Choosing a home care agency for your loved one is one of the most consequential decisions a family makes. The wrong agency means unreliable caregivers, missed visits, surprise charges, and you becoming the de facto care coordinator. The right agency feels like family — and quietly takes a huge weight off your shoulders.
Most families don’t know where to start. Agencies all sound the same on the phone — friendly, professional, eager to help. The differences only become clear once care is underway, and by then you’ve signed paperwork. This guide gives you 7 specific questions to ask every agency you’re considering, what a good answer sounds like, and the red flags that should make you walk away. Print it out and bring it to every consultation.
If you’re using the CHC Medicaid Waiver, see our CHC guide for eligibility rules. If you’re paying privately, see our cost guide for what affects pricing. Either way, our care setup process page walks through what happens once you choose an agency.
How to Use This List
Ask all 7 questions in your first conversation with each agency you’re considering. Trust your gut on the answers — if a response feels rehearsed, vague, or evasive, that’s information. A good agency welcomes hard questions and answers them clearly. A weak agency dances around them or rushes you toward a contract.
Don’t be shy about asking the same question three different ways if needed. You’re not being difficult — you’re protecting someone you love.
The 7 Questions to Ask Every Agency
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1
Are your caregivers your employees, or independent contractors?
Why this matters: Employee status determines who’s responsible if something goes wrong — injury, theft, a missed dose of medication. Agencies that use W-2 employees are responsible for caregiver training, insurance, taxes, and supervision. Agencies that use 1099 independent contractors are essentially staffing agencies — they pass the responsibility, the legal exposure, and often the tax obligations onto you.
Good answer sounds like: “All our caregivers are W-2 employees. We carry workers’ comp insurance, professional liability insurance, and we’re bonded. If anything happens, our policies cover it — not yours.”
Red flag answer: “Our caregivers are 1099 contractors, so we keep our rates low.” Translation: you may be on the hook for taxes, insurance, and liability.
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2
What background checks and screenings do you run on caregivers?
Why this matters: You’re letting another adult into your loved one’s home, often when they’re alone and vulnerable. The depth of an agency’s screening process tells you how seriously they take that responsibility.
Good answer sounds like: “Every caregiver clears FBI fingerprint-based background checks, Pennsylvania state criminal background checks, child abuse and elder abuse clearances, TB and health screenings, professional reference checks, and an in-person interview before they ever step into a client’s home.”
Red flag answer: Vague references to “thorough screening” without specifics, or only mentioning a single online background check.
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3
How do you match caregivers to clients?
Why this matters: The relationship between your loved one and their caregiver is everything. A skilled caregiver who clashes with your loved one’s personality is a worse fit than a less-experienced caregiver who genuinely connects. Good agencies treat matching as a craft, not a scheduling exercise.
Good answer sounds like: “We match based on personality, language preference, schedule fit, and the specific skills your loved one needs. If the first match isn’t right, tell us — we’ll find someone who fits better. Comfort and trust are non-negotiable.”
Red flag answer: “We send whoever’s available.” That’s not matching, that’s staffing.
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4
What happens if our regular caregiver is sick or unavailable?
Why this matters: Caregivers get sick. They take vacation. They have emergencies. The question isn’t whether your regular caregiver will miss a shift — it’s what happens when they do. Reliable backup coverage is the difference between a brief inconvenience and a serious gap in care.
Good answer sounds like: “We have backup caregivers who know your loved one’s care plan and can step in. We give you as much advance notice as possible, and you can choose to skip the visit, swap the time, or accept a substitute caregiver — whatever works best for your family.”
Red flag answer: “We do our best to find a replacement.” Hopeful, not concrete.
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5
Who is our point of contact when something needs to change?
Why this matters: Your loved one’s needs will change. Their schedule will change. Family situations shift. You need to know exactly who to call when something needs to be adjusted — and you need that person to actually pick up.
Good answer sounds like: “You’ll have a named care coordinator who knows your family. They’re reachable by phone, text, or email during business hours. We also have a 24/7 emergency line for anything urgent. You won’t be passed around or routed through a call center.”
Red flag answer: “Just call the main office.” When everyone’s responsible, no one’s responsible.
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6
How are rates structured, and what’s actually included?
Why this matters: Surprise charges are one of the most common complaints families have about home care. A reputable agency will give you an itemized rate sheet, in writing, before you sign anything. If they won’t, that’s a sign they don’t want you comparing.
Good answer sounds like: “Here’s our hourly rate for companion care, personal care, and specialized care. Here are the premiums for evenings, overnights, weekends, and holidays. There’s no setup fee, no monthly minimum, and no cancellation penalty for changes made with 24 hours’ notice. We’ll put it all in writing as part of your care plan.”
Red flag answer: “We’ll work that out once we get started.” Or quoting a single hourly rate without breaking out shift differentials.
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7
What payment sources do you accept, and can you help us apply?
Why this matters: Most families pay for home care through a mix of sources — private pay, the CHC Medicaid Waiver, long-term care insurance, Veterans benefits. The agency you pick should accept the funding you have or can qualify for, and ideally help you navigate the application processes for the harder ones.
Good answer sounds like: “We accept private pay, the CHC Medicaid Waiver, long-term care insurance from most major carriers, and Veterans Aid & Attendance benefits. If you’re applying for CHC, we sit on the phone with you and Maximus, help with the paperwork, and coach you through the in-home assessment. We don’t disappear during the wait.”
Red flag answer: “We only do private pay” (limits your options) or “We accept Medicaid but you handle the application yourself” (leaves you to navigate a confusing 30+ day process alone).
Red Flags Beyond the 7 Questions
Even if an agency answers the 7 questions well, watch for these warning signs during your consultation:
Signs of a good agency
- They ask thoughtful questions about your loved one before talking about themselves
- They explain options, including ones you might not have considered
- They invite you to take time deciding
- They put rates and care plans in writing
- They give you references from current or past clients
- They talk honestly about what they can’t do
Signs to walk away
- Pressure to sign immediately, “to lock in pricing” or “before the schedule fills”
- Vague answers about caregiver training or screening
- Unwillingness to share rates in writing before the consultation
- No named point of contact — just a general office line
- Promising things that sound too good (“any caregiver, anytime, no extra charge”)
- Bad reviews online, especially patterns of missed visits or billing issues
How Apple Home Care Answers These 7 Questions
Since we’re an agency in Philadelphia and we’re asking you to consider us, here’s how we’d answer our own list — short version:
- Caregivers: All W-2 employees, fully insured, bonded, workers’ comp covered.
- Screening: FBI fingerprint, Pennsylvania state, child and elder abuse clearances, TB/health, references, in-person interview.
- Matching: Personality, language, schedule, and skill set. Free swap if the match isn’t right.
- Backup coverage: Backup caregivers familiar with your loved one’s care plan; advance notice for any change.
- Point of contact: Named care coordinator reachable by phone or email during business hours; 24/7 line for urgent issues.
- Rates: Itemized in writing before you sign. No setup fees, no minimums, no surprise charges.
- Payment sources: Private pay, CHC Medicaid Waiver, long-term care insurance, Veterans Aid & Attendance. We help with applications.
Even if you don’t end up choosing us, ask every agency you talk to these 7 questions. Compare answers side by side. The agency that answers all 7 clearly, in writing, with no hedging — that’s the one to pick.
Frequently Asked Questions About Hiring Home Care
How long should I spend evaluating home care agencies?
If your loved one needs care urgently, you can complete consultations with 2 to 3 agencies in a single week and make a decision. If you have more time, taking 1 to 2 weeks lets you sit with the choice. The biggest mistake families make is rushing into the first agency they speak with because they feel overwhelmed. Even one or two days of comparison usually surfaces meaningful differences.
Should I get quotes from multiple agencies?
Yes — we’d say at least three. Pricing varies, but more importantly, the way each agency handles your call, your questions, and your follow-up tells you a lot about how they’ll handle your loved one’s care. The agency that takes time to listen at the consultation will take time to listen as the relationship goes on.
What if the first agency we hire isn’t a good fit?
You can switch. Home care agreements aren’t long-term contracts — most reputable agencies let you cancel with 24 to 48 hours’ notice for any reason. If the fit isn’t right, raise it directly with your care coordinator first. Sometimes a caregiver swap or a schedule change solves the problem. If it doesn’t, you have every right to move to a different agency.
Are home care agencies regulated in Pennsylvania?
Yes. In Pennsylvania, non-medical home care agencies must be licensed by the Department of Health under the Home Care Agencies and Home Care Registries Act. Licensure requires meeting standards for caregiver training, background checks, insurance, and supervision. Always confirm an agency is currently licensed before signing anything — you can verify through the Pennsylvania Department of Health.
How do I check an agency’s reputation online?
Start with Google Business reviews and Better Business Bureau listings. Look for patterns rather than individual reviews — every agency has occasional unhappy clients, but recurring complaints about missed visits, billing surprises, or rude staff are red flags. Also ask the agency directly for 3 to 5 references from current or recent clients you can call.
What’s the difference between a home care agency and a registry?
An agency employs caregivers directly, handles taxes, insurance, training, and supervision, and is responsible for the care provided. A registry maintains a list of independent caregivers and connects them to families — but the family becomes the legal employer, responsible for taxes, insurance, and oversight. Registries are often less expensive but place much more burden on the family. Most families benefit from the agency model, especially as needs grow.
Do I need to interview caregivers before they start?
You usually don’t need to interview every individual caregiver, but you absolutely should meet your loved one’s primary caregiver before the first scheduled visit. A good agency arranges an introductory meeting in your loved one’s home so the caregiver can get oriented and your loved one can start to feel comfortable. If an agency resists this, that’s a warning sign.
What if my loved one refuses help from a caregiver?
This is more common than families expect, especially for older adults who have always been independent. A skilled agency knows how to introduce care gradually — sometimes starting with companion care (which feels less intrusive than personal care), or framing the caregiver as “help around the house” rather than “someone to take care of you.” Talk to your care coordinator about strategies; pushback at the start often softens within a few weeks.