Are Home Care “Minimum Standards” Good Enough for My Parents?


In California, there are two main types of “certifications” for non-medical home care companies: CAHSAH and ABHC.  Both certifications serve as guides for families when choosing an in-home elderly care company for their older loved ones.  Both certifications use their own set of “minimum standards” for certification.

Those minimum standards are necessary but not sufficient when families are deciding which company to select to provide trustworthy care for their older loved ones living at home, and families should use additional criteria and standards besides those minimum standards when selecting in-home care companies for their parents.

Certifications vs Licensing

California does not provide licensing, regulation or any other sort of oversight regarding non-medical in-home care companies.  Because of that, it is easy to start an in-home care business.  There are already thousands of in-home care companies in California and there are more new companies entering the market every day.

In the absence of governmental oversight, those companies are free to follow any standards they choose to follow, and they often follow no standards at all.  There is no guarantee that the company that families select to provide in-home care will protect their frail and vulnerable elderly clients.

In response to this situation, independent, non-governmental standards for “certification” have been created by two completely different (and somewhat competing) organizations, CAHSAH and ABHC.  Each of those organizations has established its own set of “minimum standards” for certification, and while those two sets of standards are somewhat different from each other, they are in other ways similar.  We have written about the differences between the two standards in an article titled “Does It Matter How My Parents’ Home Care Company is Certified? on our website.

Minimum Standards – Necessary but not Enough

So what are these “minimum standards” that CAHSAH and ABHC utilize when certifying in-home care companies?  Well, the details for those programs’ minimum standards are described in detail in our article mentioned above so we won’t repeat them here.  They do indeed address some important concerns such as whether or not the caregivers are employees of the companies instead of the clients or the clients’ families.

The problem is, those “minimum standards” are not sufficient standards by themselves.

In other words, those minimum standards address some but not all of the concerns that families must consider in order to make a careful, thoughtful and thorough decision in selecting the best in-home care company for their older loved ones.  Therefore families should use a more comprehensive list of standards when selecting an in-home care company for their parents.

For example, families should ask whether the in-home care company that they are considering does the following things that are not included in the CAHSAH and ABHC minimum standards:

  • Require that new caregiver applicants have experience or training before they are hired.
  • Conduct bona-fide, in-person interviews and skills testing before hiring new caregivers.
  • Prepare and maintain a current written plan of care for each client, containing specific types of information necessary for routine matters and for emergencies.
  • Make supervisors available to both consumers and workers on a 24/7 basis for support and emergency assistance.
  • Maintain an emergency evacuation plan for each client for whom the home care company is providing at least 8 hours per day of service.
  • Provide an appropriate level of supervision, including unannounced supervision / quality control visits.
  • Ensure that the caregivers who work with its clients have the necessary language skills to safely provide care for each client, taking into account each client’s own language skills.
  • Offer continuing education or training to its caregivers.

For a more complete list of all the questions that families should ask when choosing an in-home care company for their elderly loved ones, see the Checklist For Choosing A Home Care Company on our website.

Tim Colling
Tim Colling

Tim Colling is the founder and President of A Servant's Heart In-Home Care, which provided in-home caregiving services in San Diego County, and also of A Servant's Heart Geriatric Care Management, which provided
professional geriatric care management services and long term care placement services in San Diego County. Tim has more than 30 years of experience in management in a variety of industries. He held a Certified Care Manager credential from the National Academy of Certified Care Managers. Tim is also a Certified Public Accountant (retired), and received his Bachelor’s Degree in Accounting from California State University at San Diego. In addition to writing blog posts here for the Servant’s Heart blog, Tim also is a regular contributor to and to as well as blogs of other eldercare services provider companies. Finally, Tim is also the president of A Servant's Heart Web Design and Marketing, which provides home care marketing as well as website design and online marketing for those who serve the elderly and their families.

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