What to Ask Any Home Care Agency Before You Hire One

Start with screening, because nobody volunteers this

The person an agency sends is going to be alone in your mother's house. Ask exactly how they got hired.

You want to hear specifics, not adjectives. "Thoroughly vetted" means nothing. Ask what checks are run, who runs them, and whether anyone from the agency met the caregiver face to face.

At Westmark, every caregiver passes a CORI criminal background check, reference verification, an in-person interview, and a hands-on skills evaluation. If an agency can't list its steps that plainly, that's information too.

• What background check do you run, and is it a CORI check?
• Do you verify references yourself, or take them from a resume?
• Did someone at your agency interview this person in person?
• Is there a skills evaluation, or just a paper application?
• Are caregivers your employees, or independent contractors I'd be responsible for?

Ask about licensing — and know what the answer means

This one trips up almost everyone. Massachusetts does not license non-medical home care agencies. There is no state license to hold. So if an agency tells you it's "licensed by the state" for non-medical care, ask them to name the license.

What does exist is insurance and bonding. Westmark is insured, bonded, and background-checked. That's the honest version, and it's the version you should be asking every agency for.

Also worth clarifying: non-medical means non-medical. We do companion care, personal care, dementia care, transportation, and staffing. We do not do wound care, injections, or anything that belongs to a nurse. If a parent needs skilled nursing, that's a different provider, and any agency that blurs that line is telling you something about how it operates.

Pin down the minimum before you fall in love with the plan

Almost every home care agency in Massachusetts has a visit minimum, and almost none of them lead with it. You can build a beautiful care schedule in your head and then discover the smallest unit available is more hours than you need or want to pay for.

Westmark's ongoing home care and staffing visits carry a six-hour standard minimum. There's one deliberate exception: a 4-hour post-discharge block at $44/hour, for the stretch right after a hospital or rehab stay when a family needs coverage fast and doesn't yet know what the long-term picture looks like.

Transportation has no minimum at all. It's quoted per trip. If the real problem is dialysis three times a week or an appointment in Boston nobody can drive to, you don't need a six-hour shift — you need a ride.

So ask: what's your minimum, are there exceptions, and what does a ride-only request cost?

Get the actual number, including the parts that go up

Ask for the hourly rate for the specific level of care your parent needs. Then ask what changes it. Weekends. Holidays. Overnights. A second person in the house. Mileage.

Here's ours, in full, so you have something to compare against:

• Companion care — $34/hr
• Personal care — $38/hr
• Alzheimer's and dementia care — $40/hr
• Overnight care, awake — $38/hr
• 24-hour / live-in — $816/day
• Weekends and holidays — add $3/hr
• Per-diem facility staffing — $36/hr
• Short- and long-term family staffing placements — $38/hr
• Post-discharge 4-hour block — $44/hr

Ask what happens on a Tuesday when the caregiver calls out

This is the question that separates agencies, and hardly anyone asks it during the sales conversation.

Caregivers get sick. Cars break down. If your parent needs help getting out of bed at 8 a.m., "we'll try to find someone" is not a plan. Ask who you call, whether a person answers, and how backup coverage actually works.

Westmark is available 24/7 and a real person answers the phone. Not a voicemail box you fill at 11 p.m. and hope someone checks. That's (508) 233-8062.

While you're there, ask about consistency in the other direction: will it be the same caregiver most weeks, or a rotating cast? Both happen in this industry. You should know which one you're buying.

Read the paperwork question out loud

Ask directly: am I signing a contract, and can I stop? Then ask about deposits, enrollment fees, assessment fees, and how much notice you need to give to change or cancel a visit.

Westmark's answers: no deposits, no enrollment fees, no long-term contracts. The in-home assessment is free and carries no obligation. Changing or cancelling a visit takes 48 hours' notice.

The reason this matters is that most families guess wrong at the start. You think you need three mornings a week and it turns out to be five, or you think you need daily help and Dad rallies after two weeks. A care plan you can adjust without penalty is worth more than a discount on a plan you're locked into.

If an agency wants money before anyone has seen the house, ask why.

One more: who is this actually for?

Toward the end of the assessment, ask the agency to describe the plan back to you in plain language. What will the caregiver do in those hours? What won't they do? Who writes it down, and who updates it when things change?

You'll learn a lot from how quickly they can answer. Families in this position usually know more than they think they do — you've been watching your parent for months. A good agency listens to that and builds around it instead of dropping in a template.

If you're at the beginning of this, our home care services page lays out what we cover, and you can request an assessment or just call and talk it through. No obligation, no deposit. Ask us the hard ones.

Common questions