How to Choose a Home Care Agency: Evaluation Checklist
The agency you choose will have caregivers in your loved one's home for hours each week. Evaluation quality matters more than speed. A structured comparison of 3-4 agencies using consistent criteria will surface the right fit far better than going with the first referral.
Key Takeaways
- Interview at least 3 agencies using the same set of questions so you can compare answers directly.
- Ask about caregiver screening, training standards, and what happens when a regular caregiver calls out.
- Review the service agreement line by line — especially cancellation terms, rate escalation, and liability.
What to look for in a home care agency
Start with the basics: Is the agency licensed in your state? Are they bonded and insured? Do they employ caregivers directly (W-2) or use independent contractors? Agencies that employ directly typically provide more oversight, training, and backup coverage.
Beyond licensing, look at how the agency matches caregivers to clients, how they handle schedule changes, and whether they have a dedicated care coordinator who serves as your ongoing point of contact.
- Verify current state licensure and insurance coverage.
- Ask whether caregivers are W-2 employees or independent contractors.
- Confirm they conduct background checks, drug testing, and reference verification.
- Ask about ongoing caregiver training and specialization (dementia, fall prevention).
Key questions to ask every agency
Your interview should reveal how the agency operates under pressure, not just how they sell. Ask scenario-based questions: What happens when my regular caregiver is sick? How do you handle a complaint about a caregiver? How quickly can you increase hours if needs change?
The quality of the answers matters more than specific policies. Agencies that respond with clear processes, timelines, and examples are demonstrating operational maturity.
- What is your caregiver-to-supervisor ratio?
- How do you handle caregiver callouts and backup coverage?
- Can I meet and approve the caregiver before service starts?
- How do you monitor care quality and gather client feedback?
- What is the process for changing caregivers if the match is not working?
Understanding the care plan process
A reputable agency will develop a written care plan based on an in-home assessment, not just a phone conversation. The care plan should detail specific tasks, schedules, goals, and communication protocols.
Ask how often the care plan is reviewed and updated. Needs change, and a good agency proactively adjusts the plan rather than waiting for a problem. Quarterly reviews with a care coordinator are a strong signal of quality.
- Insist on an in-home assessment before service begins.
- Review the written care plan for specific tasks and schedules.
- Ask how often the care plan is formally reviewed and updated.
- Confirm who to contact for urgent care plan changes.
Red flags that should eliminate an agency
Some warning signs are deal-breakers. Walk away from agencies that pressure you into long-term contracts, cannot provide proof of insurance, refuse to let you meet the caregiver in advance, or are vague about their complaint resolution process.
Also be cautious of agencies that quote rates significantly below market — this often means undertrained caregivers, high turnover, or insufficient liability coverage.
- Pressure to sign immediately or long-term contract requirements.
- Cannot or will not provide proof of licensing and insurance.
- No background check policy or vague answers about caregiver screening.
- High caregiver turnover rate or inability to provide consistent staffing.
- No clear process for complaints, caregiver changes, or service adjustments.
Reviewing the service agreement before signing
The service agreement is a legal contract. Read every clause, especially the sections covering rate changes, minimum hours, cancellation policy, and liability limitations.
Key items to negotiate: cancellation notice period (prefer 24-48 hours, not 30 days), rate lock period, and clear language about what happens if the agency cannot provide a caregiver on a scheduled day.
- Review hourly rates, minimum visit hours, and minimum weekly hours.
- Check cancellation terms and any early termination penalties.
- Confirm the rate lock period and how rate increases are communicated.
- Verify liability and damage coverage, especially for in-home incidents.
- Get everything in writing — verbal promises have no enforcement value.
Helpful Resources
Search Home Care Agencies
Browse and compare home care agencies in your area with reviews and service details.
View on our siteGet Matched with Home Care
Submit your care needs and get connected with pre-screened local agencies.
View on our siteMedicare Home Health Compare
Compare Medicare-certified home health agencies by quality ratings and patient outcomes.
Visit resourceFrequently Asked Questions
How many agencies should I interview before deciding?
Interview at least 3 agencies using consistent questions. This gives you enough data points to identify meaningful quality differences in operations, communication, and caregiver management.
Should I choose a franchise agency or a local independent?
Both can be excellent or poor. Evaluate each agency on its operational practices, not its brand. Local independents may offer more personalized service; franchises may have more standardized training and backup resources.
What is the difference between a home care agency and a registry?
An agency employs caregivers directly (W-2), handles payroll taxes, provides insurance, and manages scheduling. A registry connects you with independent contractors — you typically have more liability and less backup coverage.
Can I switch agencies if I am not satisfied?
Yes. Review your service agreement for cancellation terms and notice requirements. Most agreements allow termination with reasonable notice. Do not stay with an agency that is not meeting your care needs.
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