Because the scope of services is so broad, selecting a home care or private duty agency isn’t always easy. Here are some tips to help you select the right provider.

1. Be certain you understand skilled home care versus private duty.

Is your family member discharging from a hospital with the need for skilled nursing or therapy at home? Or has your family physician recommended skilled home care services to help your loved one regain strength or recover from an illness? Medicare will pay for home care for patients considered to be homebound if they are under a physician’s care. It is ok to ask your physician when you begin shopping around if he or she thinks your loved one would meet the criteria. If they don’t, they care you need is considered to be more custodial in nature. For example, a private duty caregiver could help your loved one with bathing, dressing or meal preparation. These services are not covered by Medicare.

2. Determine what your immediate care needs are and anticipate for what you will need in the near future.

What this means is that just because your family member will be receiving skilled nursing services now, doesn’t mean they won’t need private duty services in the near future. It might be easier to select an agency that provides both. These agencies tend to have staff with a greater degree of medical training and skills. The drawback is that the private duty services are usually more expensive than an agency that only deals with personal care and homemaker services. You will need to balance those two factors when making your selection.

3. Talk with physicians and the medical community.

If your loved one is being discharged from the hospital with home health care, ask the social worker or discharge planner about the agency. Have they had any complaints about them? Have they used them before? Also ask who owns the agency. Is it owned by the hospital? You have choices in providers, but you sometimes aren’t aware of that. The hospital agency might be the best one in town but don’t make that assumption. Ask the discharge planner who else they use and who else has a strong reputation for care. Remember, this agency will be coming in to your loved one’s home for a least a few weeks. Investigate more than one agency before making your choice.


Your family physician’s office can also be a good resource. Call them and ask them about your top agency choices. Have they used any of them before? Also ask your family physician if they will still be involved in oversight of care when your loved one is receiving home care.

4. Ask the agency for a meeting with a staff member.

Most agencies have liaisons or nurses that can come to the hospital or to your home to explain their services. Take them up on that service. Meet with a few agencies. Interview them just like you would a potential employee. Do they have the right credentials? Does the agency? Be sure to use the checklist to help you know what to ask. After you meet with a few agencies, your choice will probably be a little easier.

5. Understand the payments and fees.

If your loved one meets the criteria for Medicare home care services, their care will be covered. But make sure the agency agrees that they do meet the criteria and they will be billing Medicare for these services. If the services will be private duty, clarify all of the charges up front and get it in writing. Be sure you ask if there is a minimum number of hours per visit, and when the clock starts running. Are you charged from the time the caregiver arrives at your house or from the time they leave the office? Same on their departure. When does the clock stop? Are there any chores or personal care that requires additional fees? Make sure you have a written list of fees for any of these types of services.

Download Home Health Tips (PDF)