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10 questions to ask a home care agency before you hire

Updated October 15, 2026 · Reviewed against official sources

Before you sign with a home care agency, ask whether it has a state license, who employs the caregiver, how it screens and trains its staff, whether it has caregivers who speak Spanish, what happens when a caregiver can't come, and how much it charges in total. Get the important answers in writing, and take your time comparing two or three agencies.

Letting a new person into your mom's or dad's home is a big decision. An agency that's a good fit for your family gives you peace of mind, time, and a team that knows the work. Caregivers do very valuable work, and the relationship works best when everyone is clear on the rules from the start. These 10 questions help you compare agencies and make an informed choice.

First, a quick note. There are two main types of agencies:

  • Non-medical home care agencies (also called personal care agencies): they help with bathing, dressing, meals, light housekeeping and companionship. Each state regulates them, and the rules vary a lot from one state to another.
  • Home health agencies: they provide nursing and therapy with a doctor's order. If they're Medicare-certified, you can look them up and compare them on Medicare's Care Compare or in our home health agencies section.

The questions work for both, though some matter more for one than for the other.

1. Do you have a state license? Can you give me the number?

Ask for the license number and look it up on the website of the state agency that regulates home care (usually the state health department). This is a routine request, and a licensed agency will give it to you without any trouble. Keep in mind that in some states, private-pay non-medical care has few requirements. So a license is a good starting point, but it's worth filling in the picture with the other questions.

2. Who is the caregiver's employer?

This question has legal consequences. If the agency is the employer, the agency pays the payroll taxes, the insurance and the overtime. If it's a registry that only introduces you to caregivers, you could end up being the employer, with obligations to the IRS. Also ask whether they have liability insurance and bonding, which protect you in case of damage or loss.

3. How do you screen your staff?

Ask whether they run criminal background checks, whether they check references, and whether they confirm that the caregiver is on the state registry when the state requires it. If the caregiver will drive your loved one around, ask whether they check the caregiver's driver's license and car insurance.

4. What training do your caregivers have?

For home health aides at Medicare-certified agencies, federal rules require at least 75 hours of training, including at least 16 hours of supervised practical training, plus 12 hours of continuing training each year. For non-medical care, each state sets its own rules. If your loved one has dementia, ask whether the caregiver has specific training in it. Our guide to memory care, Alzheimer's and dementia explains why that helps.

5. Do you have caregivers who speak Spanish?

For many families, this is the most important question. Ask whether they can assign a caregiver who speaks Spanish, including for fill-ins, and whether the person who coordinates the case at the office speaks Spanish. When your dad can explain in his own language that something hurts or that he didn't sleep well, the caregiver can help him much better. If the agency can't guarantee it, ask how they handle it (for example, with a family member as the contact person or with an interpreter service at the office).

6. Who supervises, and how is the care plan put together?

A well-run agency does a first assessment in the home and writes a care plan (also called a plan of care) with your loved one's tasks, schedule and needs. Ask who prepares it (a nurse?), how often it's updated, and whether someone from the agency visits the home to supervise. It's a good idea to take part in that conversation. See how to prepare in our guide to the care plan meeting.

7. What happens if the caregiver can't come or isn't a good fit?

Ask how long it takes them to send a replacement, whether the service works at night and on weekends, and how you ask for a different caregiver if the relationship isn't working. Continuity matters: seeing new faces every week confuses many older adults, especially if they have memory problems.

8. How much do you charge in total?

Ask for a written price list that includes:

  • the hourly rate on weekdays, weekends and holidays;
  • the minimum number of hours per visit;
  • the rate for a 24-hour shift or for a live-in caregiver;
  • charges for mileage, for the first assessment or for canceling on short notice;
  • the deposit and how billing works.

For reference, the national median agency rate for a non-medical caregiver was $35 an hour in 2025, according to CareScout. See the numbers for Texas, California and Florida and work out your own case with the home care calculator.

9. Do you accept Medicaid, Medicare, long-term care insurance or VA benefits?

Medicare pays for home health care only when the person meets certain requirements (for example, being homebound and needing part-time skilled care). It does not pay for a caregiver to help with daily tasks when that's the only need. Medicaid can pay for personal care in many states through its programs. Ask whether the agency works with those programs and whether it will help you with the paperwork. Learn more in our guides to Medicare and long-term care and benefits for veterans.

10. How do we sort out questions or problems, and how does the contract end?

Ask who to talk to if something doesn't go the way you expected, how much notice you need to give to change or cancel the service, and whether there's a fee for doing so. Read the whole contract calmly before you sign, and ask them to explain anything you don't understand. In most cases, a call to the care coordinator sorts things out. If you ever notice something that worries you about your loved one's safety or how they're treated, talk to the agency first. In our post on abuse or neglect, we calmly explain the steps and who to turn to. If there's immediate danger, call 911.

Things to get in writing

Before you sign, it's a good idea to have these on paper or by email:

  • the price list and any extra charges;
  • the contract, including how much notice you need to give to cancel;
  • who the caregiver's employer is;
  • the initial care plan;
  • a receipt for every payment.

Take as much time as you need to decide. It's normal to take the contract home and go over it as a family.

Frequently asked questions

How many agencies should I interview?

Two or three is usually enough to compare prices, schedules and whether they have Spanish-speaking caregivers available. Ask all of them the same questions and write down the answers.

Is it better to use an agency or hire someone directly?

It depends. An agency takes care of taxes, insurance and replacements, and that's why it charges more per hour. Hiring someone directly can cost less, but you take on those tasks as the employer. We explain this in our post on how much a caregiver charges per hour.

What if what we need is a break for the family caregiver?

Many agencies offer short respite shifts. See also our post on respite care and our guide to help for family caregivers.

Your next step

Look for agencies near you in our home health agencies section, and read our full guide to home care for seniors. Ask two or three agencies these questions and compare the answers calmly, as a family.

Sources

  • 42 CFR § 484.80, home health aide training (eCFR): https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-484/subpart-B/section-484.80 (accessed October 15, 2026)
  • Medicare.gov, home health services: https://www.medicare.gov/coverage/home-health-services (accessed October 15, 2026)
  • Medicare.gov, Care Compare: https://www.medicare.gov/care-compare/ (accessed October 15, 2026)
  • CareScout (Genworth), Cost of Care Survey 2025: https://assets.carescout.com/x/8fcb50422f/282102.pdf (accessed October 15, 2026)
  • IRS, Publication 926 (2026): https://www.irs.gov/publications/p926 (accessed October 15, 2026)

This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.

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