Staff Writer
Columbus CEO

c.2013 New York Times News Service

Finding someone to care for an ill or aged relative at home can be challenging. Sorting through the options can be time-consuming, and the need to find help may arise during a crisis, when decisions must be made quickly.

Hoping to help consumers make those choices — and to help themselves stand out in a competitive field — some home health agencies are seeking voluntary accreditation by independent organizations.

“This market is crowded,” said Margherita C. Labson, executive director of the home care program at the Joint Commission, one of the major health care accreditation organizations. “These companies had no credible way of distinguishing themselves as better than others in the marketplace.”

The nonprofit Joint Commission, which accredits hospitals and other health providers, is one of three groups recognized by the federal government as accreditors of a variety of home health agencies. Its seal of approval is one route toward the certification a provider needs to receive payment from Medicare, the federal health program for those older than 65. The other two groups are the Community Health Accreditation Program and the Accreditation Commission for Health Care.

Medicare pays for home care only in limited circumstances, such as when a person needs temporary nursing care after a hospitalization. Still, companies that provide longer-term home care, including for people needing help with daily tasks like bathing and dressing, also may seek accreditation — even if they don’t accept Medicare and rely mostly on private payments or other insurance. (Medicaid, the state-federal program for the poor, does cover longer-term home health services, but eligibility and services vary by state.)

“We wanted some measure of quality beyond our own internal measures,” said Sharon Roth Maguire, the chief clinical quality officer at BrightStar Care, a Chicago-based home care franchiser with 261 locations nationally that does not accept Medicare. “It’s one thing to say we’re committed to quality, but another to demonstrate it to another third party.”

BrightStar is one of two large home care operators recognized by the Joint Commission for having at least 95 percent of its franchise locations accredited. The second is CareMinders, based near Atlanta. To become accredited by the Joint Commission, an agency must undergo detailed reviews and on-site visits, including direct observation of patient caregiving, every three years.

Roughly 7,000 home health providers are accredited by the Joint Commission, and an estimated 35 percent of them provide either skilled nursing care or personal care, Labson said. (The others provide services like physical therapy, medical equipment and special pharmacy services.) According to the Centers for Disease Control and Prevention, there were roughly 14,500 home health and hospice agencies in the country in 2007.

New regulations also are driving interest in home health accreditation, Labson said. Hospitals are now penalized if patients are readmitted too quickly after being discharged, so they are looking for providers who can demonstrate that they can help make the transition to home go smoothly.

A lack of accreditation does not necessarily mean the agency is not offering quality care, but it offers one way to gauge its commitment to high standards.

“An agency is probably not going to be accredited if they aren’t at least striving to be a cut above,” said Amy Goyer, an adviser to the AARP on family caregiving issues as well as a caregiver for her father, who has Alzheimer’s disease.

Agencies, however, pay fees to be evaluated for accreditation, she noted, so that can add to the costs — especially if you are seeking someone to provide personal care like help with bathing or eating, rather than nursing care, which might involve cleaning and dressing wounds or administering medication. Smaller operators may offer quality care, but may not yet be able to afford the accreditation process.

“You may be paying more than you otherwise might be,” Goyer said.

The National Association for Home Care and Hospice, an industry group, suggests that consumers check first to see whether their state requires home health agencies to be licensed; you can usually find this on your state health department’s website. If it does, the site will often list licensed providers, and will often have information about inspections, surveys and complaints.

While accreditation is usually voluntary, at least one state, Florida, requires home health providers to be accredited by one of the three major groups to be licensed.

Here are some questions to consider:

Q: Where should I start looking for a home health agency?

A: Your local Area Agency on Aging is often a good place to start. You can go to the website of the National Association of Area Agencies on Aging to find one serving your area.

Q: Does the federal government offer any home health care search tools?

A: The federal government maintains the Home Health Compare site, which lets you search by ZIP code for a Medicare-certified agency and see quality reports as well as client comments. Medicare doesn’t cover personal care or long-term care, but some certified agencies may offer those services and accept other insurance or private payments instead; make sure to ask.

Q: Do the accrediting bodies have search tools?

A: You can search for agencies that are accredited by three main organizations on their websites. The Joint Commission offers; the Community Health Accreditation Program offers a state-by-state search at; and the Accreditation Commission for Health Care’s search tool is at