Evaluating the quality of a provider

When evaluating the quality of a provider, you may encounter the following terms:

• Licensure. Some states require providers to have licenses to operate. Basic legal and operating requirements as directed by the state must be met to obtain a license.

• Bonding. A bond is a type of insurance policy for a provider. To become bonded, a provider must pay a set amount. The bond protects the provider from bankruptcy in the event of a lawsuit by a consumer.

• Certification. State certification by state health departments makes a home health or hospice care provider eligible for Medicare (and sometimes Medicaid) payments. To become certified, a provider must meet basic federal and state standards in patient care and financial management. Certified healthcare professionals are certified by their respective national organizations. The certification usually requires passing a national test or work experience.

• Accreditation. Nationally recognized accrediting organizations evaluate and accredit quality healthcare services. A provider must voluntarily seek out this accreditation. Some organizations that accredit home health and hospice care include:

  • Accreditation Commission for Health Care (ACHC)

  • Community Health Accreditation Partner (CHAP)

  • The Joint Commission (TJC)

Questions to ask when choosing a provider

When choosing a provider, consider asking the following questions:

• How many years has the provider been serving the community?

• Does the provider have literature describing its services, cost, and funding?

• Is an evaluation of the patient's home healthcare needs required? Is there a written plan of care for the patient?

• When are caregivers available?

• Is there a nursing supervisor on-call 24 hours a day?

• Can the provider ensure patient confidentiality?

• How is quality of care and services monitored?

• What types of payments are accepted?

The National Association for Home Care & Hospice and Eldercare Locator are resources for home care and hospice services.