Choosing the Right Home Care Provider

Selecting someone to care for a family member at home is one of the biggest decisions you’ll ever make. As you begin to search for home care services near you, it’s important to determine which one provides the best “fit” for your loved one’s needs and will give your family peace of mind.

We are so proud of the compassionate caregivers and high-quality nurses at BrightStar Care® locations across the country, yet we realize you may want to compare a few home care agencies before making a final decision. Here are some aspects of care you may want to consider.

What services does the agency offer?

Home care agency services can include Companion Care (helping with tasks like meal prep and providing socialization), Personal Care (assisting with Activities of Daily Living like dressing and bathing), Skilled Nursing (such as wound care and in-home infusions), specialized Alzheimer’s Disease and Dementia Care (to support a safe environment and meet the unique needs of those with memory challenges), or In-Home Therapies (physical, occupational or speech). Some agencies can provide a continuum of care that supports transitions to different levels and types of services as needed. 

How are providers vetted?

Ask if the agency does comprehensive background checks and drug screens for caregivers and nurses. You’ll also want to ask if the nurses are licensed, insured and bonded.

What type of supervision and training do your caregivers, nurses and other staff receive?

Some agencies provide nurse oversight for caregivers so they can ensure your loved one’s care is consistent and meets certain standards. Agencies that provide this oversight can help identify changes in your loved one’s health and adapt the plan of care to fit their evolving needs.

What is the availability of services?

You may want to ask: Is there a minimum number of hours? Do you offer overnight care? How do you handle it when a caregiver or nurse is sick and unable to carry out their shift? Is someone available for questions 24/7? Do I need to sign a long-term contract?

Now that you know some of the questions to ask, you can use the handy guide below to compare agencies.

Home Care Agency Comparison Guide

If you decide to partner with a home care agency for your loved one’s care, the list below will help you ask the right questions. Because this can quickly generate an overwhelming amount of information, we encourage you to write down the responses so you can compare the details of each home care agency.

  1. What types of home care services do you offer?
  2. Is your agency accredited by a national organization? (If so, which one?)
  3. Do you have a nurse who evaluates health and wellness, and creates a personalized plan of care?
  4. Does a nurse follow up with supervisory visits to ensure that the plan is being carried out?
  5. Are your caregivers experienced, trained and competency tested?
  6. Are all nurses and caregivers drug-screened, background checked, licensed, insured and bonded?
  7. Do you manage payment of all caregivers, including payroll taxes?
  8. Do you recommend a caregiver based on personalities and compatibility?
  9. Are you insured for accidents in the home?
  10. Can you accommodate both short shifts and up to 24/7 coverage?
  11. Can you provide a caregiver trained in specific conditions or needs my loved one has (ex: Alzheimer’s)?
  12. Is there someone on-call 24/7?
  13. What are your rates?

Download our free home care agency comparison chart.

Download Chart

Home Care Options: Agency, Direct Hire and Registry

If you’ve decided that you or a loved one need help at home but aren’t sure if an agency is right for your needs, there are other ways to bring in a home care provider, including hiring them directly or choosing from a registry.  Below you’ll find a comparison of home care agencies, direct hires and registries so you can determine the best approach for your family’s needs.

There are benefits and drawbacks to all approaches – and every situation is different – so it’s important to look at your decision from a variety of perspectives. This overview of in-home care service options is designed to serve as general information and should not be taken as legal or tax advice.

Home Care Agency

This type of organization handles both the business and clinical aspects of hiring a caregiver, nurse, physical therapist or other in-home provider. The agency is responsible for background checks of care providers, payroll, taxes and other essential administrative functions. They ensure that caregivers and nurses maintain appropriate licensing requirements.

Some home care agencies provide staff ranging from companion care to complex skilled care. Those that provide comprehensive services are able to ensure that your loved one will receive the right type of care as their needs evolve. Agencies can often send a substitute provider if yours falls ill or is otherwise unable to come at their scheduled time. Caregivers can also collaborate with nurses and other team members to provide a more thorough care experience.

These comprehensive agencies typically provide training and guidance to the individuals they send to your home. Ongoing education should include skills and insights that help keep your loved one safe at home by decreasing the potential for falls, accidents or injuries. The quality of training and support varies by organization, so it’s important to choose an agency with a strong reputation for superior care, nursing oversight and a commitment to the families they serve.

Direct Hire

Some families have success with hiring a relative, neighbor or friend to provide care at home. Perhaps they’ve had good luck hiring a caregiver or nurse they know in their community or have found them online or by referral. This arrangement may be agreed-upon informally with a few conversations or it may take on a more business-like approach with a contract and written set of expectations for the in-home care.

Even though the hourly cost may be less, you’ll be responsible for any legal paperwork, payroll tax and other employer requirements. You should also ask an attorney about any potential liability and consider a liability insurance policy in case the caregiver gets hurt on your property or while providing support such as transportation.

Caregiver Registry

This approach builds upon the direct hire concept, but you have access to a larger pool of candidates. Sometimes called a private duty registry, independent contractor agency or referral agency, this type of company collects the names of caregivers, nurses, physical therapists and other individuals that provide home care services.

After identifying your needs, they'll share a list of possible providers that you interview and may choose to hire directly. In most cases, the registry agency doesn’t complete background checks or provide training – of course, this can vary. The agency typically charges a finder’s fee and then all aspects of the relationship with the caregiver or nurse are your full responsibility.

Comparison of Home Care Agency, Direct Hire and Registry

Now that we’ve reviewed the various options, let’s look at a summary of the key aspects of three different sources for in-home caregivers and nurses.

Home Care Agency:

  • Cost: Moderate
  • Responsible for background check, payroll, benefits, taxes, etc.: Agency
  • Provides training, supervision, making sure care provider is properly licensed and certified: Agency
  • Available personnel for back-up coverage: Agency handles this for you
  • Range of service offerings: Agency may have providers along the entire continuum of home care (varies by location)*
  • Schedule flexibility: Can usually support variety of short- or long-term needs
  • Covered by long-term care (LTC) insurance: Usually

Direct Hire:

  • Cost: Lower
  • Responsible for background check, payroll, benefits, taxes, etc.: You
  • Provides training, supervision, making sure care provider is properly licensed and certified: You
  • Available personnel for back-up coverage: If you arrange for it
  • Range of service offerings: Limited
  • Schedule flexibility: Varies
  • Covered by long-term care (LTC) insurance: No


  • Cost: Relatively Low
  • Responsible for background check, payroll, benefits, taxes, etc.: Usually you
  • Provides training, supervision, making sure care provider is properly licensed and certified: Depends, but generally you
  • Available personnel for back-up coverage: Could possibly call another provider
  • Range of service offerings: Variety of providers, but not part of a collaborative team
  • Schedule flexibility: Varies
  • Covered by long-term care (LTC) insurance: Possibly

These lists represent the common characteristics of the three options described above and is not a definitive guide to the types of services offered by various categories of providers. Source: Family Caregiver Alliance,

Download our guide to understanding home care options.


It’s All About Your Loved One

Although there are many different factors that affect your choice of an in-home care provider (including the types of services offered, cost, availability, etc.) the most important aspect is your loved one’s health and safety – and your peace of mind. 

If you would like to learn more about in-home care services, please send us a message, reach out to your nearest BrightStar Care location or return to the beginning of our online Home Care Guide.

*Skilled care availability varies by location. Contact your local BrightStar Home Care agency to learn more about their specific range of services or call 866-618-7827.