A: Accredited (accreditation): Is the home health agency accredited by The Joint
Commission (JCAHO)? The Accreditation Commission for Home Care? CHAP (Community Health Accreditation Program)? This means the organization voluntarily sought accreditation and met national health and safety standards.

Licensed: Is the home health agency required to be licensed in your state? If so, are they? This means they have met certain standards set by a state or local government agency.

Certified (certification): If the home health agency is Medicare certified, it has passed an inspection survey done by a state government agency. Being certified is not the same as being accredited.

Background checks: It is extremely important that the agency conduct NATIONAL background checks on its employees. It is too easy to cross state lines and hide a criminal record. Do NOT compromise on this.

Before we get into the details about inspection reports and how to read them, I have a few disclaimers. First, while the agencies are evaluated by trained inspectors, please remember the inspectors are human, the patients/residents are human, and so are the staff at the organizations. Meaning, sometimes, people perceive things differently from each other. Furthermore, the quantitative standards used by Medicare only tell one side of the story. It is really hard to measure compassion and caring—both very important characteristics in home health aides.

Basically, I urge you to use both Medicare reports as guidelines, not the Holy Grail. They are extremely valuable tools in helping you determine the general level of quality of the facility. They tell you where the problems have occurred and how responsive the provider was in fixing the problems.

It is vital, however, that you think about what you are reading and evaluate whether or not a deficiency really presents a problem. Medicare does “risk adjust” to ensure agencies that serve older, frailer residents do not have much worse scores than those serving primarily “younger elderly.”