Home Care Services

A home health aide (HHA) has completed formal training — typically 75 hours minimum, as required by federal law for Medicare-accepting agencies — and can perform some basic health-related tasks like checking vital signs under nurse supervision. A personal care or home care aide has no federally mandated training requirements, though requirements vary by state. If your parent is recovering from surgery or managing a complex condition, ask specifically whether the agency employs certified HHAs and whether their caregiver has experience with your parent's diagnosis.

Start with your state's licensing database — most states maintain a public registry of licensed home care agencies. Verify the license is current and ask to see their certificate of liability insurance directly. Beyond that, look for clear caregiver background check policies, client references you can actually speak with, and a written service agreement before care begins. Agencies that resist providing any of these are a red flag. Every provider in tendercare's Trusted Network has completed a six-point vetting process before being listed.

The most important ones: What is your caregiver turnover rate? What happens if our assigned caregiver calls out sick? Are your caregivers employees or independent contractors? How do you match caregivers to clients? Can I speak with current or past client families? What does your supervision process look like? High turnover, unclear backup protocols, and vague matching processes are the most common signs of a poorly-run agency.

Non-medical home care typically costs $20–$35 per hour nationally, though rates in cities like New York, San Francisco, and Boston can exceed $40. Most agencies require a minimum of 3–4 hours per visit. Medicare does not cover non-medical home care — it only covers skilled care ordered by a doctor. Medicaid may cover it depending on your state and your parent's eligibility. If your parent has a long-term care insurance policy, review it carefully — many cover home care once your parent can no longer perform two or more activities of daily living.

It depends on your state and your parent's eligibility. Most states offer home and community-based services (HCBS) waivers that cover non-medical home care for Medicaid-eligible adults, but waiting lists can be long. To find out what your parent may qualify for, contact your state's Medicaid office or a local Area Agency on Aging — they can help with eligibility and the application process.

This is one of the most important things to ask before signing with any agency. Reliable agencies have an on-call coordinator available around the clock and a pool of backup caregivers they can deploy quickly. Before starting care, ask: if our caregiver calls out with less than two hours' notice, how do you handle it? How quickly can you send a replacement? Agencies that can't answer clearly, or that put the responsibility back on the family, are not well-organized for real-world care delivery.

Home care means a caregiver comes to your parent's home — they stay where they live and receive support on a schedule that fits their needs. Assisted living is a residential facility where your parent moves into a communal setting with 24-hour staffing. Home care is generally right when your parent can still live independently with some support and values their familiar environment. Assisted living makes more sense when round-the-clock supervision is needed, or when managing care at home has become unsafe. Many families use home care as a bridge before eventually transitioning to a facility.

Most agencies can begin care within one to two weeks of initial contact, though some move faster for urgent situations. The process typically involves an intake call, a home assessment, caregiver matching, and scheduling. If your parent is being discharged from a hospital, social workers can often accelerate the referral. The earlier you start the search, the more options you'll have — agencies with the best caregivers often have waitlists.