Parent Care

Questions to ask a home-care agency before signing

Twelve specific questions the agency expects you to ask — and the answers that should give you pause. Built with three hospice social workers and an eldercare attorney.

Dave Dobbins builder, 50by50

A spiral notebook open to a page of handwritten lines, a fountain pen resting beside it on a wooden kitchen table, warm overhead light.

The first home-care meeting is dense, emotional, and full of language designed for people who've done it before. If you walk in without pre-written questions, you'll leave with a tour pitch and a brochure. The twelve questions below are organized into four domains so you can hand the agency a copy at the start of the meeting and take notes in the margins. Nothing here is medical or legal advice — talk to professionals for specifics about your parent's situation.

Questions about who actually shows up

Care quality is set by the person who walks through your parent's door, not by the agency's marketing. Four questions to ask:

  1. Are your caregivers W-2 employees or 1099 contractors? W-2 means the agency carries liability, training is consistent, and a no-show triggers a real coverage protocol. 1099 means you're often paying a placement fee for a relationship that belongs to the caregiver. Both can work, but the difference determines who's responsible when something goes wrong.
  2. What was your caregiver turnover rate last year? The honest number from a good agency is 30-60%. Anything above 75% means caregivers are leaving as fast as they can be trained. "We don't track that" is the same answer as "it's bad."
  3. If our caregiver is sick, what's the average notice we'll get for a substitute? The answer should be in hours, not "we'll do our best." Two hours is reasonable for a morning shift; "you'll have someone by the afternoon" is not.
  4. How deep is your background check? The honest answer names which databases — DOJ Live Scan, county criminal, national sex offender registry, OIG exclusion list, motor vehicle records if driving is part of the role. "We do background checks" without specifics is a non-answer.

Questions about training and skills

State minimums for home-care training are usually 5-10 hours. Good agencies do more, and they can tell you what "more" means.

  1. How many training hours do new caregivers complete before their first shift, and how many continuing-education hours per year after that? Ten and ten is the state floor. Twenty and twelve is normal. Forty and twenty is what good agencies actually do.
  2. What dementia-specific training do caregivers receive? If your parent has memory concerns, this is the question that matters most. Look for named curricula (Teepa Snow's Positive Approach, Alzheimer's Association essentialALZ, CARES Dementia Basics) and recurring refreshers, not a one-time module.
  3. What's your scope on medication management? Most non-medical home-care agencies can remind but not administer — meaning the caregiver can hand your parent the pill bottle but not put the pill in their hand. Agencies that overstate this are the ones to walk away from.

Questions about money and contracts

The pricing structure tells you what the agency expects you to do. A minimum-hours policy reveals whether they're built for short check-ins or long stretches; cancellation policy reveals whether they value your time as much as theirs.

  1. What's your minimum hours per visit, and is it daily or weekly? A four-hour minimum is normal for skilled care. A two-hour minimum exists; an "as-needed" no-minimum does not, because the agency loses money on a 30-minute check-in. Ask about your real schedule.
  2. What's your cancellation policy if we have to cancel within 24 hours? The fair answer is "no charge for weather, hospitalization, or family emergency; otherwise half the visit fee." A "100% no matter what" policy is a red flag for a contract that treats you as the source of risk.
  3. What's billable and what's included? Mileage, holiday rates (usually 1.5x), overnight rates, weekend rates, agency fees on supplies — get the full sheet, not the starting rate.

Questions about supervision and accountability

The two final questions are about what happens when something goes wrong — because eventually it will, and the agency's protocol matters more than their pitch.

  1. How often does a supervisor visit, and what do they check? The right answer is monthly in person, with a documented assessment. The wrong answer is "as needed."
  2. What happens the first time a caregiver doesn't show up? The agency should have a documented escalation path that names a person, a phone number, and a timeline. "Call our office" is not an escalation path.

The three answers that should make you keep shopping

None of these are about agency size or fanciness of office — they're about how the agency treats you in the first meeting, before any contract is signed.

  • Vague answers on turnover. Real agencies know their number. Agencies that don't, don't track it, which means they don't manage it.
  • Defensive reactions to documentation requests. Asking for a sample care plan, a copy of the training curriculum, or written cancellation terms should be normal. If the response is "we don't share that with prospective clients," the agency is signaling something about the documents.
  • Pressure to sign at the first meeting. A good agency wants you to talk to two or three others. They know the comparison will favor them. An agency pushing the contract across the table on day one is either hungry or hiding the comparison.

If any one of these three things happens, this is not your agency. Walk out polite, walk out firm.