Non-Skilled Home Care

There are two types of home care services

• Non-skilled home care (ANV lists only this type)
• Skilled home care

What are non-skilled home care services?

• Non-skilled home care is often called private duty nursing
• Private duty nurses are typically Certified Nurse Assistants (CNA’s), Home Health Aides (HHA’s) or Companions.
• Services they provide include: 1) Meal preparation, 2) Medication reminders, 3) transportation, 4) Light Housekeeping, 5) Laundry, 6) Bathing, 7) Dressing, 8) Incontinence care, 9) Transfers, 10) Companionship, and many others.

What is the difference between the three types of “private duty non-skilled caregivers”?

• Certified Nurse Assistants (CNA’s) in Virginia have 120 hours of training and have passed a State exam for CNA’s and is licensed in Virginia. States vary on the requirements to be called a certified nurse assistant
• Home Health Aides (HHA’s) have received the 120 hours of training but have not taken the State exam to become licensed.
• Both CNA’s and HHA’s are qualified to provide personal care services. Personal care includes help with bathing, toileting, assisting with transfers from one surface to another when the individual has trouble walking, helping with meals, feeding etc.  Anything that requires “hands on” care that is not skilled.
• Companion’s may have no formal training and provide “companionship” and no “hands-on” or personal care. A companion typically provides socialization, help with errands, meal preparation, and light housekeeping.

Where can I find a private duty caregiver or companion?

• Home Care Agencies (on the ANV list) employ licensed caregivers or companions. This means the company screens each employee with a background check (SSN, driver’s license and citizenship status) and is responsible for paying social security and workman’s compensation for each employee. All the agencies on the ANV list are licensed by the State and are bonded.

• Referral agencies, (none of which are on our list), are another source for home care workers. A referral agency will do the background checks and provide you with a list of potential caregivers.  The individual needing the caregiver then interviews and hires the caregiver.  Once hired, the caregiver is your employee and therefore, you are required to pay their social security and workman’s compensation.

Interviewing Home Care Providers

“Home care” usually refers to “non-medical” (non-skilled) services such as personal care, meal preparation, housekeeping services or transportation. (“Home Health Care” covers medical care). Be sure to know what services you need.  When you choose a home care provider, you are inviting someone into your home.  A little precaution and research can go a long way in giving you peace of mind and preventing problems.  Asking friends, relatives or a trusted advisor for home care recommendations is a good start. Your medical providers (such as your hospital discharge planner, social worker or your family doctor) may also have suggestion. Starting with a few good recommendations from ANV or your Doctor can save time and anguish.

Questions to ask:

1. Is the agency licensed in VA?
2. Is the agency locally owned and operated? Are the owners on-site and actively managing?
3. If the agency is part of a franchise, what ‘watchdog’ organization are they members of?
4. Are the agency’s care-givers employees or independent contractors? (You want an agency that knows its employees, not one that just acts as an employment agency.)
5. Are caregivers bonded and insured? (They should be.) What criminal screening and background checks does the agency run on its caregivers? Are these national or simply local? (Other Screening?)
6. What sort of training do the employees receive? Is training ongoing?
7. Will an agency supervisor evaluate the quality of care you receive? How often?
8. What services can the agency provide? E.g. do the providers drive.
9. How is billing handled? If private insurance will pay for some of the costs, will the agency bill them directly?
10. If you have a family member or friend involved in your care, how does the agency ensure that they stay informed / included? What if your family lives in a different state?
11. What provisions are there for backup care? Who do you call if no one shows up? Does the agency have someone on call? After hours? What provisions are there for care during a disaster?
12. What is the process for resolving problems? Who can you call to discuss any issues and be sure to have them resolved?
13. Are you committed to a long-term contract with the agency?
14. How long will it take to get a caregiver on site?
15. Can the agency provide services to someone in a facility (hospital, nursing home, assisted living, etc)?