How Do I Choose a Home Care Company?
This is the fourth of five installments in our Making Home Care Work for Your Aging Loved One series. The transition of introducing care into your aging loved one’s home can feel very overwhelming! We started by compiling five of the main concerns our customers have expressed to us. Each installment focuses on one specific obstacle and how to tackle it, based on our 30 years of home care experience. Remember: you can do this.
Concern #4: How do I choose a home care company?
We asked Cooperative Home Care, Inc.’s CEO and Owner Mitch Waks how to choose a home care company. Mitch is a busy professional who is also a caregiver for his aging parents. He has used home care and hospice services for his parents, and he understands the importance of choosing the right provider as efficiently as possible.
There are six things to consider when choosing your home care company. I will preface them by recognizing that whether this is a sudden decision or has developed gradually, I understand timeliness is going to be very important. Commit to considering at least these six things, as most of them can be answered very quickly during a phone or in-person interview. If you do, you can expect to make a good home care decision that is also timely.
You should also know that you have a choice. Your loved one’s care providers may recommend the home care company with which they are affiliated (especially when it is hospital-based care) but your loved one is entitled to choose their provider. Again, if we are not careful, we can cut corners when making a decision because our time is short. Exercise your right to choose, follow my efficient process and ensure your home care company meets the following criteria.
- How do they look online?
Start by accessing readily available online information to do some initial screening. If you have friends and/or family who can make a recommendation that is another good starting point. Visit company websites and read their reviews. You can also call them, identify yourself as a potential customer and ask to speak to their Director of Nursing. If they have an uninformative website, negative online reviews, and/or a nursing director who is unwilling to speak with you, these are easy clues to move on quickly to the next agency on your list.
- Are they certified and/or accredited?
Assuming they pass the first test, are they certified by Medicaid, Medicare, CHAP and/or ACHC? If yes, then they are a great agency that cares about quality and is willing to have others come into their offices and look at them as if under a microscope. The state and federal government have strict standards of care that are important indicators of the quality of care you can expect. If an agency isn’t certified by either Medicaid or Medicare, they are not accountable to the care standards to which certified agencies are. In Missouri, there are no licensing requirements for agencies that don’t accept Medicaid or Medicare. This means a private duty home care agency can operate with no oversight. Choose an agency over which Medicaid and/or Medicare is providing a set of standards and a watchful eye, to care for your loved one. Examples of Medicare’s stringent oversight include unannounced on-site audits to examine hiring practices, training, personnel files, nursing and therapy documentation, and patient charts. The surveyors usually interview and/or visit current patients for their feedback as well. If they find deficiencies, they issue correction plans. In extreme cases of non-compliance they will suspend or revoke an agency’s license.
One step further than government certification and oversight is the independent oversight of accreditation. These organizations provide even more extensive regulations to gain their accreditation seal of approval. Community Health Accreditation Partner (“CHAP”) and Accreditation Commission for Health Care (“ACHC”) are two highly regarded independent organizations that come in to a home care company and provide training, expectations, and standards that are the highest you can achieve. To pass an accreditation requires a disciplined team of people that are dedicated to doing every phase of home care correctly.
Another reason to choose an agency that is Medicare-certified is this: as your loved one ages, they will likely need additional care. An agency that doesn’t accept Medicare won’t be able to offer the free care that is available through Medicare for those who qualify. They will have to call in another agency, which will create confusion from working with two different agencies, instead of cohesive services through one agency that accepts many different types of funding.
- Are there 24/7, on-call employees?
Problems happen at all hours of the day or night and sometimes can’t wait for the office to open the next day or on Monday morning. A good home care company has a 24-hour on-call system utilizing real employees, not an answering service. When a staff member is on-call, they can triage and respond immediately if there is an emergency. If you need a nurse, or if your regularly scheduled caregiver cannot fill their shift, the on-call employee can help. An answering service is of little value to you as they simply take messages. Even if they attempt to contact the agency, they are delaying the time to respond which is inefficient and frustrating.
- Medical Director: yes or no?
Does the agency have a Medical Director? This is an important role in a high quality agency. They prescribe services, oversee care plans, attend case conferences and provide medical oversight and guidance. Even if you think, “My parent doesn’t need a doctor or skilled nursing”, at some point they may. You want an agency that has the licensed professional staff to provide medical care if needed which gives you (and them) peace of mind that if their needs change, they are covered. Don’t be fooled by the private duty agency that promises they have a good relationship with a Medicare-certified agency. It never works as well when there are multiple agencies working with one patient instead of one agency that can provide every service.
- How do they screen and train their caregivers?
A sound agency can quickly share an outline or syllabus of their orientation and ongoing education and training requirements. If they hesitate to share these with you, or simply say “Our caregivers are the best trained caregivers in town”, this usually means they do no or minimal initial or ongoing training and education. Do they do pre-hire screenings including criminal background checks and drug screenings? Do they do On-The-Job Training? Do they offer specialized Alzheimer’s and Dementia Training to meet the specific needs of your loved one? Do they require annual CPR and First Aid certification? If not, then they are not investing in the people that are going to provide care for your loved one.
- How do they help keep your costs down?
If an agency takes Medicaid, Medicare and/or Veterans Insurance, they can significantly manage your costs. They should be able to confidently qualify you for every type of home care service before you pay out-of-pocket. If they don’t, then you may be paying extra when you don’t need to. This can add up to thousands of dollars in free care services that you are missing, if your agency that doesn’t provide these services.
We’ll wrap up our five part series with Concern #5, coming soon. Stay tuned and meanwhile, share your thoughts and suggestions on our Facebook page!