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Long-Term Care

How to Evaluate a Home Health Care Agency

Being cared for at home is an ideal situation for many elderly patients who need assistance with the activities of daily living (ADLs). Remaining in a familiar environment, surrounded by the comforts of home, may provide psychological benefits that aid healing and promote longevity.

The demand for home health aides is growing dramatically as the population ages. Not surprisingly, so is the number of agencies supplying personnel. Now, more than ever, it's critical to compare the services of competing agencies, as well as evaluate the cost and quality of the care they provide.

 Conduct a Smart Search

Here are a few ideas that can help you "separate the wheat from the chaff" as you look for the best fit in a home health care agency.

Ask for an Evaluation—Many agencies will provide you with a professional evaluation to determine exactly what type of care is needed and for how many hours a day or week. The best evaluations are conducted in person and at home, where the agency can evaluate the patient and the home environment—something hard to do over the phone.

Obtain a Written Plan—The evaluation should lead to a detailed plan of action and job description. Use this document to compare agencies and assess the performance of the agency you select.

Look for Certification—The premier agencies hire only Certified Home Health Aides who have had experience working with older clients. The agency should also be able to verify that aides are in good health, do not have criminal records, and comply with labor and immigration laws.

Insist on Case Managers—Look for agencies that employ case managers to supervise their home health aides. These case managers coordinate care, make regular home visits, and maintain contact with you or another family member. They are essential to quality care delivery and open communication.

Identify Back-Up Plans—Find out what contingency plans your agency has in place when a home health aide gets sick or goes on vacation. Satisfy yourself that care will be there when you need it.

Inquire About "Matchmaking" Techniques—Learn what criteria the agency uses to match a patient with a caregiver. Do they consider compatible personalities and shared interests, in addition to scheduling and a patient's physical and medical needs? Find out what steps they take when the match is wrong and a change of personnel is in order.

Research the Agency's History and Reputation—Make sure the agency is an established business and is licensed by the state. You may want to check on its reputation with local hospitals, rehab centers, and visiting nurse associations. Ask the agency for at least three references and check them thoroughly.

Understand the Cost Structure Thoroughly—Ask for a comprehensive, written rate schedule. Make sure you understand what you're paying for, as well as the terms and schedule of payment. Some agencies will only take private pay patients and do not accept Medicare or Medicaid. Some require a personal check or credit card and will not accept assigned payments directly from a long-term care insurer. Determine how you will pay—and when—before you receive services.

Confirm that the Agency is the Employer—First, confirm that home health aides are not independent contractors, but employees of the agency. Satisfy yourself that the agency pays them in accordance with overtime and minimum wage standards, deducts state and federal taxes, and is responsible for Social Security and unemployment taxes, as well as workers compensation insurance. If the agency fails to do the above, the aide may be considered your employee and you may be held responsible.

Give Yourself Enough Time

If you think you or a loved one may need care sometime in the near future, start the search process now. Avoid waiting until the need is critical—when an accident happens or upon discharge from the hospital—before making your first phone calls. By planning ahead, you'll have time to carefully consider the options and make the best decision for your needs, or those of a loved one.

Copyright © 2003 Liberty Publishing, Inc. All rights reserved.


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