How to Choose a Home Care Agency: Questions to Ask and Red Flags to Watch For

Choosing a home care agency is one of the more consequential decisions a family makes, and it's usually made under time pressure, right after a hospital discharge, a fall, or a hard conversation. This guide is meant to slow that process down just enough to ask the right questions.

Start With Licensing and Insurance

• Confirm the agency is licensed or registered in your state, and ask for the license number
• Confirm caregivers are bonded and covered by liability and workers' compensation insurance
• Ask whether the agency itself employs caregivers directly, or contracts them out — this affects supervision and accountability

Questions About Caregiver Screening

• What background checks are run, and how often are they repeated?
• Are caregivers required to complete training specific to your loved one's needs (dementia care, fall prevention, medication reminders)?
• Who supervises caregivers, and how often does that supervisor visit in person?
• How does the agency match a caregiver's skills and personality to a client?

Questions About Day-to-Day Care

• Who creates the care plan, and how often is it reviewed or updated?
• What happens if a caregiver is sick, quits, or is a poor fit — how fast is a replacement provided?
• Is there a minimum number of hours per shift or per week?
• How does the agency communicate with family members who live out of town?
• Can family request a different caregiver without penalty if the fit isn't right?

Questions About Cost and Contracts

• What is the hourly rate, and does it change on nights, weekends, or holidays?
• Are there additional fees for assessments, care plan changes, or transportation?
• What is the cancellation policy, and how much notice is required?
• Get the full agreement in writing before care begins, and read the cancellation and rate-increase clauses carefully

Red Flags to Watch For

• Reluctance to provide a license number or proof of insurance
• No in-person assessment before starting care
• Pressure to sign a contract on the first call
• Vague answers about caregiver screening or supervision
• No documented care plan, or no way to review caregiver notes
• Unusually low rates with no clear explanation

A Simple Way to Compare Agencies

Call two or three agencies and ask the same set of questions from this guide. Note not just what they say, but how directly they answer. An agency that welcomes detailed questions and has ready answers is usually the one that runs a tight operation behind the scenes — which is exactly what you want managing care for someone you love.