Home care
How to check on my elderly parent's caregiver
In September, Ohio’s attorney general announced indictments against eighteen Medicaid providers, most of them home-health aides. The charges read like a list of visits that could not have happened: billing while a client was in the hospital, while an aide was out of state, after a client had died. One of the cases did not come out of an audit. According to the release, one aide was charged after a client’s family members raised concerns about inconsistent care; investigators found she was routinely absent on days she billed, and the release says she told them she provided at most ten hours of care a week. These are allegations, and the release itself says the defendants are presumed innocent unless proved guilty. Still, the order of events is worth sitting with. The paperwork said the visits happened. The family noticed something was off.
What a family sees, and what the paperwork sees
A family sees the house. The milk that was or wasn’t bought, the pill organizer, the dishes in the sink, the way your mother sounds on the phone on a Thursday. That knowledge is real, and in that case it was the family that raised the alarm. What it misses is everything outside the hours you are there, and outside what your parent remembers well enough to tell you about.
The agency sees the paperwork: the schedule, the times the caregiver checked in and out, the care notes. For Medicaid-funded personal care and home health visits made in the home, a federal law, the Cures Act’s Section 12006(a), requires states to use electronic visit verification, so a check-in record of each such visit should exist. Federal guidance leaves out care from a caregiver who lives with the person, though a state can still ask for it. What that record holds is the caregiver reporting the visit. Our guide to verifying that a caregiver showed up makes the same point from the agency’s chair: a clock-in records a claim, and the bath, the meal and the medication are not in it. Neither view is enough alone. Put together, they tell you a good deal.
Four habits, in the order that pays off
- Visit at different times, and keep notes. A morning one week, an afternoon the next. Write the date, the time, who was there and what you saw. Your notes are the one record in this story that you author yourself, which is exactly why they are worth keeping.
- Ask the agency what record a visit leaves. Ask for scheduled and actual visit times, the care notes, who supervises the caregiver, and how often a supervisor comes by. Then ask the question that tells you most: if I named a date, how would you show me what happened that day?
- Ask your parent, and listen for patterns. One bad afternoon is a bad afternoon. The same missed lunch three weeks running is a pattern, and patterns are what an agency can act on.
- Know who to call when it is bigger than a missed visit. If you believe your parent is in danger, call 911. For everything else, the Eldercare Locator, a public service of the Administration for Community Living, connects older adults and their families with services where they live.
| Check | What it shows | What it leaves open |
|---|---|---|
| Dropping by | How the home and your parent look that day | Every day you are not there |
| Asking your parent | How the care feels to them | Memory, and reluctance to complain |
| Care notes | What the caregiver says they did | Written by the person being checked |
| EVV clock-in and clock-out | When a check-in was made, and often where | Which tasks were done |
| A live photo of the task, timed by the server | A live-camera photo, with the time set by the server on arrival, and location if the caregiver shares it | Where it was taken, unless location is shared, and whether the care was done well |
What a better visit record looks like
An agency can add one thing to a visit: a picture of the task once it is done, sent through a texted link. LockProof, field work verification software for home care agencies, property managers and field service teams, works that way. The caregiver installs nothing. Tapping the link brings up the camera and keeps old pictures out of reach, so each one is taken live. The server stamps the time when the picture arrives instead of believing the phone’s clock, and GPS coordinates are added if the caregiver lets the phone share location. A SHA-256 fingerprint seals the record; if anyone altered the picture, the recorded time or any coordinates afterward, the seal would stop matching, and the change would show.
For a family, the useful part is that the agency can send a record as a link. Anyone can open it without signing up for anything, and it stays live for seven days. It shows the photo, the site and the server-set time, rather than a line on a timesheet. It does not tell you the care was kind or thorough; a photo shows a task was there to photograph, not how it was done. That part still belongs to your own eyes and your parent’s voice. The longer agency-side version of this argument, written for an agency facing a complaint, is our piece on proving a contested home-care visit, and the home care page shows how agencies set it up.
The feeling, and the record
As the release tells it, the family had a sense that the care was inconsistent, and they said so. That instinct is the most important check on this page, and nothing here replaces it. What a good record does is give the instinct something to stand on: a date, a time, a task, a photo, so the conversation with the agency starts from what happened rather than from who sounds more certain. If you want to understand the rules behind those records in your parent’s state, the EVV requirements by state page links each state’s primary sources.
Common questions
How can I check on my elderly parent's caregiver when I can't be there?
Ask the agency what record each visit leaves, then compare it with what you see when you do visit. Request the scheduled and actual visit times, the care notes, and who supervises the caregiver. Keep your own dated notes. When the three sources agree, you have reassurance; when they don't, you have specifics.
Can I ask a home care agency for records of the visits?
Yes, you can ask, and a good agency expects the question. What it can share depends on its systems, its policies and who is authorized on your parent's account. For Medicaid-funded personal care in the home, federal law requires electronic visit verification, so a check-in record should usually exist. A caregiver who lives with your parent may be exempt.
What should I do if I think the caregiver is skipping visits?
Write down the dates and what you noticed, then take it to the agency's care manager or supervisor and ask to see the record for those specific days. Patterns carry more weight than a single bad day. If you believe your parent is in danger, call 911 first.
Is a caregiver's clock-in proof that the visit happened?
A clock-in records that a check-in was made, by the caregiver, at a time and sometimes a place. It is the caregiver reporting the visit. It does not show which tasks were done. A record made when the task is finished, timed by a server rather than a phone, says more about the visit.