How To Find A Quality Home Care Franchise Company
By Diane Walker, RN, MS
Adults over 65 who require assistance with activities of daily living and individuals living with a disability almost always prefer to remain at home for as long as possible – commonly referred to as aging in place. The Federal government included new incentives in the recent health care bill to encourage adults to remain at home, which may place a greater burden on family caregivers to be responsible for helping their loved ones.
Caregiving can lead to poor physical heath and burden if family members don’t take time off periodically to rest and address personal needs. Family members often feel anxious about how to best handle all of the issues that arise with providing care at home. For example, balancing work/family and caregiving duties, seeking qualified help including home care providers, assessing a loved one’s finances, and finding appropriate community resources. Such decisions can be stressful when there is time to carefully consider the options; unfortunately loved ones often experience sudden health challenges so decisions are made during a crisis.
When the challenges become overwhelming, the task of selecting an agency to provide professional assistance in the home can be daunting: how do you select a high quality company you can trust to support your efforts? Because of the rising need for in-home assistance, new companies are entering the marketplace every day. All the claims can be confusing as you attempt to sort out what is fact and what is a sales pitch.
Here are several key points keep in mind as you screen non-medical homecare providers:
· History and Reputation – Does the company have a tradition of service and what reputation do they have? Are they known to the Chamber of Commerce and the local Area Office On Aging? Do they have a website you can visit to learn about them before you call?
· State Requirements – Your state may require a license and/or has other requirements. Ask for a copy of their professional liability insurance coverage, and their license if one id required in your state.
· Range of Services – What services do they offer? For example do they offer flexible hourly, live-in (not 24 hours of hourly care), overnight with sleep and awake options? Do they charge extra for personal care if your loved one needs assistance with bathing or has continence issues? Do they have upfront fees or require deposits, set a minimum number of hours each day or week, or impose other fees? Some companies offer all their services for the same price. Some offer free assessments in your home or wherever the prospective client currently resides: the hospital, rehabilitation unit, etc.
· Payment Options – Are you offered a variety of ways to pay for the services like checks, credit card, and depository accounts? Does the company work with long-term care insurance companies, selected State Medicaid programs, and the Veteran’s Administration? Do they help you determine if you are eligible for assistance?
· Consumer Orientation – You want to determine what services you receive, when you receive them, which worker provides them, if the care meets your standards, and if you want to continue receiving services from the worker or would prefer a replacement. You or someone in your family wants to able to direct the care the client receives. The company should also be willing to handle your special requests.
· Worker Screening – You want to know about the quality of the caregiver they refer to provide services for your loved one. Carefully inquire about their screening process. This is a critical step! Some companies state their workers are bonded (you may be able to recover the value of stolen property if you get a conviction which may be very difficult when a number of individuals have access to the home) but that alone is not a sufficient process to assure a safe, reliable worker is being referred. The company should have an extensive, multistep screening process intended to help to avoid referring someone who may take advantage of a loved one or be abusive. The process should include: statewide or, better yet, national criminal background checks; face-to-face interviews with the worker; completion of several work and personal references in person/by phone; annually updated references from clients; completion of a competency exam or certification as a certified nursing assistant, home health aide, or personal care attendant; a review the worker’s skill set and personality; determination that the worker is fit to work and free from communicable diseases by a health care provider; and valid identification and work authorization documents. Many families prefer to work with a company because of the complexity of this process. Work and identification documents change frequently to meet new federal and state regulations. Carefully decide whether you want to bring someone into your home who has not gone through this extensive process.
· Affordability – The services you pay for include the worker’s earnings and the company’s fees and costs. Are they affordable when you compare various companies’ rates? Find out how much the worker is paid. You want to find a company that is affordable and pays the workers a living wage. Some companies charge higher fees but pay their workers only minimum wage. Caregiving is difficult, demanding work – you know that from your own experience! You want to feel assured you being referred the most qualified, dedicated professional who views their work as a career and is compensated in that manner. Does the company also offer educational programs so the workers advance in their chosen profession?
· Business Model – Does the company refer employees or self-employed workers? Both models have advantages. Self-employed workers are directed by you, the consumer, employees are supervised by their employer. Having someone referred who is self employed is just like contracting with a gardener or painter. Self-employed individuals garner further work because of the quality of the services they provide and their reputation. If you are concerned about on site personal injury to such business invitees, a rider on your home owner’s insurance may be more cost effective when compared to higher costs per hour over time. Remember too that an employer’s workers compensation policy only protects the agency. In either case you want a carefully screened, qualified, and well recommended person who will do what YOU want them to do.
· Customer Service – What does the company do to earn its fees? How often do they call and visit you to ensure your satisfaction and safety? How do they determine if your loved one’s needs have changed or if you have a concern? Can you speak with someone from the office regularly? Will your concerns be addressed immediately (do they have enough qualified caregivers to send a replacement the next day if you aren’t satisfied or the worker has an emergency)? Do they have a satisfaction guarantee? People from the office should be very aware of what services are being provided and what quality of services you are receiving to ensure your comfort and peace-of-mind.
· Neutrality – Evaluate their conversation with you. Reputable companies do not bash competitors; attempt to dissuade you from using other companies, or use scare tactics to get your business. They have their own reputation and services and that is what you want to hear about, not misinformation about a competitor’s business.
· Quality Review – Does the company go through an independent quality review process, state inspections or is it otherwise accredited? In many states, an independent review is necessary to ensure the office meets safety and reliability standards. How has the office you are speaking with done on their reviews?
Many family caregivers find this role enriches their life and they grow personally because of the experience despite the demands and periodic chaos. Remember you are not alone! 65 million other people are right beside you. There are many national advocacy organizations you can contact who will have some or many of the answers you need. More and more people are turning to the internet to get the answers they need, from each other and from professionals. As an example, visit www.CaringTimes.org and click on the educational resources or links tabs. There are also experts listed you can email with questions.
If these questions have been helpful, an easy assessment tool is posted at www.CaringTimes.org to screen companies when you require respite or more ongoing services. The tool can also be obtained from all 115 offices of Griswold Special Care and you can test the tool out with that office to see how well it works.
