The typical home health referral goes like this: hospital discharge planner provides a name, family agrees, care starts within 48 hours. Very few families interview the agency before committing.
That's a mistake. You're inviting healthcare workers into your home — or your parent's home — for weeks or months. You have the right to ask questions, and the answers will tell you a lot about the quality of care you can expect.
1. What is your CMS quality rating?
Every Medicare-certified home health agency has a Quality of Patient Care star rating from CMS, updated quarterly. If the agency can't tell you their rating off the top of their head, that's informative. If they deflect the question, that's more informative.
A strong agency knows its rating and can explain what drives it. An agency with a 2-star rating that claims to provide excellent care should be able to explain the gap.
2. What is your hospitalization rate?
This is the percentage of patients who end up back in the hospital during a home health episode. The national average is roughly 15-16%. Ask for the number and compare it to other agencies in your area.
An agency that doesn't know its hospitalization rate, or won't share it, is not tracking its own outcomes with the seriousness you want in a healthcare provider.
3. Who will be my primary nurse, and how often will they visit?
You want consistency. The same nurse seeing you at each visit catches changes in your condition that a rotating roster misses. Ask how many patients your assigned nurse carries. Ask what happens when your nurse is sick or on vacation.
4. How do you coordinate with my doctor?
Home health agencies are supposed to work with the patient's physician. Ask specifically how they communicate — do they call the doctor after every visit? Send reports weekly? Have a system for flagging urgent changes?
Agencies that are vague about physician coordination are agencies where things fall through the cracks.
5. What specific services will I receive?
Home health can include skilled nursing, physical therapy, occupational therapy, speech therapy, medical social work, and home health aide services. Not every agency offers every service, and not every patient needs all of them.
Get specific about your care plan. How many nursing visits per week? How many therapy sessions? For how long? What are the goals — and when would they discharge you?
6. What happens if I need care outside of business hours?
Patients don't get sick on a schedule. Ask whether the agency has an on-call nurse available 24/7, or whether you're directed to call 911 for anything after 5 PM.
An agency that says "call 911" for after-hours concerns is an agency that will contribute to a higher hospitalization rate. On-call nursing is a baseline expectation.
7. How do you handle medication management?
Medication errors are one of the leading causes of hospital readmission in home health patients. Ask the agency how they handle medication reconciliation, how they educate patients about new drugs, and what happens when they identify a potential drug interaction.
The answer should be specific, not vague.
8. Can I switch agencies if I'm not satisfied?
Yes. You can. Medicare allows you to change home health agencies at any time. You do not need your doctor's permission. You do not need the hospital's permission. You can simply call a different agency and request a transfer.
Most families don't know this. The agency you start with is not the agency you're stuck with.
Look up CMS quality data before you commit. Compare agencies near you