• Are they Skilled services; like nursing or physical therapy, or
• Are they Non Skilled services that a 'CNA or NA would provide; like assistance with bathing, meal preparation, laundry, etc... Sometimes referred to as companion or Personal Care Services
• Possibly you need a combination of Skilled and Non Skilled

Then: Determine how frequently you need assistance.

• If it is for Skilled services, generally your doctor will write orders for care.
• For Non Skilled services or Personal Care Services, you probably have a good idea of your needs, but it will be helpful for you to give it some thought prior to initiating your search for an agency. It will make the search process a lot easier by knowing what you are looking for and having consistent information to compare. Things to consider:
• What type of care or services do I need?
• What time(s) of day do I want assistance?
• How many days a week do I want or need assistance?
• Do I need assistance for 1 day, 1 week or longer?

Skilled services require the agency to be licensed by the state and to meet specific rules and regulations governing the way they operate, for example:

• The agency must have a supervisory RN on Staff.
• All visits to the client and care provided to that client, must be documented by each caregiver.
• A state regulatory agency will perform annual audits of the agency's operations before renewing their home health license.

Non Skilled services generally are not regulated and do not require a license. This is an area of concern because anybody can offer these services. Therefore, it is particularly important to understand how the agency operates.

• Is the agency Insured and Bonded?
• Are the caregivers covered by workers compensation insurance?
• Are the caregivers employees or contract workers?
• How does the company screen their caregivers? Is it through simple reference checks or 3rd party background checks? Is drug testing required of all employees?
• A care plan should be created based on input from the client, family members and appropriate health care professionals.

• ...will insure that you are getting the service requested and will document it for future reference.
• ...creates a clear set of instructions for care to be followed by all caregivers.
• ...helps avoid duplication of services by other agencies that might be involved in the care.

• How will my caregivers be selected for my care?
• Does the agency have a back up for my caregiver(s) if they were to become sick or not able to provide my care as scheduled?
• How flexible is the agency with my changing needs if I suddenly require Skilled care in addition to the Personal Care Services?
• If my needs increase or change, can the agency provide the services?
• What is the agency's commitment to providing the care you want?
• Are they available 24/7 or do they use an answering service?
• Can I reach them on the weekends and holidays?
• Is a Care Coordinator assigned to work with you to coordinate your needs and insure that they are met to your satisfaction?
• Once you select an agency, how do they follow up to see if your services meet your expectations?
• What does the agency do to insure continuity of care?
• How long has the agency been providing care in the community?
• What type of training is given to the caregivers?
• Will the agency give me assistance for billing my insurance and what are the policies regarding billing cycles and down payments?
• Does the agency work with Medicare, Medicaid and other private insurances companies?