Points to Ponder
People can go to any number of resources, especially online, where they are given pointers on what to look for when searching for caregivers for a family member. It can be an intimidating thought...
....Who will be the strangers we allow into our home?
When researching, people are often given the requisite list of items to check off:
• Does the agency do CORI background checks?
• Do they have liability insurance?
• Are they bonded?
• Does the agency train their employees?
• How do I make sure I am not getting someone who will neglect or abuse myself or my family member?
Most of these are issues where you are taking a defensive stand.
....That is an awful way to have to shop for such a personal and important service.
How many caregivers who steal or abuse are caught, and prosecuted vs quietly let go and moved on to the next Agency, facility or family?
... Almost none!
If a caregiver is not convicted of a crime, their CORI will show nothing. This is not an assertion that caregivers are criminals, as very few are. Instead, it is a caution not to be lulled into a false sense of security by a background check process that means almost nothing.
If an agency has insurance and bonding, sure! Then if you suffer a loss you should be covered, after a lot of stress and aggravation that you should not have had to experience in the first place.
Wouldn’t it be better to have people in your house with a long track record with the agency you hire, who are well known to the Agency?
This homecare industry is a for profit industry which is notoriously low paying. In Massachusetts, private duty agencies are not regulated by the state. Private duty agencies are not even required to be licensed.
... Just think about that....
Anyone can open a Home Care agency. All someone needs is a great looking website and a good phone manner. If you really probe when doing your research, you will find out how many are just this.
Following are some important questions to consider and any Agency who values
your business also values your right to have answers to these questions.
⚬ How many direct care employees do they have?
⚬ Will they send your family member the same aide (s) so that a strong relationship can develop?
⚬ Will they guarantee that if someone calls in sick they can cover the shift?
⚬ Will they remove aides your family has come to be very fond of because they feel the aide has become too close to the family ? (Yes, believe it or not this happens)
⚬ Will they replace an aide if someone is not a good fit for you for any reason?
⚬ What is the average length of employment for their direct care workers? What is their turnover percentage per year?
⚬ When an agency puts together a schedule for you, how much experience do those aides have and how many years have they worked for the agency in particular? i.e does the Agency know the employee they are sending into your home or did they just hire them last week?
⚬ How did they hire them? Were they referred by their longstanding, high performing employees or hired by advertisement?
⚬ How much do they pay their employees?
While you do need to understand there are considerable expenses with running a service business, you do want to have the reassurance the people in your house are making a living wage.
You get what you pay for. By that we mean, not what you pay the agency owner as an hourly rate but what is passed on to the caregiver entrusted with your family member.
If you are sensitive in how you ask the question, you should be ale to get an answer, let them know you do not begrudge them making a living and that you know there are overhead expenses, you are simply curious.
It tells you something if you can not get an answer, even if that means you are not getting your information from someone who actually knows answers but someone to answer phones and give canned responses.
⚬ Always ask the agency to provide a coverage selections page for their Workman's Compensation insurance.
This assures you that the caregivers are employed by the agency legally and not a liability to you should they hurt themselves on the job in your home. It also means you are not paying an Agency owner market rates, only to have them pay their employees under the table to skirt all the expenses of running a business.
⚬ Are the Agency rates very competitive?
All that more important to ask for proof of Workman’s Compensation insurance and that they are true W2 employees, not given a 1099 at the end of the year which is illegal in Massachusetts and another way Home Care companies skirt various liabilities.
⚬ If you are concerned about liability, also ask for the coverage page of the current liability policy.
⚬ Ask the agency if they are accredited with any number of industry associations.
These Associations impose standards of behavior and expectation and that is important in a state where there are no licensing requirements. Home Care Alliance of Massachusetts is one such association, they are politically active in Massachusetts and are active in trying to get licensing requirements passed in order to protect consumers. HCA of Massachusetts has an accreditation program which they hope will be used to map out the standard requirements for licensing of Home Care Agencies in the future. CSA Eldercare is a member of HCA and is currently preparing for accreditation.
When you start thinking of all these points, the questions on the standard checklists start to come in perspective. Yes, you should make sure CORI’s are run and it’s never a bad idea to make sure employees are trained and that you are protected by liability insurance. But as can be seen from the points made above, there are many other important points to consider.