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Hiring In-Home Help

HOME HEALTH OR HOSPICE CARE

  • The medical provider ordering home health or hospice will make a referral to an agency; however, every individual can choose or change their home health or hospice agency. 

  • Use Medicare's Find and Compare to learn more about local agencies. 

 

HOMECARE  - you can hire a homecare worker through a home care agency, using a placement agency/on-line platform,  or hire an individual privately. 

Homecare Agency: the worker is employed by the home care agency.

  • The home care agency is the employer and is responsible for paying the worker, verifying work eligibility, providing insurance, hiring, and firing. 

  • The worker is covered by the agency’s workers’ compensation policy, and therefore the agency is fully liable for the worker.

  • The home care agency will conduct screening and background checks. You may be able to interview and choose your worker from among their employees. 

  • The agency will provide supervision and training for the worker. 

  • You and the homecare agency agree upon a schedule. Depending on the availability of workers, you may have multiple homecare workers. 

  • The agency will send a replacement if a worker cannot work a shift. 

  • The agency will work with you and/or the worker to resolve disputes or problems. 

  • Agencies are usually more expensive than privately hired workers; however, long-term care insurance may cover some or all costs. Some agencies can file claims on your behalf. 

 

Registries, Placement Agencies and On-Line Platforms: the worker is employed by you

  • These are businesses that maintain a database of caregivers and match you with potential caregivers.

  • Some provide liability insurance and payroll services - it is important to check with them to confirm.

  • Some provide screening and background checks.  Ask the agency what their policy is. 

  • You and the worker agree upon the schedule and payrate.

  • If the worker cannot work a shift, you may be able to find a replacement through the agency. 

Private Hire: the worker is employed by you.

  • You are the employer and responsible for withholding taxes, verifying work eligibility, insurance, hiring, and firing. 

  • You are liable if the worker gets injured on the job.

  • You and the worker agree upon a schedule and the pay rate.

  • If the worker cannot work a shift, there is no replacement.

 

How to Find a Private Worker

  • A private worker may be someone you know or who was recommended to you by a family member, friend, or through a religious or community agency.

  • You can also find private workers by posting an ad or job announcement.

  • A private worker may be hired from a homecare registry or placement agency.  

  • You will need to interview and screen applicants.   See the next section, Questions to Ask When Hiring In-Home Help

 

Note: Hiring privately or through a placement agency is generally less expensive than hiring a homecare agency. However, long-term care insurance may not reimburse you if an agency does not employ the worker.  

Questions to Ask When Hiring In-Home Help

If you hire an individual privately, you will want to develop interview questions to assess their experience and how they deal with specific situations and check for references. The questions below are meant to guide you, whether you are hiring an individual privately or contracting with an agency, and can be adapted to meet the specific situation.

 

Sample Interview Questions

  1. What services are provided? Are there tasks the worker will not do?

  2. Is there a minimum amount of hours per shift or week?

  3. What is the worker’s availability?

  4. Would the same worker always come, or would there be different workers?

  5. Can I interview the worker before agreeing to have them work for me?

  6. What kind of screening and background checks does the agency conduct?

  7. How are workers supervised?

  8. What kind of training have workers received?  What training does the agency provide?

  9. Do workers have experience in providing care for someone with dementia, difficult behaviors, needing assistance with bathing, needing assistance with transferring, etc.....…?

  10. Does the agency have workers who speak a specific language?

  11. Does the worker know how to cook or prepare meals?

  12. Can the worker drive the client?  If so, whose car will they use? 

  13. Does the agency check insurance and driving records? 

  14. How is mileage reimbursement handled?

  15. Does the worker bring their food, or do I need to provide it?

  16. What is the process if I am not satisfied with a worker?

  17. What is the process if I want to change the schedule?

  18. Is someone available for me to speak to 24/7 in case of an issue?

  19. How soon could services start?

  20. What is the hourly rate?

  21. Are there overtime, holiday, or other charges?

  22. How does the agency bill for services?

  23. How often and in what manner does the staff communicate with the family?

  24. How long has the agency been providing home care?

  25. How many homecare workers are employed by the agency?

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