How to find and vet a home care agency

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Choosing help means inviting someone into your parent’s daily routines. Make room for your parent’s preferences as you compare agencies, including who provides care, which tasks are wanted, and how concerns will be raised.

To find and vet a home care agency, start with the Eldercare Locator. Check any required state license. Compare ten questions about screening, employment, backup care, training, and fees, then get the service terms in writing.

Agency or independent hire: who is the employer?

An agency may employ its aides or refer workers for families to hire. The business name does not settle employment status or insurance responsibilities. Ask who directs the work, who pays the worker, and what the agreement requires from the family.

Agency-employed aides: Under IRS Publication 926 for 2026, a worker supplied by an agency is not your household employee if the agency controls both what work is done and how it is done. Ask the agency to identify the employer and provide written details about payroll, screening, insurance, and replacement arrangements. Check the policy’s coverage and exclusions; an agency agreement does not automatically eliminate every family responsibility or guarantee a replacement aide.

Directly hired or agency-referred aides: The IRS says a household worker is your employee when you control both what work is done and how, even when hired through an agency list. If the worker alone controls how the work is done, the worker may be self-employed. Household employment taxes depend on applicable thresholds and exceptions. Ask a qualified tax adviser about the arrangement and an insurer about liability and injury coverage. State employment and workers’ compensation rules also need checking.

Compare the administrative work and the actual service commitments with the full price. The Bureau of Labor Statistics reports a May 2025 median wage of $17.21 an hour for home health and personal care aides across employment settings. That is a worker-wage figure, not a family’s agency bill or a measure of agency overhead. Compare written local quotes rather than treating the difference as proof of insurance coverage, profit, or value.

What a non-medical home care agency covers

For help with daily activities rather than skilled treatment, ask about non-medical home care. BLS describes personal care aides as helping with everyday tasks. Depending on the worker’s permitted duties and the service plan, tasks to discuss include:

• Help with bathing, dressing, grooming, and toileting
• Meal preparation and feeding assistance
• Light housekeeping, laundry, and errands
• Medication reminders; ask separately about any medication assistance, permitted duties, training, and supervision
• Companionship and agreed supervision hours
• Transportation to appointments; confirm whether rides are offered and how they are covered

Skilled services such as wound care, injections, and physical or speech therapy require a different service scope. Medicare’s home health guidance distinguishes these from personal care alone. An organization may offer more than one service, so ask which department and qualified professional would provide each task. Medication-related duties also depend on state requirements, training, and supervision; do not assume every aide can perform the same tasks.

If skilled care is needed, ask the treating healthcare provider about a home health assessment or referral. Medicare home health eligibility does not require a prior hospital stay. Medicare’s Care Compare can help locate Medicare-certified home health agencies. Certification for that benefit does not establish that an agency’s separate private-pay personal-care service is covered.

How can I find home care agencies to interview?

A search result or listing can supply a name. Follow it with checks of the actual provider, required licensing, services, and written terms. These resources can help build a shortlist; a referral does not replace the ten questions below.

Eldercare Locator: This public service of the U.S. Administration for Community Living connects older adults and families with local resources. Visit eldercare.acl.gov or call or text 1-800-677-1116. Ask about local home care resources and the Area Agency on Aging. Confirm the provider’s qualifications and availability yourself.

State regulators: Ask which state authority regulates the service being offered and whether a license is required. Where applicable, verify its current status and scope with the issuing authority. The National Institute on Aging also recommends checking complaints with state and local agencies that regulate the company before signing.

A geriatric care manager: NIA describes care managers as helping identify needs, make a care plan, and find community services. Ask what a proposed assessment or agency search would include and what it costs. Our guide to hiring a geriatric care manager covers scope, fees, credentials, and referral relationships.

Listings and referral services: Ask which providers a service includes, who pays it, and what its screening actually checks. Obtain the provider’s own license and insurance information where applicable. A profile, rating, or introduction alone is insufficient evidence that the agency can provide the tasks and hours your parent needs.

Discharge planners and social workers: If your parent is leaving a hospital or rehab facility, ask the discharge team for local service options. Ask how the list was selected, whether any financial relationship exists, and what the team will help arrange. Confirm each agency’s scope and current capacity directly.

Ten questions to ask a home care agency

Ask every agency the same questions and record the answers. NIA’s guidance on services at home includes a care-provider question worksheet and recommends checking references and complaints. The following ten questions add practical checks of the agency agreement. Ask for written confirmation of any answer you will rely on.

Which unanswered questions should pause the hiring decision?

Resolve these gaps before relying on the proposed service. A clear written response may address a misunderstanding; an unexplained gap remains part of the decision:

• Required licensing cannot be verified. Where a license is required, verify a current license covering the offered service before proceeding.
• Screening remains unexplained. Ask the intake worker to obtain the written process or refer the question to a supervisor. Do not rely on a vague assurance that everyone is checked.
• Pressure to sign before reviewing terms. Request the full agreement, rates, and cancellation conditions, with time to compare them.
• No workable explanation of missed shifts. Establish what the agency will attempt, what it promises, and what must happen if essential care would otherwise be left unmet.
• Training or permitted tasks are unclear. Ask what the assigned aide has been trained and authorized to do for your parent’s particular needs.
• Care is offered without enough assessment information. Ask how the agency learned your parent’s needs and the relevant home conditions. If it proposes starting before a home visit, ask what information it has, what remains unassessed, and how that gap will be addressed.

What should a home care assessment cover?

Ask who conducts the assessment and whether it includes a home visit. Request a discussion of your parent’s daily routine, care tasks, relevant home conditions, preferences, communication needs, and the days and hours requested. Ask which questions require a nurse or another qualified professional rather than the intake worker.

Compare the resulting written service plan with what was discussed. Does it name the tasks the aide will perform, tasks the agency cannot provide, the schedule, and who to contact about changes? Ask how the plan is updated if needs change. If the assessment is remote or incomplete, ask how the agency will check the missing information before relying on it.

Include your parent in the discussion to the extent they want and can participate. Ask how preferences or disagreements will be recorded. Use the meeting to test whether the proposed arrangement is clear, rather than predicting the agency’s whole culture from one interaction.

What should I ask about aide turnover and continuity?

In July 2025, the Home Care Association of America reported a caregiver turnover rate of 75.0% for 2024, down from 79.2% the year before, citing Activated Insights’ industry benchmarking report. This is a historical survey figure, not a forecast of whether your parent’s aide will leave. It does not establish an individual agency’s staffing record.

Ask, “How long do your aides typically stay with one client?” and “What is your agency’s average aide tenure?” These measure different things, so ask how the answers were calculated. Request the plan for introducing a substitute, sharing the service plan, and communicating a staffing change with your parent.

Ask what continuity arrangements can be included in writing and what the agency cannot promise. If familiar routines or communication are particularly important to your parent, describe them in the service plan and ask how a new aide will learn them.

What does home care cost, and when might coverage apply?

The CareScout Cost of Care Survey reports a 2025 national median of $35 per hour for a non-medical caregiver, up 3% from $34 in 2024. Its non-medical category combines homemaker and home health aide services. This provider-survey median is a comparison point, not a local quote or a guaranteed price. Request actual rates and minimum hours for your parent’s schedule.

Medicare does not cover personal care when it is the only care needed. Under Medicare’s home health rules, eligible people can receive part-time or intermittent skilled services and home health aide help alongside qualifying skilled care. Eligibility includes being homebound, needing covered skilled care, a qualifying face-to-face assessment and order, and services from a Medicare-certified agency. For the homebound test, leaving must be medically inadvisable or require help because of illness or injury. The person must also normally be unable to leave home, with leaving requiring considerable effort. Permitted short absences do not automatically disqualify someone. Coverage can support maintaining a condition or slowing decline, and a prior hospital stay is not required. Help with bathing or meals alone is outside this benefit.

Medicaid coverage depends on the state program and eligibility. State-plan personal care is an optional Medicaid benefit; home- and community-based services waivers may also include personal care, homemaker services, or support coordination. Waivers can target particular groups, require an institutional level of care, and limit enrollment. Ask the state Medicaid office which route applies, what services and hours are authorized, and which providers can bill the program. A private-pay agency is not automatically an approved provider. Our Medicaid long-term care guide explains the broader eligibility questions.

If a move to a facility is also being considered, compare the actual schedules, services, and total costs of both proposals. Our in-home care versus assisted living guide addresses that separate choice.

How can I compare written quotes from several agencies?

Give each agency the same description of the requested tasks, days, hours, location, and your parent’s preferences. Ask it to identify any task it cannot provide and the earliest schedule it can actually commit to. Keep your notes from the ten questions with each written quote so the price is tied to a defined service.

Compare the first week’s and first month’s total, minimum visit hours, assessment or setup fees, travel and holiday charges, cancellation terms, and the cost of changing or ending service. Record who employs the aide, insurance details, substitute arrangements, and what happens if a shift cannot be filled. Where quotes differ, ask which service or charge explains the difference before choosing.