The people (questions 1 to 7)
- Are caregivers your W-2 employees, or 1099 contractors? (Employees means the agency carries taxes, insurance, bonding and supervision. This question alone sorts the field.)
- Describe your screening: background checks, fingerprinting, references, drug testing, driving records. Renewed how often?
- How many hours of initial training, and is dementia care training included or extra?
- What is your caregiver turnover rate? (Industry turnover is notoriously high. An agency that does not know its own number, or will not say, is hiding it.)
- How long has your average caregiver been with you?
- Will we meet the caregiver before care begins?
- If the match is wrong, what exactly happens?
The supervision (questions 8 to 13)
- Who writes the care plan, and what license do they hold? (The answer should be a registered nurse, not a salesperson.)
- How often does a supervisor visit the home, and are any visits unannounced?
- How do you communicate with family after visits, and can out-of-state children see updates?
- What happens, step by step, if our caregiver calls out sick at 6 am?
- What is your protocol when a caregiver finds something wrong: a fall, confusion, a medication problem?
- Who answers your phone at 2 am? (Call their number at night before you decide. Seriously.)
The money (questions 14 to 19)
- What are your exact hourly rates by level of care, in writing?
- What is the visit minimum, and are there weekly minimums?
- Are there enrollment fees, deposits, holiday surcharges or cancellation penalties?
- Do you verify Medicare, Medicaid, VA and long-term care insurance benefits before care starts, and is that free?
- Can you bill long-term care insurance directly?
- What notice is required to change or stop services?
The accountability (questions 20 to 25)
- Are you licensed by the State of Nevada, and may we see the license number?
- Are you Medicare-certified, and accredited by whom?
- Are you bonded and insured, including for theft and liability in the home?
- How do you measure quality: readmissions, falls, client satisfaction, and will you share the numbers?
- May we have three references from current client families in our area?
- When something goes wrong, who calls us, how fast, and what does the correction process look like?
Red flags that end the interview
- Vague or defensive answers about screening, employment model or turnover
- Pressure to sign anything on the first call, or long-term contracts with penalties
- No nurse anywhere in the care planning process
- Prices they will quote on the phone but refuse to put in writing
- A 2 am test call that goes to a full voicemail box
Should we hire an independent caregiver instead of an agency to save money?
The hourly rate looks better until you price what it omits: payroll taxes that become your legal responsibility as a household employer, no bonding or liability coverage when something breaks or goes missing, no backup when your one caregiver gets sick, no supervision, and no recourse beyond firing someone you now depend on. Some families make it work; most discover why agencies exist during their first bad week.
How many agencies should we interview?
Three is the sweet spot: enough to feel the differences, few enough to finish before the need becomes a crisis. Use the same 25 questions for each, and weight how they answer as much as what they answer. Evasiveness on screening or pricing questions is itself an answer.
What single answer disqualifies an agency fastest?
Ask whether caregivers are W-2 employees or 1099 contractors. Contractor-model agencies shift taxes, insurance and supervision risk onto you while calling themselves an agency. The second-fastest disqualifier: they cannot tell you, specifically, how caregiver consistency is staffed and measured.