Choosing a home care company for yourself or a loved one is one of the most important decisions a family can make. The right provider can improve quality of life, provide peace of mind, and help older adults remain safe and independent at home. Unfortunately, not all home care companies operate at the same level of professionalism, transparency, or ethics.
With so many options available, it is important to know what questions to ask, what warning signs to avoid, and what standards consumers should expect from any company providing care inside the home.
The National Association of Senior Advocates (NAOSA) created its Consumer Guides and Gold Standards of Professional Practice™ to help consumers make informed decisions and avoid unethical business practices. These standards were developed by industry professionals and are designed to protect older adults and families during the selection process.
Understand the Type of Care Being Provided
Before selecting a provider, determine exactly what type of care is needed. Many home care companies provide custodial or non-medical care, which may include:
- Companionship
- Meal preparation
- Medication reminders
- Light housekeeping
- Transportation
- Assistance with bathing, dressing, and mobility
Medical home health care, however, involves skilled nursing or therapy services and is regulated differently. Understanding this distinction helps ensure you are choosing the appropriate provider for your situation.
Verify Licensing, Bonding, and Insurance
One of the most important NAOSA Gold Standards of Professional Practice™ is ensuring the agency is properly licensed, bonded, and insured. Consumers should never hesitate to ask for proof.
A reputable company should readily provide documentation showing:
- State licensing
- General liability insurance
- Professional liability coverage
- Bonding information
This protects both the client and the caregiver in the event of accidents, negligence, or other issues.
Ask About Background Checks and Employee Screening
Inviting a caregiver into the home requires a tremendous amount of trust. According to NAOSA’s Home Care Consumer Guide, companies should conduct thorough employee screening and criminal background checks on all caregivers.
Families should ask:
- Are national and state criminal background checks performed?
- Are references verified?
- Are caregivers drug tested?
- How are caregivers supervised?
- What training is required before working with clients?
If a company avoids these questions or gives vague answers, consider it a major red flag.
Understand Liability and Employment Status
Consumers are often surprised to learn that some agencies classify caregivers as independent contractors rather than employees. This distinction can have significant legal and financial consequences.
NAOSA’s Gold Standards emphasize that agencies should assume liability for the actions of caregivers through proper insurance coverage. If a caregiver is classified as an independent contractor, the consumer may face greater difficulty recovering damages if something goes wrong.
Always ask:
- Is the caregiver an employee or independent contractor?
- Who is responsible if negligence occurs?
- What insurance protections are in place?
This protects both the client and the caregiver in the event of accidents, negligence, or other issues.
Watch for High-Pressure Sales Tactics
Ethical home care companies should educate families — not pressure them. Unfortunately, some providers use fear-based or rushed sales tactics to push families into quick decisions.
Warning signs include:
- Pressure to sign immediately
- Refusal to clearly explain pricing
- Vague service agreements
- Large upfront payments
- Claims that “this offer expires today”
NAOSA encourages consumers to work only with professionals who prioritize transparency and place the client’s interests first.
Review Reputation and Consumer Feedback
Online reviews should not be the only factor considered, but they can provide valuable insight into a company’s professionalism, responsiveness, and consistency.
Look for:
- Verified consumer reviews
- Complaint history
- Better Business Bureau information
- State regulatory actions
- Testimonials from families
NAOSA also recommends working with professionals who belong to organizations that enforce ethical standards and accountability.
Use the NAOSA Consumer Guides
The NAOSA Consumer Guides were created specifically to help consumers navigate complex industries and avoid scams and unethical practices. The Home Care & Assistance Guide outlines the key factors families should evaluate before hiring a provider, including licensing, caregiver screening, liability protection, and ethical business practices.
Unlike general online advice, the NAOSA guides are built around the organization’s Gold Standards of Professional Practice™, which are required standards for NAOSA members. Members who violate these standards may face censure or revocation of membership.
Why Ethical Standards Matter
In today’s marketplace, many unethical practices are technically legal — but that does not make them right for consumers. NAOSA was created to identify these gray areas and promote higher standards designed to protect older adults and families.
When evaluating a home care company, ask yourself:
- Are they transparent?
- Do they prioritize safety?
- Are they willing to answer difficult questions?
- Do they place the client’s needs ahead of profits?
The right company should make families feel informed, respected, and confident — never pressured or confused.
Final Thoughts
Choosing the right home care company requires more than comparing prices or reading advertisements. Families should focus on professionalism, transparency, accountability, and ethical business practices.
Before making a decision, review the NAOSA Consumer Guides and insist on the Gold Standards of Professional Practice™ designed to protect consumers. Taking the time to research and ask the right questions can help ensure your loved one receives safe, compassionate, and trustworthy care.
