Search for Home Care by ZIP Code:  :

Selecting a Home Care Agency

When hiring home health care help for older adults, it's critical to understand the ratings an agency receives by the state and federal agencies. But knowing the ratings is not enough, you need to learn exactly what the factors mean and how each affects your loved one's quality of care.

The Centers for Medicare and Medicaid Services clearly understands the ratings' significance, so much so, that they've created the Five-Star Quality Rating System to guide consumers, their families, and caregivers to compare home health care agencies; to identify areas about which you may want to ask questions.

Non-medical Home Care providers, in most but not all states, receive a license and certification. Home Health Care is state certified and must follow Medicare and/or Medicaid applicable laws, regulations, and compliance concerns.

Being a consumer, it's imperative that the research and due diligence is thorough before choosing and hiring help for care at home.

Be a smart home care shopper. Follow the same requirements and ask the questions that CMS designed in the Five-Star Quality Rating Systems to better identify the best home care for you or your loved one.

Choosing Home Care

Searching for Home Care
Searching for Home Care

The CMS quality rating system uses the following sources for rating home health care agencies. We adapt and display those ratings in our home care directory. Evaluate the information in the Home Health Compare carefully when seeking home care help. Use it with the other information you gather.

Talk to your doctor or other health care providers for references, questions to ask, what to look for, and how to choose a home care provider. They know best the type of care an aging adult needs to age in place safely and remain independent.

Recovering from surgery or need long-term care for a chronic illness, faced with another situation, an individual may need home care services. Home care services range from skilled care provided by nurses or therapists to household support, such as cleaning, cooking and running errands.

Medicare Quality Ratings for Home Health Care Agencies

When calculating a rating for the overall quality of care, each question weighs equally for the questions where complete data is available. Questions without complete data are ignored. When calculating overall ratings, both the patient survey and quality of care information is available for viewing. If only one factor is available, that's the one used.

Remember: Ratings are only available for Medicare-certified agencies. Ratings may also not be available for all agencies due to a lack of sufficient data to accurately rate the agency.

Quality of Care Data

Quality of Care includes Process Measures and Outcome Measures. Process Measures tell you how often a home health care agency gave the recommended care such as checking patients for depression at the beginning of an episode of care. A rate of 90% means that the home care agency provided the recommended process 90% of their episodes of care.

Patient Surveys

The patient survey data collected by Medicare through the Home Health Consumer Assessment of Healthcare Providers and Systems program. The data's collected from patients, their families, and their friends on a nationwide since the fall of 2009.

The Care Data Measured by Medicare

Professional Care

  • There were no problems with the home health care
  • Providers were always gentle
  • Providers were always respectful
  • Providers were always up-to-date about the patient's treatment


  • Explained services before giving them
  • Gave advice promptly
  • Always said when staff would arrive
  • Always explained things clearly
  • Always listened carefully

Health and Safety Issues

  • Discussed medicines, pain, and home safety
  • Discussed all of these topics

Gave Their Agency a Rating of 9 or 10

  • 0 is for the worst home care possible
  • 10 is for the best home care possible


  • Would Recommend to Friends/Family
  • The percentage that said yes to recommending the agency

Learn more about Medicare's Ratings

Qualifying Home Care

Check the Qualifications

Medicare Ratings on Health Care
Medicare Ratings on Health Care

If it's time to recruit the help of a home care agency or hire a personal home health aide, knowing what questions to ask can lead and help you receive good and safe care.

Home Care Agency

Is the home care agency licensed by the state? Most states require a license and reviews. Request a review through your state health department.

Is the home care agency certified by Medicare to meet federal requirements for health and safety? Most home care agencies are not, but some are Medicare certified. If they are not certified by Medicare, ask why not?

What type of screenings performed before hiring staff?

Ask for references. Ask for a list of doctors, hospital discharge planners or other professionals with experience working with the home care provider.

Ask for a list of current and former clients.

Ask doctors, family and friends for home care recommendations.

It's important to know if The Joint Commission accredit the home care provider. The Joint Commission is an independent group that evaluates and accredit health care organizations. If so, ask to see the results of the most recent survey.

Private Hire Personal Home Health Aide

Include relevant questions above!

What are the aide's credentials?

Are you comfortable with the aide's training and experience? Learn what training the aide received and the experience.

Get references from the person applying for the personal home health aide job. Can the aide provide references?

Take time to check the aide's references thoroughly.

Ask doctors, family and friends for home health aide recommendations.

Quality of Care

Home Care Agency

How does the agency hire and train caregivers?

Does the agency provide continuing education?

Are the caregivers licensed and insured?

How closely is the staff member supervised by the agency? What are the factors used for evaluating the home health aide?

Does the agency have a quality improvement program?

Do the agency's employees seem friendly and helpful? Make sure you feel comfortable with the agency's representatives.

Private Hire Personal Home Health Aide

Does the home health aide have a good attitude? Is the aide friendly?

Are you comfortable with the person?

Is the home health aide certified and insured?

Has the aide received training? If so, what kind and what topics?

Does the aide receive continuing education?

Home Care Costs

Home Care Agency

  • How does the agency handle expenses and billing?
  • Obtain information that explains the services and fees, and details of costs associated with home care.
  • Will agency fees be covered by health insurance or Medicare?
  • Find out what arrangements are in place for specific health insurance plans.
  • Is financial assistance provided Is a payment plan available?

Private Hire Personal Home Health Aide

  • How much does the aide charge for home health services?
  • Make sure you're comfortable with the fees and services.
  • Does the aide require payment for sick days, vacation days or holidays? How many sick and vacation? What about vacation time?

Home Care Services

If you're receiving home care services from an agency or a private home health aide, learn about the services:

Will you receive a written care plan before service begins? The care plan lists in details the medical equipment and specific care needs the recipient requires. Make sure the plan includes input from your doctor, and updated frequently.

  • Get a copy of your rights and responsibilities, a patient's bill of rights.
  • Will nutritionists, dietitians, counselors, therapists or other specialists referred to you, if needed?
  • How does the home care provider include your family members and health care providers?
  • Must you identify a primary family caregiver? If so, what's required of that person?
  • Are limits set on the types of tasks performed?
  • When will service be provided? Is care available round-the-clock, when needed?
  • What procedures are in place for emergencies?
  • How are problems addressed and resolved? Whom can you contact with requests, questions or complaints?
  • When can services begin?

Keep Watchful Eye

Monitor your home care services - After you find and hire home care services, stay alert and mindful. Monitor the care given. If concerned, discuss it immediately with the agency or home health aide. If necessary, involve your doctor.

Search for Home Care by ZIP Code

The quality of care given at Eldercare Services Institute Home Care is periodically evaluated by Medicare. The results of the most recent evaluation period listed below to help you compare home care agencies in your area.


Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.