Most families don’t start looking for home care until something has already happened, like a fall, a hospital discharge, or finding out your mom hasn’t been taking her medication and nobody noticed for a week. By then, you’re calling home care agencies, and every one of them tells you they’re the right choice.
Here’s how to choose a home care agency in New York. We’ll start with the questions that separate agencies that run well from the ones that only sound good on the phone.
The short version: confirm the agency is licensed, ask whether caregivers are agency employees, find out how background checks, training, and matching work, read the care plan before care starts, ask what happens when a caregiver calls out, and get Medicaid details and fees in writing.
Is the Home Care Agency Licensed in New York?
Start by confirming that the agency is licensed or certified by the New York State Department of Health. Most agencies that provide personal care hold a Licensed Home Care Services Agency (LHCSA) license. You may also see the term CHHA (Certified Home Health Agency). CHHAs are Medicare-certified and can provide skilled services like nursing and therapy, while LHCSAs focus on personal care and home health aide support.
You can look up any agency, check its license type, and see inspection information in the DOH Home Care Agency Profiles directory. If you can’t find the agency there, ask them to explain why before going further.
Are Caregivers Agency Employees or Independent Contractors?
You should ask this early, because the answer decides who is responsible if something goes wrong. When an agency employs its caregivers, it handles workers’ compensation, taxes, and liability. If the caregiver is classified as an independent contractor, some of that can shift to you as the client. Employment also affects how much oversight the agency has over training and conduct.
Are Home Care Aides Background Checked?
At minimum you want criminal background checks. Some home care agencies also verify references and professional credentials, and some keep monitoring after a caregiver is placed, so ask which of those they do.
What Training Do Caregivers Receive?
Find out what’s required before placement and whether anyone supervises caregivers once they’re in the home. If your family member has a specific condition, such as dementia, Parkinson’s, or recovery from a stroke, check whether the home care agency has caregivers with experience in that area and how that factors into placement.
How Does a Home Care Agency Match Caregivers to Clients?
Some agencies send whoever is available. Better ones take time to understand a client’s routine, personality, and language preferences before they place anyone. Across New York, and in New York City in particular, language matters. If your parent speaks primarily Spanish, Chinese (Mandarin or Cantonese), or Haitian Creole, a caregiver who speaks the same language matters most on the days your parent is confused or in pain. Ask how the matching process works and whether language is part of it.
Can I Meet the Caregiver Before Care Starts?
Most reputable home care agencies will arrange a short introduction before the first shift, and it doesn’t need to be long. It gives your parent a chance to meet the person coming into their home, and gives you a chance to share anything the agency should know, like routines, preferences, or how your parent likes to be addressed. If an in-person meeting isn’t possible, such as when care needs to start right away, ask for a phone or video introduction instead.
What Should a Home Care Plan Include and Who Creates It?
A care plan should reflect your parent’s actual daily life: their schedule, their habits, what they need help with, and any medical considerations. Ask who develops it, whether someone does an assessment before care starts, and how often the plan gets updated as needs change.
What Happens When a Caregiver Calls Out?
Coverage gaps are one of the most common complaints families have about home care, and they tend to come up at the worst times. Ask what the agency’s backup process is, how quickly they can place a replacement, and whether you’ll find out in advance or at the last minute.
Who Can I Contact After Hours If There Is a Problem?
Find out whether a real person picks up after hours and who your consistent point of contact is. Some home care agencies assign a dedicated coordinator to each client, and others route everything through a general line, which can make a big difference when a caregiver hasn’t shown up and you need an answer quickly.
Does Medicaid Cover Home Care in New York?
Yes, it can. New York Medicaid covers home care, such as personal care and home health aide services, for people who meet its financial and medical requirements. Most people who qualify get those services through a Managed Long Term Care (MLTC) plan, a Medicaid program that arranges and pays for home care and other long-term services. You can read more in the NY State Department of Health’s MLTC overview. Since September 1, 2025, New York has also had stricter “minimum needs” requirements for personal care, so eligibility isn’t automatic. If you’re relying on Medicaid, confirm that the agency is enrolled and actively accepting new clients under the relevant program, and ask which MLTC plans it contracts with. If you have long term care insurance, ask whether the agency works with your insurer and what documentation they provide for reimbursement claims. Get rates, minimums, and any additional fees in writing so you know what to expect.
What If My Parents Don’t Have Medicaid?
Many families pay for home care privately, either because their parents do not qualify for Medicaid or because they need care to start before their Medicaid application is approved. If you are paying privately, ask the agency about its hourly rates, minimum hours per shift, and any additional fees, and get everything in writing. It is also worth asking how billing works, whether rates can change over time, and what the cancellation policy is.
True Care offers private home care in New York City, Westchester County, and Rockland County. If you would like to apply for Medicaid, True Care’s team can review your parents’ situation and help with the application at no cost. Contact us to get started.
Next Steps for Choosing a Home Care Agency in New York
If you’d like to hear how True Care answers these questions, we’ve provided home care across New York City, Westchester County, and Rockland County since 2009. Our care team can walk you through your coverage options and help with Medicaid applications at no cost. To learn more, visit our home care services page, or contact us and we’ll help you figure out the next step.
