The Questions to Ask Before Hiring an In-Home Care Agency

Start with the agency's licensing and insurance

Before you talk about rates or schedules, ask whether the agency is licensed by your state. Licensing requirements vary — some states license all home care agencies, others only those providing skilled nursing or personal care. Your state's health department website will list which agencies hold current licenses in your area. Ask the agency directly for their license number and verify it yourself rather than taking their word.

Then ask about insurance. The agency should carry general liability insurance and workers' compensation insurance for their employees. Request a copy of their current certificate of insurance, not just a verbal confirmation. This protects you if a caregiver is injured on your property or if something in your home is damaged. A reputable agency will have this documentation ready to show you.

Ask what happens if a caregiver calls in sick or quits mid-contract. Some agencies may provide a replacement within hours; others may leave you without coverage for days. This matters more than it sounds — if you depend on someone to help you bathe or take medication, a sudden absence creates a real problem. Get the answer in writing.

Key Takeaways

• Verify the agency's state license through your state health department website, and ask for proof of general liability and workers' compensation insurance before signing anything.
• Ask in writing what happens when a caregiver is unavailable, because some agencies may provide same-day replacements while others may leave you without coverage.
• Request the specific caregiver's background check results, training certifications, and references from previous clients — not just confirmation that checks were done.
• Clarify exactly what tasks the caregiver will and will not do, because "personal care" means different things to different agencies.
• Ask how billing works, whether there are cancellation fees, and what happens if you need to pause care temporarily.

Ask about the specific caregiver assigned to you

The agency's reputation matters less than the person who will actually be in your home. Ask whether you can meet the caregiver before the first scheduled visit, or at minimum see a photo and read their background. Request their specific training certifications — for example, CPR certification, dementia care training, or medication management. Ask how long they have worked in home care and whether they have experience with your particular needs (mobility assistance, dementia support, wound care, etc.).

Ask for references from at least two previous clients the caregiver has worked with. A good agency will provide these without hesitation. Call them and ask concrete questions: Did the caregiver show up on time? Did they follow instructions? Would you trust them alone in your home? Did they communicate well with family members?

Ask whether the same caregiver will come each time, or whether you should expect different people. Consistency matters for safety and comfort — a caregiver who knows your routine and your preferences can spot changes in your health that a stranger might miss. If the agency rotates caregivers, ask how they handle continuity and how you communicate preferences to new people.

Understand what tasks are actually included

"Personal care" and "companion care" sound straightforward but mean different things at different agencies. Ask the agency to list exactly what the caregiver will do: Will they help you bathe and dress? Will they prepare meals or just heat up food you already have? Will they do laundry, or only help you with laundry? Will they manage medications, or only remind you to take them? Will they accompany you to appointments, or stay home?

Ask what they will not do. Most agencies do not allow caregivers to give injections, change wound dressings, or perform other skilled nursing tasks — those require a nurse. Some will not do heavy cleaning or yard work. Some will not drive you in their own car. Get a written list so there are no surprises when the caregiver arrives.

Ask how the agency handles changes to the care plan. If you need the caregiver to start helping with a new task, or if you need to reduce hours, how quickly can that happen? Is there a fee to modify the agreement?

Get clear answers about cost and billing

Ask for the hourly rate and whether it varies by time of day (some agencies charge more for evening or weekend hours). Ask whether there is a minimum number of hours per week you must book, and whether you pay for cancelled visits if you cancel with short notice. Some agencies require 24 hours' notice; others charge a fee even with notice.

Ask whether the rate includes travel time. If the caregiver has to drive across town to reach you, some agencies build that into the hourly rate; others charge separately. Ask whether you pay the agency or the caregiver directly — most agencies handle billing themselves, but some operate differently.

Ask about payment methods. Do they accept credit card, check, or bank transfer? Do they bill weekly, monthly, or per visit? Ask whether they offer a contract with a set schedule, or whether you can book visits as needed. Ask what happens if you need to pause care for a few weeks — can you resume without signing a new agreement?

Ask about communication and oversight

Ask how you will know what happened during each visit. Some agencies require caregivers to fill out a simple log noting what was done and any concerns. Ask whether you can call or text the caregiver directly, or whether all communication goes through the agency office. Ask whether a supervisor will check in with you periodically to make sure things are going well.

Ask what happens if you have a problem with the caregiver — if they are late, rude, or not doing the job right. How quickly can you report it, and how quickly will the agency respond? Ask whether you can request a different caregiver, and whether that request is free or costs extra.

Ask whether the agency has a 24-hour phone line if something goes wrong when the office is closed. If a caregiver does not show up, or if you have a medical emergency, you need to know who to call.

Clarify what happens in an emergency

Ask what the caregiver is trained to do if you fall, have chest pain, or show other signs of a medical emergency. Will they call 911? Will they call the agency first? Ask whether the caregiver has your emergency contact information and your medical history. Ask whether they know where you keep important documents like your advance directive or medication list.

Ask whether the agency has a protocol for reporting concerns to your doctor or family members. If the caregiver notices you are more confused than usual, or not eating well, how does that information reach the people who need to know?

Ask about background checks and training

Ask what background checks the agency runs on caregivers. Most states require criminal background checks; some also require checks for abuse or neglect in elder care settings. Ask whether the agency checks references before hiring, or only after a complaint. Ask what disqualifies someone from working there — for example, do they hire people with certain types of criminal history?

Ask what training all caregivers receive before their first visit. Do they get training on how to help someone safely without causing injury? Do they learn about recognizing signs of abuse or neglect? Do they get training on confidentiality and respecting your privacy? Ask whether the training is documented and whether you can see a summary.

Ask whether caregivers get ongoing training or just initial training. Caregiving practices change, and good agencies keep their staff current. Ask whether the caregiver assigned to you has any specialized training related to your specific condition or needs.

Frequently Asked Questions

Can I request a male or female caregiver?

Yes, and most agencies will honor that request. Ask when you first contact them whether they have caregivers of your preferred gender available, and whether there is an extra fee. Some agencies can may provide it; others can only try to match you. Get the answer in writing so there is no confusion when the caregiver arrives.

What if I do not like the caregiver after the first visit?

Ask the agency upfront what their policy is on switching caregivers. Most will assign someone new at no extra cost if there is a genuine mismatch, but some charge a fee or require you to give the first caregiver a second chance. Knowing this before you start helps you decide whether to work with that agency.

Do I need to provide meals and supplies for the caregiver?

That varies by agency and by what you have agreed to. Ask whether the caregiver is expected to eat with you, or whether they bring their own lunch. Ask whether you provide cleaning supplies and personal care items, or whether the caregiver brings them. Clarify these details so nobody is uncomfortable or surprised.

What if I need care on a holiday or weekend?

Ask whether the agency offers weekend and holiday coverage, and whether those visits cost more. Some agencies operate seven days a week; others are closed on weekends. If you need regular weekend care, make sure the agency can provide it before you sign up.

Can the caregiver help with medication management?

It depends on the caregiver's training and your state's rules. Some caregivers can remind you to take medication or help you organize pills into a weekly organizer. Most cannot give injections or handle controlled substances. Ask what your specific caregiver is trained to do, and whether a nurse needs to set up a medication system first.