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I'm in the process of working out a private duty schedule beginning Saturday, after having resolved a lot of other issues. At last - we can get started! However, I just learned during the assessment that "home visit" charges are applied, in addition to the hourly rate for the worker. These charges apply to all levels of service, for every visit, graduating from around $40 for home care assistance up to $115 for a nursing visit (PLUS the hourly rate). ie, a CNA (which is in the care plan I developed) would be $27/hour x 3 hours (the minimum) = $81 plus a $97 house call, for a total of $178, for each visit. I called probably a dozen private duty companies when I was searching but NONE mentioned anything about house calls in addition to an hourly rate. Any quick advice would be very much appreciated. For those who've used private duty, are these home visit fees typical? Thanks for any input; I need to literally change the plan of care by tomorrow and really need to know if others have experienced these "tack-on fees."

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CM, I haven't checked websites recently, but I did when I begin searching last June, and documented all my calls. None mentioned any other fees besides the flat rate hourly fee and mileage for chore or appointment trips.

But, in retrospect, that doesn't mean that the situation would change once we got farther in negotiations. So, I only have baseline quotes by which to compare.

The only mention of travel issues were general comments that attempts are made to find staffers within a general area, or that the company wants to maximize the number of clients that can be served by keeping caregivers within specific geographic area.

Whenever the issues of travel and distance were discussed, the comments were generally that workers close by are preferred.


Igloo, since I had spent so much time with this company and was pleased to find one which so suited my needs, I was really reluctant to change, and hoped to work out a compromise.

I did think about a short test, trial period, but after posting and speaking again with the assessment nurse, I began to get a different "vibe." I realized they really weren't interested, even though the home office was.

I've deal with 2 different levels of the company, in separate geographic areas. There has always been a distinct difference between the branches, with the assessment done by one that isn't quite to the standard of the home office.

I thought they really would want my father as a client, but as I discussed the issue later in the day after posting here, I was shocked to detect that it didn't seem to make any difference to them one way or the other.

Thinking it over, this local branch doesn't seem to participate in critical decisions beyond deciding on clientele; everything else is referred to the home office. I did have the impression a few times that there was resentment over the levels of responsibility. There may be some issues going on which extend beyond who to accept as a client, and I suspect this is the only way in which the branch participates.

So, as I do when I'm frazzled, I reread both your answers repeatedly, tried to think of alternate courses of action, looked at a few garden magazines, dreamed of masses of irises and daylilies blooming in late spring, and cleared my head to make a decision.

I contacted another well known company, we met for an assessment and the approach was so totally different that I realized I had been impressed with the first company ONLY with the home but not the branch office. And it wasn't the first time I had misgivings about the locals.

This second company can "move on a dime", and did so. We met, discussed a variety of issues and contingencies, I signed the contract, making a few changes while doing so. They're now in the process of finding someone, hopefully for tomorrow. The other company said they'll just wait until I decided what to do - NO attempts whatever to negotiate! Just take it or leave it.

In reviewing my notes, I recalled that the first company wouldn't even agree to charge batteries on the medic alert pendant, and most definitely not the oxygen batteries. I was also advised that they would NOT even change filters on the HEPA air filter, which to me isn't more complicated than changing bags on a vacuum cleaner.

I saw the signs, but I was so impressed by the home office and assuming that it had jurisdiction that I suppressed them. Lessons learned.

Thanks to both of you for taking the time to help me, put things in perspective and move to make a good decision.
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Garden - that’s kinda steep...... however since it’s Thursday and this is to start this Saturday (right?) and you’ve already spent considerable time & research to get the “ fit” right for dad, I’d go ahead and give it a 7 or 10 day trial. And monitor what staff and back office is doing & by time. Then ask for serious reduction of the “home visit” fees.

Negotiation time. Their going to want dad as a client and your going to want to keep this caregiver group that does things along the system you’ve developed. Bet they’ll reduce costs once a pattern of time is determined.
Good luck!
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Can you check on the alternative companies' websites and see what they say about call-out charges?

Whether they're reasonable or not I suppose depends on how far the staff have to travel, and whether it's a standard fee or sliding scale?
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