When you compare home care agencies, the price is the easiest line to read and the least useful one to trust on its own. Two agencies can quote the same hourly rate and offer very different protection. Check the paper first, then the service, then the price.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Ask for the license or registration number

Ask each agency for the license or registration number that covers the service you are buying, and confirm it through the state licensing records maintained by the Missouri Department of Health and Senior Services. Ask which services the license covers and which it does not. An agency may hold a license for one kind of service while selling another, and you need to know which kind you are buying. If an agency cannot give you a number, stop there.

Check Medicare listings only where they apply

Medicare-certified home health agencies appear on Medicare's Care Compare site, and that listing is the right check for skilled services ordered by a physician. A private non-medical agency will not appear there, which does not make it unsafe. Do not treat a missing listing as a fault, and do not treat a listing as proof of quality. Use it for what it covers.

Ask for the insurance and bonding papers

Ask for a certificate of liability insurance and, where the agency offers it, proof of bonding for theft or property loss in your parent's home. Read who is named on the certificate. Ask whether the coverage applies to the agency's own employees while they work in your parent's home, and how a caregiver's injury on the job is handled.

Ask what the screening covers

Ask which criminal record checks the agency runs, how far back they reach, whether the agency checks the state abuse and neglect registry for each caregiver, and how often checks are repeated. Ask the agency to name which checks state rules require for the service you are buying, then confirm that answer with the state. Do not accept a general promise to 'screen everyone' in place of a written list.

Read the task list

Ask the agency, in writing, which tasks its caregivers perform. A non-medical aide may give medication reminders and pick up prescriptions as an errand. Medicines stay with the family, the doctor, and the pharmacist. If the agency's list says an aide will sort, hand out, or manage medicines, ask for the list to be corrected before you sign.

Ask what happens when the plan breaks

Ask how the agency handles a missed shift, who covers it, how fast, and whether you may refuse a replacement. Ask who supervises the caregiver, how often a supervisor visits, and where complaints go. Write down each answer and the name of the person who gave it.

Compare them like bids

Put the answers from each agency on one page, using the same questions for every agency, and place price last. Ask rate questions by phone and keep the answers in writing. For free help comparing options and reading agency paper, see the local help page. To see how this desk checks what it cites, read the how we write page.

The License Is the First Line of the Quote: Verify an Agency's Paper Before You Compare Its Price