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What you need to know BEFORE you hire a home care provider

BY J.A. STROM —
When you hire a home care provider, you are inviting someone into your home. So don’t let “Minnesota Nice” get in the way of asking tough questions. A little precaution and research can go a long way to giving you peace of mind and preventing problems.

Make sure you’re hiring the right person or agency for your needs. Asking friends and relatives for recommendations is a good start. Your family doctor may also have suggestions.

The Minnesota Department of Health has survey and inspection information and complaint results for home care and home health care agencies and individuals. Providers are licensed by the State and must comply with state laws governing their activities, such as the Patient’s Bill of Rights.

You can find these survey and inspection results on the Department of Health’s Web site. Or you can call 651-201-4201 to ask about a specific agency or a licensed care giver.

Where to begin

One of the first steps is to determine the kind of care you need. “Home care” usually refers to non-medical services, such as meal preparation, housekeeping services or transportation. “Home health care” is medically oriented, such as help with medication, physical therapy or other services that help you recover from an illness or injury. Those who provide home health care are usually nurses, therapists or home health aides.

Make sure that whomever you hire can provide the services you need. Some agencies offer both kinds of services, some only housekeeping and some only health care. If you need skilled care, such as injections, oxygen or wound care, make sure your caregiver is trained and certified to do those services.

Having the agency visit your home before you finalize any decision can also help determine if the caregiver can meet your needs.

If you choose to work with an agency, here’s a checklist of things to ask:

• What screening does the agency do on its caregivers, such as background checks?
  

• What sort of training do the employees receive? Are their credentials investigated and is training ongoing?
  

• Will an agency supervisor evaluate the quality of care you receive on a regular basis?
  

• Will you have the same caretaker each week?
  

• What exactly are the services that will be provided and how much will they cost? Make sure you get a written care plan so you know what you will be getting and there is no misunderstanding later.
  

• How are billing and expenses handled? If Medicare or your private insurance will pay for some of the costs, will the agency bill them directly? You want to make sure you understand all of the possible service fees and how payment will be handle.
  

• If you have a family member who is involved in your care, is there anything you need to sign so that person can also contact the agency for information and be involved in your care?
  

• What provisions are there for backup care or care during a disaster? Does the agency have someone on call? Who do you call if no one shows up?

My mother’s caretaker was wonderful, but Minnesota winters sometimes prevented her from making it in to work. My mother had me as a backup as I lived only three miles away. But it could be a real problem for others if the caretaker or a replacement doesn’t show up.

• Are there limitations in terms of what tasks will be provided or the time of day?
  

• What are the provisions for resolving problems? Who can you call to discuss your issues?
  

• Are you committed to a length of time to the agency, even if you are unhappy with the care you are receiving?

Home health care

If you need home health care, the questions can get a little more complicated because the care often is. Your doctor should probably be involved in the care plan. Many agencies will work directly with a physician to plan your care.

• Does the agency have a nursing supervisor available to provide on-call assistance 24 hours a day?
  

• Who will be providing what care? For example, what will the nurse do and what will a health aide do?
  

• If you rely on equipment such as oxygen, is there a 24-hour number you can call for service?

One Saturday the electricity went out in my mother’s senior building. Her electric-powered oxygen tank wouldn’t work, and we weren’t sure she had enough backup tanks to last as long as the blackout might. Luckily, I was home when she called in a panic, and the supply store was still open. But after carrying several tanks up seven flights of stairs, I was the one who needed oxygen. She required a service that would respond 24 hours a day, 7 days a week. We learned a valuable lesson that weekend.

Hiring on your own

If you hire an individual, rather than going through an agency, it is even more important to do screening, check references and have a backup plan in case the caregiver doesn’t show up.

Have potential caregivers fill out an employment form that includes:

• Full name, address and phone number

• Date of birth

• Educational background and training

• Work history

• References

Ask to see their Minnesota state licenses and certificates, if applicable, and personal identification including Social Security card, driver’s license or photo ID.

Check references from previous employers and be certain to contact them. If there are gaps in the references, it might indicate that past employers were not satisfied with their performance. Talk directly to former employers rather than just accepting letters of recommendations.

There are specific licensing requirement for self-employed home care workers. Individual paraprofessionals who perform home health aide tasks are required to obtain a Class C home care license and be supervised by a registered nurse. Individuals who perform only home care aide tasks or home management tasks have no supervisory requirement.

Taxes could be an issue

Generally, if you hire an individual home care provider, you hire the worker as an employee or as an independent contractor. If the worker is an employee, you are responsible for paying all applicable taxes, such as Social Security. If the worker is a contractor, you have to report all earnings to the Internal Revenue Service. Check with your tax advisor to make sure you are following IRS rules, as there can be a fine line between being an employee or contractor.

Read the IRS information on this issue.

You should also check with your insurance company about coverage for a home care provider concerning any liability issues.

Home care can be a valuable solution, but it pays to be a smart and informed consumer.

(Search for Minnesota companies providing home care in the GrayTimes directory of senior services.)

(Posted: March 5, 2008)