are on an entire array of medications, this can be a huge temptation.

5. Do you perform random drug screens on your employees? We conduct drug screens after the initial hire to ensure the safety of our clients.

6. Do you use paper or electronic timecards for hours billed? The Federal government is becoming more strict on timecards, however it has been standard practice in many smaller agencies to use paper timecards. Unfortunately, many of the seniors we serve have dementia, or may feel intimidated. So they might sign a document they do not understand, or that they feel they must. If telephony or GPS technology is used for time cards, then it is possible to verify that the caregiver is at the location with the client.

7. Are you and your employees all licensed, bonded and insured? It's important to know that the caregivers are also covered. When they are independent contractors, they may not be covered by the agency's license or insurance. If something were to happen, it wouldn't be covered by the agency's insurance, and the client may be out of luck.

8. Are your caregivers employees or are they independent contractors? Unless you are using a caregiver registry, or hiring a caregiver directly, they must be an employee of the agency. If you hire a caregiver privately, then you must provide proper withholding and payroll taxes.

9. Do you follow national, state and local laws regarding minimum wage? This should be a no-brainer. However, many agencies will allow a caregiver to live in the client's home 24/7 with no guarantee that the caregiver is getting adequate sleep. This can put both the client and caregiver at risk. If a caregiver is being paid $100 a day to live in with a client, you can be sure that applicable minimum wage laws aren't being followed, which can open you up to a lawsuit.

10. Do you conduct random, unannounced visits to caregivers while they are working? One of my dad's caregivers, who was phenomenal, worked with him 12 hours a day, 7 days a week for 2 years. The number of supervisory visits that were made during her working hours throughout that time? Zero. Since she worked from 5:30 PM - 5:30 AM, and since it wasn't during first shift, no visits were made.

By asking a lot of questions about the care that your loved one will be receiving, you will get the best possible care. Note that there was one very big question that wasn't listed, and that was about price. The reality is that most home care agencies charge relatively the same rates, within a dollar or two of each other. You can't measure how good a home care agency is by price alone, nor should you choose one based solely on price. I'm not saying that cost shouldn't be part of the equation, but the reality is that it shouldn't be the only deciding factor when choosing an agency.

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