Most families start looking for home care in a hurry — a parent is being discharged Friday, or a fall has made it clear that living alone isn't safe anymore. That pressure makes it tempting to call the first agency on the list the hospital hands you. A few targeted questions, asked of two or three agencies, will tell you far more than a brochure.
Use the questions below on every call. Write the answers down; the differences become obvious quickly.
Licensing and credentials
1. Are you licensed in Virginia?
Home care organizations in Virginia must be licensed by the Virginia Department of Health, Office of Licensure and Certification. Ask for the license number and check that the name matches the business you're talking to.
2. Are you Medicare-certified?
If your loved one needs skilled nursing or therapy and you expect Medicare to pay, the agency must be Medicare-certified. Certified agencies appear on Medicare's Care Compare, which also publishes quality star ratings and patient survey results. Non-medical home care agencies won't be listed there, and that's normal.
3. Are caregivers employees or contractors?
Employees are usually covered by the agency's insurance, workers' compensation and training programs. Contractors may not be. Neither is automatically wrong, but you should know which you're getting.
Starting care
4. How quickly can you start?
For hospital discharges, a good agency can often schedule an assessment within a day or two. Ask what they need from the doctor to begin.
5. Who does the first assessment?
For skilled care, a registered nurse or therapist should visit to build the plan of care. For non-medical care, ask whether a nurse or a care coordinator does the intake, and whether they come to the home.
6. Do you serve our exact neighborhood?
Hampton Roads is split by water. An agency in Chesapeake may happily cover Ghent but not Ocean View, and some Southside agencies won't send caregivers through the tunnels to Hampton. Give them the actual address.
Day-to-day care
7. What happens when a caregiver calls out?
This is the question that separates agencies more than any other. Ask how many backup caregivers they have for your area and how you'll be told about a change.
8. Can we meet the caregiver first, and request a change?
Consistency matters, especially for someone with dementia. Ask whether you'll have one primary caregiver and how easy it is to request someone new.
9. How is the care plan supervised?
Virginia requires supervisory visits for personal care aides. Ask how often a nurse or supervisor visits and whether family members get updates.
10. How do you handle after-hours problems?
You want a real person on call at night and on weekends, not a voicemail box.
Cost and paperwork
11. What will we pay, and how is it billed?
Get the hourly rate, the minimum shift length, and any weekend, holiday or overnight differential in writing. Ask which insurance plans, Medicaid programs and long-term care policies they bill directly.
12. What does it take to cancel or change the schedule?
Look for reasonable notice periods and no long-term contracts for private-pay care.
Using ratings the right way
Google ratings are a starting point, not a verdict. Read the most recent reviews, look for how the agency responds to complaints, and pay attention to reviews from families rather than employees. Our Norfolk directory weighs ratings by the number of reviews so that a handful of five-star reviews doesn't outrank a long track record — see how we rank.
