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How to Choose the Right Home
Care Provider
By Coker Day
In the last part of our series on
home care services, we discussed the difference between skilled and custodial
home care services, which is good preparation for this month's topic, the
selection process. Why? Because it helps to know what kind of care you need
before choosing the right home care provider for yourself or a loved
one.
To begin with, those needs are typically based on a physician's,
case worker's or your own assessment of what's needed. If both skilled and
custodial care are required, you could work with an agency that provides both,
or just as easily, hire an agency with certified nursing assistants that works
directly with your physician and/or nurse case manager. There are also
individual or independent caregivers with nursing backgrounds who may offer
both kinds of care and who work with other nursing professionals.
Depending on the scope of services required, your first decision may be
whether to go with an agency or an individual, since the selection process for
each will be quite different and require very different time commitments. (See
September's Senior Sun article on the pros and cons of individuals vs.
agencies.)
Spelling Out Services/Fees/Hours
When
interviewing prospective home care agencies, start by asking if they provide
free estimates (surprisingly, not everyone does). At the top of most people's
list of the questions are fees: they may be listed as hourly, daily and/or
weekly. Ask if there are minimum and maximum hours of service and if there are
limitations as to the tasks and/or times of the day when services are provided.
Some agencies provide a customized plan of care, with all of the
services, duties and responsibilities, including financial arrangements,
outlined in detail. Having a care plan can help you keep track of the care
being delivered to ensure it's what you expected and/or what the doctor
ordered. A care plan is especially important to adult children who live away
from parents for whom they've contracted services. On the other hand, having a
plan and executing it are entirely different things.
That's why at
DayBreak, we developed a remote computerized system that allows us to keep tabs
on our caregivers using the clients' own telephone. Caregivers simply dial into
our computer and are automatically checked in and out for the day. The system
also helps us provide substitutes (often our own supervisors), if the regular
caregiver can't make it in one day; it matches special needs with unique
caregiver skills, as well.
A home care company may or may not offer a
contract, but before you sign anything, make sure you carefully review it. For
example, make sure you understand who will be providing the care and whether
they are home care specialists, licensed practical nurses or registered nurses,
and who will be supervising the caregivers (preferably some type of nursing
professional). With an individual caregiver, chances are you will be the
supervisor, so ask yourself if you'll be comfortable in that role.
Third Party, Independent Quality Measures
Although many
states require home care agencies to be licensed, South Carolina is not one of
them. So one way to judge the quality of an agency is to ask what kind of
training it provides caregivers and how often they receive subsequent training
to maintain their skills. You might also ask whether the agency's caregivers
are "W2 employees" or "1099" independent contractors. Your preference should be
for the former, since they are more likely to have liability, workers
compensation and other forms of insurance coverage that contractors seldom
have.
Among the most important questions to ask: Are caregivers bonded?
and What kind of background checks, tests and screens are conducted (e.g., law
enforcement, personnel, drug and history of infectious disease)? You'd be
surprised how many agencies don't conduct criminal background checks and drug
screens.
Find out how long the agency has been in business, or if an
individual, how much experience he or she has in providing home care services
(both on her own and working in a facility or an agency). References for both
individuals and agencies can include health care professionals who know them by
reputation and consumers who have used the service (or know the individual);
check every one thoroughly.
Also, find out if any complaints have been
filed with the Better Business Bureau, state consumer protection agency or
state attorney general's office. On the positive side, another quality measure
is whether or not the agency staffs its phones 24 hours a day, in case you,
your loved one or a caregiver needs help for any reason.
To some, this
may seem like a long list of issues to consider. The truth is, I've barely
scratched the surface here. When you consider that you're allowing perfect
strangers into your home to perform highly personal services, I think you'll
agree that it's important to be thorough and to ask a lot of probing questions.
Of course, uncertainty can be minimized by using a reputable agency,
which can screen, train and hire professional caregivers on your behalf, in
addition to protecting you against theft and other types of loss. What's more,
if the first caregiver doesn't happen to work out, you can always try another
one from the same agency, without having to go through the hiring process all
over again, as you would with an individual.
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Selecting Home
Care Services: A Checklist
 Individual or Agency?
Fees
o Hourly Daily Weekly Live-In
o Minimums? Maximums?
Limitations? "
Plan of Care? Contract?
o Who
provides care? When? Supervised by whom?
Caregivers
o
Qualifications … Training/re-training … Background Checks
...Screens/Tests
Caregiver Monitoring System?
Complaints
References
______________________________________________________________
Coker
Day is founder and president of DayBreak Adult Care Services Inc., an in-home
care services company serving the Midlands and Lowcountry with offices in
Lexington and Charleston, S.C. |
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