As some of you know, I've been looking for a private duty company to provide nonmedical home care, focusing on dysphagia support, with some minor housekeeping tasks. I'm amazed at what I'm learning, and am also becoming discouraged because I feel as though there are a lot of agencies with minimum qualifications but an intent to get as much as they can from the family. I'm beginning to realize this might be a real boon for companies that want to target the senior population, and which feel they have the upper hand b/c they're providing the services.
So I'm interested in other's experiences, especially on these issues:
Fee for "assessment" ranges from $75 to $200. This includes "assessment" of the patient, ADL needs, what they feel is necessary, etc. I find $200 to be pretty steep.
Deposits; most require 2 weeks deposit, which isn't held in an interest bearing trust account and is allegedly either refunded on termination of service or used as the last 2 weeks of service. If hours are changed or increased during the term of care, the deposit is increased accordingly. Has anyone had any difficult getting their deposit returned?
Although these agencies have highly qualified staff (according to their websites), they would need training on pureeing food for dysphagia management. I would be training staff, apparently being paid for and their hourly rates charged to me. Essentially, I would be paying to train them. Maybe I should plan to hire out my services to train their staff?
Many are franchise operations, but the individual ones have authority to determine whether or not to take charge, which many don't. They require weekly or semiweekly payments either by check or cash. No way do I pay anyone in cash!
Background checks can be done to state level, or more thorough ones to the federal level. If only to the state level, I wonder how they might identify someone like some of the scammers I've read about here who move to different states. I'm not particularly comforted by this.
Service agreements are onerous, sometimes restrictive, and always in favor of the company to the point that there's no balance of equality of standards or obligations. E.g., one company requires several days written notice of termination but it can terminate w/o any previous notice at all. Has anyone ever had to invoke contract provisions, or been penalized for alleged violations of terms?
Liability of workers is capped, in one case at $1,000 for all incidents, not only for the workers but for the staff of the company which doesn't even participate in the home care work. In another, liability doesn't exist at all.
Have any of you ever taken action against companies you hire, for whatever reasons? It might be that a really good company isn't going to generate any liability, but I don't like waiving recourse before care even starts.
Any other concerns, advice, suggestions for an equitable relationship with a private duty firm?
Thanks for any thoughts, suggestions, recommendations, etc.