Your first phone call with a home care agency is the only interview you get before a stranger walks into your home or a parent’s. A reputable agency answers every question on that call plainly, and it doesn’t mind hearing them twice.
Brent Auslander opened Preferred Care at Home of MetroWest Boston after visiting his grandmother in a Florida assisted living facility, where she wasn’t being kept clean. “I couldn’t believe it and thought, how could this be?” he says. That memory is why we’d rather families grill us than trust us on sight.
Choosing an agency starts with the list below, so keep it by the phone. Every question on it applies to any agency serving Framingham and the nearby MetroWest towns, ours included.
Who Screens Your Caregivers, and How?
Every caregiver we send passes a 7-step screen, from background checks and reference verification to a multi-touchpoint interview. Any agency you call should be able to name each step of its own without putting you on hold.
Put these to every agency on your list:
- What does your background check search, and how far back does it go?
- Who calls a caregiver’s references, and what do they ask?
- How much training comes before a first shift?
- Which caregivers are trained for memory loss?
The people we send are experienced and trained caregivers, including CNA and HHA professionals. Dementia and Alzheimer’s care is a signature service here, and our Dementia Care caregivers are trained in memory care approaches and behavior management.
If an agency’s answer is “they’re all very experienced,” call the next one.
Who Actually Employs the Caregiver?
IRS Publication 926 lists caretakers and health aides as household workers. The IRS says paying one household employee $3,000 or more in cash wages in 2026 triggers Social Security and Medicare taxes.
A worker an agency provides isn’t your employee when the agency controls what work is done and how it’s done. If you direct the work yourself, the IRS says that worker can be your employee even when an agency found them.
The question for any agency is whether its caregivers are its employees or independent workers it refers. Follow up with who withholds their taxes, and whose insurance pays if one slips on an icy front step.
Either setup can work, but you should know which one you’re paying for before the first visit. We’d cross off any agency that can’t answer in one sentence.
Insurance, Bonding and the New State License
The Massachusetts Legislature’s fact sheet on S.3170, An Act to Improve Massachusetts Home Care, describes a licensing process that includes fingerprinting and background checks. It also requires the state to post a list of licensed agencies online.
Unverified outfits can’t advertise as a home care agency without a license, so check that list once it’s posted. Insurance is the other half: request proof of liability coverage and bonding. Then ask for workers’ compensation, and auto coverage if the caregiver drives.
An agency that says “we’re covered” but won’t send the paperwork hasn’t answered you.
Who Checks on the Caregiver After Day One?
The last of our 7 screening steps is ongoing quality monitoring after a caregiver starts. You can also follow visits through the Transparency Room, our Transparency of Care portal.
Push any agency past “we check in regularly.” Who is the supervisor, by name? Is that person a nurse? How often do they visit the home, and can you read the caregiver’s notes from out of state?
A supervisor you’ve never met isn’t supervising anyone.
How the Care Plan Gets Written and Rewritten
We write each care plan after a consultation, then match a caregiver by personality and experience. Bilingual caregivers who speak English and Creole are available through our office.
This is non-medical home care, so a useful plan says exactly what the caregiver does and doesn’t do. Check five things in it:
- Who writes it, and whether you get your own copy
- Which Personal Care tasks it covers, such as assistance with bathing and dressing
- Where housekeeping and meal preparation fit in the week
- How your loved one’s routines and preferences are written down
- What triggers a review, like a fall or a hospital stay
A plan that lives only in the office’s computer is one you can’t check. Get it on paper, and request a fresh copy every time needs change.
The Sick-Day Question Most Families Forget
- Who covers an early-morning shift when the regular caregiver wakes up sick?
- Will the fill-in read the care plan before walking in the door?
- What happens when an ice storm closes the back roads out of Hopkinton?
- Does a person pick up late on a Sunday night, or a voicemail box?
The office has 24/7 availability for urgent needs, and care runs from 1 hour to 24 hours a day.
In MetroWest, New England winters are when backup plans get tested. Short days and icy driveways turn a missed visit into a real problem for someone who lives alone.
We’d rather explain our backup plan on the first call than improvise it during a storm.
Reaching the Office and Paying for Care
You’ll find our office at 945 Concord St in Framingham, and you can call (508) 375-7174 or email metrowest@preferhome.com. Good communication means someone calls you when a visit runs late, not the other way around.
Per Medicare.gov, Medicare’s home health benefit doesn’t pay for 24-hour care at home. It also skips personal care like bathing and dressing when that’s the only care you need.
Long-term care insurance can cover part of that gap, and we accept it. Any agency you’re considering should say plainly whether it bills your policy, and put its hourly rate and cancellation terms in writing.
Red Flags That Should End the Call
- Advertising as a home care agency while dodging questions about the state license the Massachusetts Legislature’s S.3170 creates
- No clear answer on who employs the caregiver or who withholds taxes
- Proof of insurance that’s always “on the way”
- A long-term contract before anyone has met your loved one
- A care plan that never makes it onto paper
- Nobody asking about your loved one’s routines, down to breakfast
- Pressure to start today and sort out the details later
Brent’s rule for our office: “If you are not happy, neither are we!”
Call our Framingham office at (508) 375-7174 and put every question on this list to us. Or use our Get Care Now form, and we’ll call you.
