How Good is Dad’s Home Healthcare Service? 7 Questions to Ask about Quality

How can you be sure the people you hire to help Dad or Mom are caring, well-trained, and professional? Whether the home healthcare agency is a local franchise of a large national corporation, a small privately owned local firm, or a local nonprofit organization, here are 7 important questions to ask:

1. Is the agency is accredited by a national organizations such as the Joint Commission on Accreditation of Health Care Organizations (JCAHO) or Commission on Accreditation of Rehabilitation Facilities (CARF)? These certifications tell you that the agency conforms to national industry standards. There is always comfort in dealing with an organization that has proven its worth to its peers.

2. Is the agency Medicare-certified? As the name implies, if you want Medicare to pay for the services, the agency must be Medicare-certified. However, be aware there are some complications associated with Medicare’s coverage of home health services (see “Surprise! Medicare Doesn’t Pay for Most Home Healthcare”). Many high-quality home healthcare agencies are not Medicare-certified. Instead, their clientele pays for the services directly or their private insurance covers it.

3. Can the agency provide references from former clients? By talking to former clients, you can get a good sense for whether or not the staff is caring and respectful. Family members can tell you all the reassuring (or alarming) details.

4. What experience and training do Home Health Aides (HHAs) have? How about Homemakers? All Home Health Aides need to be trained, competency-tested and supervised by an R.N. However, the level of training required may vary depending on what type of license the agency has. For example, agencies with a Minnesota Class C license require their HHAs to be Certified Nursing Assistants (also called Certified Nursing Aides, Nursing Assistant –Certified, or Nursing Assistant-Registered).

But Minnesota agencies with a Class A license don’t require their HHAs to be Certified Nurse Assistants. Instead, they provide some training for their HHAs. Whether or not the agency employs Certified Nursing Assistants, their training should include home safety practices as well as training in caring for and communicating with elderly people.

Homemakers and Companions should have driving safety training as well as first aid, home safety training, and experience working with elderly people. Answering these questions will help you establish the agency’s professionalism.

5. Does the agency do criminal background check on ALL of the employees? In addition, the in-home staff should be bonded and the agency should have malpractice insurance.

If you have any concerns about an agency’s practices, contact the Minnesota Office of Ombudsman for Long-term Care. They can answer questions and investigate if necessary. The Minnesota Board on Aging can also provide information.

6. Is there a care plan? Is it updated regularly for the HHA? Before a HHA starts helping your parent, an R.N. should assess Dad or Mom. Then the family and the R.N. will discuss what care is needed, and the nurse will write a care plan for the HHA to follow. If your parent’s needs change, the care plan will be updated.

7. How closely are the HHAs and Homemakers supervised? HHAs can only be supervised and directed by an R.N. Homemakers are usually supervised by the agency’s program manager. However, any time you have questions or concerns, you should contact the agency, and the appropriate person should call you within 24 hours.

By law, you and your parent should also be given a copy and explanation of the Minnesota Home Care Bill of Rights, so you know what to expect. In addition, the R.N. supervising your HHA will visit in 14 days to check on progress and then every 14 to 60 days after that, depending on what tasks the HHA performs. The nurse can also change the care plan by phone if need be.

Knowing how to evaluate home health care agencies will help you find the best services for your loved one.