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Autumn 2026·7 min read·Bruce Tollefson

How to choose a home care agency in Minnesota

The questions that actually separate agencies, and two places you can check one yourself.

Why this article exists

By the time most families start calling agencies, the hard part is already behind them. Someone has decided that a parent needs help at home. What is left is a list of names that all say the same three things: compassionate, trusted, family owned. Half the websites use the same photograph of a younger hand resting on an older one.

If that list looks undifferentiated to you, it is because the marketing is undifferentiated. The things that genuinely vary between agencies are mostly invisible from the outside, and no amount of careful reading will pull them out of a homepage. You are not missing an obvious signal.

The questions below are the ones that find the differences, and there are two public records you can check yourself before anyone signs anything.

A note on what this is. This article is general information from a care provider. It is not legal, financial, or medical advice. Talk with your parent's physician about anything clinical, and with a qualified advisor about money, insurance, or legal questions.

What the license tells you

Every agency you call in Washington County will say it is licensed, and every one of them will be telling you the truth.

Minnesota licenses home care at two levels, under Minn. Stat. ch. 144A. A basic license covers assistive tasks: dressing, self-feeding, oral hygiene, grooming, toileting, bathing, standby assistance, medication reminders, and household work such as laundry and meals. A comprehensive license covers all of that plus the skilled side: the services of registered and licensed practical nurses, of physical, occupational, respiratory, and speech therapists, of dietitians and social workers, along with medication management, hands-on transfer assistance, treatments and therapies, and help eating for someone who has trouble swallowing.

So the license tells you the ceiling on what an agency is allowed to do, which is a different question from what it does well, or often, or at all.

Ask about the nurse

Under a comprehensive license, a registered nurse has real work to do, and the timeline is set in statute. The initial assessment must be completed within five days after services are first provided. Monitoring and reassessment must happen in the client's home no more than fourteen days after services start. After that, they follow changes in the person's needs and cannot exceed ninety days from the last assessment.

Those are floors. Ninety days is the longest an agency may wait, and plenty of people need eyes on them more often than four times a year. The law says nothing above that floor, which is where agencies differ from one another.

So ask plainly. Who is the nurse? Will we meet her? How often does she come to the house for someone with my father's needs? Who calls me when something changes on a Tuesday afternoon? If the answers come back soft, ask for the specific version: how many nurse visits did your longest-running client have last year? You are entitled to ask, and the answers should have numbers in them.

What "delegated" means

This word comes up in every sales conversation, and it carries more weight than it sounds like it should.

Minnesota lets a registered nurse delegate certain nursing tasks to unlicensed staff, but only to staff who are competent and possess knowledge and skills consistent with the complexity of the task, and the nurse must document the instructions in the client's record. Delegation is how a caregiver who is not a nurse can legally do work that started as nursing work.

So when an agency tells you its caregivers handle tube feeding, or a tracheostomy, or a BiPAP machine, the useful follow-up is three questions: who trained the caregiver who will be in the house, which nurse signed off, and where is it written down.

Ask for the clinical list in writing. The nursing side of Abloom Senior Living's in-home line covers tracheostomy care without a ventilator, G, J, and GJ tube feeding, BiPAP, CPAP and oxygen, two-person transfers, and dementia care. Any agency should be willing to put its own version on paper for you, with the things it does not take named as clearly as the things it does.

Ask who is actually coming

Once care is underway, the complaint families raise most often is the parade of unfamiliar faces. Your mother is being asked to let someone help her into the shower. Doing that with the same person every week is a different experience from doing it with a new person on Thursday.

Four questions get at this: How many different caregivers should we expect in a typical month? Who covers the shift when the regular caregiver is sick? Do we meet people before the first shift, or do they simply arrive? And what happens if my mother does not take to someone?

If an agency describes overnight coverage as live-in, ask what that means in practice. A caregiver who sleeps in the house covers a night differently from one who stays awake through it. Abloom Senior Living staffs overnight need as awake shifts and does not place caregivers to sleep in a client's home.

Background studies

Everyone connected to a licensed home care provider in Minnesota has to pass a background study: owners, managerial officials, employees, contractors, and volunteers, under Minn. Stat. 144A.476 and 144.057 and chapter 245C. Anyone disqualified under chapter 245C may not be involved in the management, operation, or control of a provider.

Because every licensed agency carries the same obligation, ask about practice instead. Does every person who will be inside my parent's house have a current study on file, including anyone brought in to cover a shift, and can you confirm it before the first visit?

Look the agency up yourself

The Minnesota Department of Health keeps two public tools that most families never hear about.

The first is the provider database, which lists licensed home care providers with addresses, administrator names, and current license status, searchable by name, city, county, or provider type and updated daily. Use it to confirm the agency in front of you holds a current license under the name it is trading under.

The second is the home care survey results page, which posts state inspection findings for a licensed provider.

One caveat. A clean record often means only that nobody has filed a complaint, and a smaller agency may not have been surveyed recently, so an empty page is not an endorsement. A single old citation is not a disqualification either. Read what is there and ask the agency about anything you find. The Office of Health Facility Complaints is where concerns about a licensed provider go if something goes wrong later.

What you should receive before care starts

Before the first visit, a home care provider must give you the home care bill of rights in writing, under Minn. Stat. 144A.44, along with a written statement of whether it holds a basic or comprehensive license and what that license authorizes.

No later than fourteen days after services begin, you should have a finalized written service plan. The statute sets out what belongs in it: the services and the fees, who provides them, how the work is monitored and who oversees the staff, and a contingency plan covering interruptions in service, emergency contacts, and how advance directives are handled.

Families skip the contingency plan and later wish they had read it, because it answers the 5 a.m. question of what happens when nobody comes. Our questions to ask a home care provider worksheet has the rest of the list, and you are welcome to take it to any agency, including ours.

If none of this arrives on its own, ask. Every item is something the agency owes you in writing.

When an agency should tell you no

An agency that says yes to everything on a first phone call is answering a sales question. Ask what they do not do. Every honest agency has a line somewhere: a clinical task they will not take, a payment source they do not accept, a level of need they will not try to cover at home with hourly shifts.

Abloom Senior Living's in-home line is private pay, and it works alongside long-term care insurance. It does not accept Minnesota waivers or Medical Assistance for in-home services. A family that needs waiver-funded care at home hears that on the first call, along with a referral to agencies that do take it.

Ask one more thing: what happens if home stops working? Needs at home usually grow, and you want to know whether the agency has thought past the arrangement it is selling you today. Abloom Senior Living keeps a five-resident home in Woodbury, which means a family already working with the in-home line does not have to begin again with strangers if the day comes.

What to do this week

None of this has to be settled today. If you want somewhere to start: call two or three agencies and ask about the nurse, the caregivers, and what they do not do; look each one up in the state database; and ask each for a written rate card and a sample of the service plan they would put in place. If you have not yet worked out whether care at home is the right step at all, start there instead.

Minnesota Aging Pathways, formerly the Senior LinkAge Line, will talk any of this through with you at no cost. It is a free statewide service of the Minnesota Board on Aging and the area agencies on aging, and nobody there is selling anything. Reach them at 800-333-2433.

If you would like our answers to the questions above, tell us about your parent's week and we will read it before we reply. You are also welcome to have us come to the house, or to come and see the home in Woodbury and ask whatever you like across the kitchen table. If Abloom Senior Living is not the right fit for your family, we will tell you so and point you toward someone who is.

Frequently asked questions

What is the difference between a basic and a comprehensive home care license in Minnesota? A basic license covers assistive tasks such as dressing, bathing, grooming, toileting, self-feeding, standby assistance, medication reminders, and household work. A comprehensive license covers all of that plus skilled services, including nursing and therapy services, medication management, hands-on transfers, treatments and therapies, and help eating for someone who has trouble swallowing. The license tells you what an agency may do rather than what it does regularly.

How can I check whether a Minnesota home care agency is licensed? The Minnesota Department of Health publishes a searchable database of licensed home care providers with current license status, updated daily, and a separate page of home care survey results where state inspection findings are posted. Both are free and open to the public.

Are home care caregivers in Minnesota background checked? Yes. Owners, managerial officials, employees, contractors, and volunteers connected to a licensed home care provider are subject to background studies under Minn. Stat. 144A.476 and 144.057 and chapter 245C, and a person disqualified under chapter 245C may not be involved in the management, operation, or control of a home care provider.

How often does a nurse visit under a comprehensive home care license? The statute requires an initial assessment within five days after services start and monitoring and reassessment in the home within fourteen days. After that, monitoring and reassessment follow changes in the person's needs and cannot exceed ninety days from the last assessment. That ninety days is a maximum rather than a schedule, so ask any agency what it does in practice.

What questions should I ask a home care agency before hiring? Ask who the nurse is and how often she comes to the house; how many different caregivers to expect in a month and who covers a sick call; who trained the caregiver for any clinical task and where that is documented; what the agency does not do and which payment sources it does not accept; and what the written service plan and contingency plan will say before care begins.

Sources

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