ACS :: I Want to Choose the Right Home Care Provider. What Should I Ask when Looking into a Home Care Agency?

There are many things to look at in choosing the best agency to meet your needs. First, you will want to talk with your cancer care team and figure out which types of services you will need. Then you can find agencies that offer those services. Ask the agencies you are looking into about their accreditation, licensing, and certification. You'll also want to learn about the quality of cancer care, type of experience with providing cancer care services, and the skills and training of staff at the agencies you are considering.

There are a number of questions you might ask when you're looking at a home care service.

Is the agency accredited by a nationally recognized accrediting body, such as the Joint Commission? You can look up the agency on the Joint Commission Web site at www.qualitycheck.org. The Joint Commission is an independent, not-for-profit organization that evaluates and accredits health care organizations and programs that volunteer for their review. Accreditation is an important measure in selecting quality health care services. You can ask to see the results of the home care agency's most recent Joint Commission survey.

Is this home care program Medicare-certified? Medicare-certified programs have met federal requirements for patient care and management. Because of legal requirements, services provided by these agencies are closely supervised and controlled. Medicare certifies only agencies with skilled nursing care. To find a Medicare-approved home health agency, you can visit "Home Health Compare" on the Web at www.medicare.gov. This helpful tool is listed under the search tool "Compare Home Health Agencies in Your Area" on their home page. It gives you names, addresses, and phone numbers of nearby agencies. You can also look at quality measures and compare how well the home care agencies deal with common health problems.

Most states require licensing of home health agencies. If it is required in your state, is the provider licensed?

Does the agency have written statements that list services (including cancer care services), eligibility requirements, costs and payment procedures, staff job descriptions, and malpractice and liability insurance? Ask that they send you any brochures or other information they can share about their services.

How many years has the agency been serving your community? Can the agency give you references from cancer care professionals, such as an oncologist, oncology nurse, cancer center, or an oncology social worker, who have used this agency? Ask for names and phone numbers. A good agency will give these to you if you ask. Talk to these people about their experiences. You may also wish to check with your local Better Business Bureau, your local Consumer Bureau, or the State Attorney General's office. They can tell you if complaints have been filed against the agency.

How flexible is this agency in applying its policies to each patient or working out differences? If the agency has up-front conditions that you do not feel comfortable with, it may be a sign that it is not a good fit for you. Is the agency willing to help you find out whether you or your family member qualifies for Medicare-covered home care, or whether you even want it? This can be useful in finding out how willing they are to work with you.

Does the agency create a plan of care for each new patient? Is the plan carefully and professionally developed with you and your family, or is it based only on what you asked for? Is the plan of care written out? Are copies given to all involved? Check to see if it lists specific duties, work hours/days, and the name and phone number of the supervisor in charge. Is the plan of care updated as your needs change? Ask if you can see a sample plan of care.

Does a nurse or social worker evaluate you before you are admitted to find out which services will be needed? Is it done in your home rather than over the telephone? Does it highlight what you can do for yourself? Does it include talking with oncology professionals, your family doctor, and other professionals who are already providing you with health and social services? Are other members of your family involved?

If you are looking into an agency, are references on file for home care staff? Ask how many references the agency checks (2 or more should be required for each staff member who gives in-home care). Does the agency train, supervise, and monitor its caregivers? Ask how often the agency sends a supervisor to the patient's home to review the care being given to the patient. Ask whether the caregivers are licensed and bonded. Whom can you call with questions or complaints? How are problems resolved?

Does the agency require a family primary caregiver as a condition of admission? How much is expected of the family caregiver? Can the home care agency offer help to coordinate and assist the family by filling in around job schedules, travel plans, or other responsibilities? If you live alone, what other options can the agency suggest?

How does the agency handle payment and billing? Get all financial arrangements such as costs, payment procedures, and billing in writing. Read the agreement carefully before signing. Be sure to keep a copy. What resources does the agency provide to help you find financial aid if it is needed? Are standard payment plan options offered?

If equipment such as a respirator, oxygen machine, or dialysis machine is used, does the agency teach you or a responsible family member how to use and care for it at home? Who is available if equipment problems come up at night or on weekends?

Does the agency have a 24-hour telephone number you can call when you have questions or complaints? How does the agency respond to your very first call? Does the telephone staff seem caring, patient, and competent from the first contact, even if they need to return your call? Do they speak in simple language, or do they use a lot of jargon? What is their procedure for receiving and resolving complaints? How an agency responds to that first call for help may give you a good idea of the kind of care to expect. You may also ask if the agency does customer satisfaction surveys. If so, ask to see the results of the last survey.

Does the agency have an emergency plan in place in case of a power failure or natural disaster? Ask to see a copy of the plan. In case of an emergency, you need to know if the agency can still deliver services to your home.

How quickly can the agency start services? What are its service boundaries -- do they serve your area? Does the agency offer specialized services by rehabilitation therapists, dietitians, family counselors, or art therapists when these could improve your comfort? Does the agency offer to lend used medical equipment or other items that might also enhance your quality of life?

What are the agency's policies regarding inpatient care if you should need it? Where is such care provided? What are the requirements for an inpatient admission and how long can you stay? What happens if you no longer need hospital care but cannot go home? Can you tour the residential facility the agency uses? Which hospitals contract with the agency for inpatient care? What kind of follow-up does the agency provide for inpatients? Do nursing homes contract with the agency? Does the agency provide as much nursing, social work, and aide care for each patient in the nursing home as it does in the home setting?

Does the agency explain these? Ask to see a copy of the agency's patient's rights and responsibilities information if it is not offered to you.

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