Ask agencies directly whether they employ caregivers or use independent contractors, since this affects liability and oversight.
Confirm how the agency handles caregiver absences and last-minute schedule changes before you sign anything.
Get a written breakdown of all fees, including any charges for holidays, nights, or minimum-hour requirements.
Check that the agency carries liability insurance and workers' compensation coverage for caregivers in your home.
Ask about supervision: who monitors caregiver performance and how often.
Verify what background screening each caregiver goes through before being placed with a client.
Why these questions matter
Choosing a home care agency is a significant decision. A caregiver will work in your home, often with a family member who is vulnerable, and the agency behind that caregiver sets the standards for how that person is hired, trained, and supervised. Asking detailed questions before you sign a service agreement helps you understand exactly what you are purchasing and protects you if things do not go as expected.
This checklist is general educational guidance. For decisions involving complex medical needs or Medicaid-funded home care, consult a licensed social worker, elder law attorney, or your state's Area Agency on Aging. You can find your local agency through the Eldercare Locator, a free service supported by the U.S. Administration on Aging.
A good agency will encourage an in-person meeting between you, your family, and a prospective caregiver before care begins.
The checklist
Work through each group below when speaking with a prospective agency. Take notes and compare answers across agencies before making a final decision.
Agency structure and licensing
Ask whether the agency is licensed by your state and request the license number so you can verify it with your state health department.Must
Confirm whether caregivers are direct employees of the agency or independent contractors, since employment status affects who is responsible if something goes wrong.Must
Ask whether the agency carries general liability insurance and workers' compensation that covers caregivers while they are in your home.Must
Caregiver screening and qualifications
Ask what background checks the agency runs on every caregiver, including criminal history, sex offender registry, and abuse registry searches.Must
Confirm what training caregivers receive before their first placement, including any required certifications such as a home health aide (HHA) or certified nursing assistant (CNA) credential.Must
Ask whether the agency checks caregiver references and how recently those checks were completed.Should
Find out whether caregivers receive ongoing training after placement, particularly for clients with dementia or chronic conditions.Should
Supervision and quality oversight
Ask who supervises caregivers after placement and how often a supervisor visits or contacts both the caregiver and the client.Must
Find out how you report a concern about caregiver conduct and what the agency's process is for addressing complaints.Must
Ask whether care plans are written, how often they are reviewed, and who updates them if a client's needs change.Should
Scheduling and backup coverage
Ask how the agency handles a caregiver calling out sick on short notice and how quickly a replacement is typically arranged.Must
Confirm whether you have any say in who the replacement caregiver is, or whether the agency assigns someone without consultation.Should
Ask whether a consistent caregiver is assigned to your household or whether staff rotates regularly.Should
Costs and billing
Request a written fee schedule that includes hourly rates, minimum daily or weekly hours, and any surcharges for overnight, weekend, or holiday care.Must
Ask whether the agency accepts Medicaid, long-term care insurance, or Veterans Affairs (VA) benefits, and what documentation you need to provide.Must
Confirm how billing works, including the billing cycle, accepted payment methods, and what happens if a scheduled visit is cancelled.Must
Service agreement and exit terms
Ask for a copy of the service agreement before signing and take time to read it fully, including cancellation and termination clauses.Must
Find out how much notice either party must give to end services and whether there are any fees for reducing hours or ending the arrangement early.Must
After you finish the checklist
Once you have answers from one or more agencies, look for consistency between what a representative says verbally and what appears in the written service agreement. If an agency is reluctant to put policies in writing, that gap is worth noting.
Pay close attention to cancellation terms. Some agencies require advance notice of 30 days or more, and some charge fees if you reduce hours below a contracted minimum. Understanding common terms in home service agreements can help you read those documents more confidently.
Families who are also thinking ahead to a possible move should read through the step-by-step guide to planning a move to a senior community, which covers how to assess care needs and compare facility options alongside home-based alternatives. For a broader look at what staying home long-term actually involves, an honest review of aging in place covers both the advantages and the practical challenges.
This article is for informational purposes only and does not constitute legal, medical, or financial advice. Home care needs and regulations vary by state. Consult a qualified professional for guidance specific to your circumstances.
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