Accreditation Q & A
1. What regulations apply to home care agencies in Massachusetts?
All businesses in Massachusetts are subject to regulation by the Secretary of State’s office. Additionally, all agencies that accept Medicare/Medicaid dollars are required to pass rigorous federal standards. However, Massachusetts does not have any specific regulations or standards for home care agencies that do not accept Medicare/Medicaid dollars. These agencies are also known as Private Care Agencies.
2. How are Private Care Agencies different from Medicare Certified Agencies?
They operate under completely different business models and offer different services.
Medicare Certified agencies can bill Medicare/Medicaid for their services, and many accept only Medicare patients. To qualify for Medicare reimbursement, patients must be 1) home-bound, 2) have skilled medical need requiring a nurse or other trained professional, and 3) have a doctor’s order verifying these first two.
Private Care agencies can not bill Medicare, but accept pay from a variety of other source, including private insurance programs, and out-of-pocket. Some Private Care agencies offer a combination of medically skilled and unskilled services, while others exclusively offer only non-medical. All of this gives private care agencies far greater flexibility than their certified cousins.
All other situations and circumstances must be paid through other means. This is where Private Care Agencies can help.
3. What standards must an agency pass to become Alliance Accredited?
To become accredited, an agency must meet fifteen specific standards concerning their business operations and caregiving staff. Agencies must:
- Provide clients with a written service agreement;
- Have procedures to respond to complaints and/or abuse;
- Directly employ & properly pay its staff;
- Properly train & supervise its staff;
- Be available 24/7 in case of an emergency;
- Conduct criminal background checks on all employees;
- Maintain general & professional liability insurance;
- Adheres to all other federal, state, and local laws;
The full standards are available for download. Only agencies that meet all fifteen standards are accredited.
4. How does an agency become Accredited?
Agencies can apply for Accreditation by submitting documentation to the Alliance that demonstrates their compliance with the Accreditation standards. The applications are carefully reviewed by staff of the Alliance. Accreditation is granted only after this rigorous review, and agencies are required to renew their accreditation at least every two years.
5. Who developed the Accreditation standards?
The standards were developed by a task force composed of private care agency directors from across Massachusetts. The task force members are all industry leaders with in-depth knowledge and experience in managing home care programs and who share a commitment to providing high quality services.
6. What about Private Care agencies that are not Accredited?
The Home Care Alliance's Accreditation program is entirely voluntary, so agencies are under no compulsion to participate. Also, any agency that is a member of the Home Care Alliance — whether accredited or not — must directly employ its workers and operate according to the Alliance’s Code of Business Ethics.
7. How do I know if an agency is Alliance Accredited?
A full list of accredited agencies is available on this website. All Accredited Agencies will be noted as such in the 2011 editions of our print directories, the Home Health Resource Directory and the Guide to Private Care Services. Accreditation is also indicated in the “Add’l Notes” section of each agency’s listing on our online Find An Agency search.
8. Can Medicare Certified Agencies receive Accreditation?
Yes. Medicare Certification is more rigorous than Alliance Accreditation, so you can reasonably assume that any certified agency would pass the Accreditation Program.
9. What is the Home Care Alliance of Massachusetts?
The Home Care Alliance of Massachusetts is a non-profit trade association that has promoted home care as an integral part of the health care delivery system for over forty years. To learn more about us, visit the About the Alliance page.