Is the agency licensed? Yes___ No___
Does Medicare certify the agency? Yes___ No___
Is the agency accredited? Yes___ No___
Does the agency have a contract with your insurance company/HMO? Yes___ No___
Does the agency bill Medicare or your insurance provider or is the family responsible? Yes___ No___
Will the agency provide you with a written description of the services and charges? How much will be paid by Medicare, private insurance etc. so you will know what you are responsible for? Yes___ No___
How does the agency screen their staff?
What type of training, supervision and monitoring does the agency provide to it's staff?
Does the agency develop a plan of care with the types of services, the frequency and the length of time the patient will need? Yes___ No___
Will a nurse, therapist, or social worker provide the initial assessment? Yes___ No___
Does the agency provide training to the aid and your family on high-tech equipment in the home? Yes___ No___
Is there a 24-hour emergency contact for your questions, problems, emergencies or complaints? Yes___ No___
Does the agency assure you that their staff is available at your requested times? Yes___ No___
How does the agency insure you about the consistency of their care providers?
Is there a charge for canceling a scheduled appointment or shift? Yes___ No___
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