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Everyone’s looking for a deal. We clip coupons, sign up for online specials, search for promo codes for online orders, etc. But when it comes to selecting a company to provide in home care for a loved one, cost has to be measured as only one of several key factors.

It’s always recommended to talk with a handful of service providers for any work you are looking to have done, but especially with in home care. All companies should provide a free consultation with no obligation. Meet with them, and have a list of questions that you can ask all of them, so your comparison is consistent. Some companies will offer a checklist of critical questions you can ask the companies you interview.

If you interview four companies, one of the factors you will unquestionably consider is the cost per hour. But are there underlying aspects to that cost? Ask these questions to get the answer.

1.  Does that cost cover all services or service levels?

It is common for companies to have a cost if the caregiver uses their own vehicle to take a client to an appointment or to run errands, but is there a higher rate if the client needs hands on care vs. companionship?  If there is, what happens if a shift that is scheduled to be for companionship becomes hands on care?  Some companies will send staff to a companion shift that aren’t certified or even have personal care experience.  Are they ready to help someone immediately if the need arises?

2.  Are the care providers employees or independent contractors?

If they are hired employees, the company pays their contribution toward federal and state income taxes, as well as Medicare and Social Security.  The company also pays a company share of Medicare and Social Security taxes equal to what the employee contributes.  If the care provider is a contractor, the company not only doesn’t deduct their taxes, they don’t have the burden of paying Social Security or Medicare.  Being an independent contractor means you individually assume responsibility for anything that goes wrong in the home.  Most companies who use independent contractors will have a clause in their service agreement that asks you to agree not to hold the company accountable for the actions of the contracted care provider.  This can save you a few dollars an hour up front, but if something goes wrong, who is there to back it up?

3.  What are the minimum requirements for their care providers?

We’ve all been to the grocery store and had the new bagging clerk handling our groceries.  The bags are packed poorly and you run the risk of your bread being mashed by canned vegetables.  Come back a year from now and that same clerk will have your bags organized and packed efficiently (well, you hope anyway).  This is fine in the grocery store, but when it comes to the person helping your loved one with a shower, do you want to be part of their learning curve?  The best companies will require a combination of certification and experience prior to hiring them.  It makes the hiring process more challenging, but it means that the companies that do it right can select almost any caregiver on their roster to handle your needs effectively, efficiently and safely.  All companies will have caregivers who are CPR and First Aid certified, but you and I can get that in an evening, does that make us caregivers?  Hiring quality, experienced caregivers that you hope to keep longer than a month means you will have to provide a compensation package that encourages them to stay with you.  But in the end, the quality is what matters.

4.  Does the company have insurance policies that cover the employees in your home?

We’ve all heard the phrase “licensed, bonded and insured”.  But does that cover the care providers, or just the office staff?  Liability coverage, worker compensation coverage and a criminal bond can cost a company $10,000.00 or more a year depending on the number of caregivers they have (and cover).  But if the caregiver breaks the glass top stove when they are cleaning up in the kitchen, you can rest assured it’s covered if the employee is covered by the liability policy.  If the caregiver is changing the bed linens and pulls their back, resulting in weeks off of work, knowing that the company covers them with worker compensation insurance will provide the relief that the caregiver can’t sue you for the injury.

Between insurance coverage and the company portion of the taxation, hiring employees properly can cost a company $25,000 – $30,000 a year.  Unfortunately, when you combine this with a higher cost for caregivers, this can result in slightly higher rates per hour.  Can you find an excellent caregiver at a great rate simply by looking in the newspaper or by choosing the cheapest company you can find?  Sure, if you’re lucky.  Improve the odds, and hire a company that eliminates the gambling and just does things right.