Choosing a Home Health Care Agency

If you have ALS or are caring for a loved one with ALS, there are many reasons to consider hiring in-­‐home help. For example, a change in condition could necessitate a higher level of skilled care, or it may be helpful to have assistance with personal care or some of the routine tasks associated with managing the household. One route is to find and hire help on your own, but a home health care agency can provide a wide range of care and support services while also handling day-­‐to-­‐day administrative tasks, such as managing personnel and payroll. If you’re thinking about hiring help through a home health care agency, here’s an approach for finding an agency that is a good match.

Define your needs

First, give some thought to your requirements. Begin by writing down what services you are interested in. For example, do you need an agency that can provide skilled care (i.e., nursing or therapy services), assistive care (i.e., assistance with personal care or housekeeping tasks), or both? What specific tasks would the caregiver be responsible for completing? Also write down other considerations that are important to you, such as whether or not the agency accepts Medicare or other insurance. Your list can help you narrow the field of choices initially, as well as serve as a guide during your discussions with potential agencies.

Identify your options

Next, research the options in your area. Medicare’s online comparison tool, Home Health Compare, is a good place to start. On Home Health Compare, you can find information about the quality of care provided by Medicare-­‐certified home health agencies in your area. The National Association for Home Care & Hospice (NAHC) also offers a search tool on its website, with access to a database of more than 30,000 providers nationwide. Your doctor, a care manager, or staff at your local ALS association chapter may also be able to offer recommendations.

Vet your choices

Finally, follow up with a phone call to the agencies that interest you most. Typically, the next step will be an in-­‐person meeting that takes place in your home. Be prepared with questions that can help you gauge whether or not the agency is a good fit. Ask about:

The agency

• How long has the agency been serving the community?
• Is the agency locally owned and operated, or part of a franchise?
• What services can the agency provide?
• Is the agency a certified Medicare provider? If not, why not?
• Is the agency licensed by the state?
• Is the agency accredited (i.e., has an independent, non-­‐profit organization officially recognized that the agency meets certain standards of quality)? Accrediting organizations for home health care include the Accreditation Commission for Home Care (ACHC), the Community Health Accreditation Program (CHAP), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), and the National

The staff

• What types of health care providers are available through the agency to provide care (e.g., registered nurses, licensed practical/vocational nurses, therapists, certified nursing assistants, home health aides)?
• Are care providers employees of the agency, or independent contractors?
• Are care providers bonded and insured?
• What hiring process does the agency use to ensure that care providers are competent, qualified, trustworthy, and legally authorized to work in the United States? Does the agency conduct background checks, health screens, and so on?
• What training does the agency provide to care providers? Is the training ongoing?
• If you have specific language or cultural needs, are care providers available who can meet those needs?

Provision of care

• Is the agency able to begin providing services immediately? If not, how long is the wait?
• Is care available after regular business hours and on weekends and holidays?
• How does the agency assess what care and services are needed?
• How will the care plan be developed, and how often will it be updated?
• Which care providers will be assigned to our family? May I have information about their experience and length of time with the agency?
• Will a staff member (e.g., a case manager) be assigned to oversee the care that is provided? If so, how often will this staff member make visits to my home?
• How does the agency ensure continuity of care, especially if more than one care provider is assigned to our family?
• What procedures are in place to ensure continuation of care in the event that a care provider is not able to come as scheduled?
• Does the agency have an emergency preparedness plan to ensure continuation of care in the event of a disaster or weather emergency?

Quality assurance

• Are inspection reports available for me to review?
• Can you provide me with references or testimonials from other clients?
• Does the agency have written quality standards? What procedures are in place for maintaining and improving quality of care?
• What procedures are in place for handling concerns or problems with care? Is it possible to have another care provider assigned to our family if necessary?
• How does the agency address important principles of quality care, such as safety, infection control, confidentiality, and fostering independence?

Financial arrangements

• How are expenses and billing handled?
• Can you provide me with written documentation of services and their associated fees?
• Are there charges in addition to those for services (e.g., deposits, fees)?
• Is financial assistance available (e.g., a sliding fee schedule based on income, payment plans)?

Finding in-­‐home help can seem like a daunting task, but by doing the legwork and asking the right questions, you can help to ensure that the provider you ultimately decide on is a good fit for you and your family.

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