The Home Care Intake Process: What to Expect at Your First Meeting

What Is the Intake Process?#

Before home care services begin, you'll go through an intake assessment. This meeting determines:

• What care services you need
• How many hours you qualify for
• Who will provide the care
• Your care plan and goals

Whether you're working with a private agency, Medicaid program, or insurance-based care, the process is similar. Here's what to expect.

Timeline Overview#

Step	Who	When	Duration
Initial call	Care coordinator	Day 1	15-30 min
Intake assessment	RN or case manager	Days 1-7	1-2 hours
Care plan development	Care team	Days 2-10	N/A
Caregiver matching	Agency	Days 3-14	N/A
Care begins	Caregiver	Days 7-21	Ongoing

Private-pay agencies move faster (often care within 24-48 hours). Medicaid programs move slower (2-4 weeks is common).

The Initial Phone Call#

Your first contact is usually a phone screening:

What They'll Ask:#

• Basic demographics (name, address, DOB)
• Who needs care and their general condition
• What type of help you're looking for
• How you heard about them
• Insurance/payment information
• Urgency of need

What You Should Ask:#

• Are you licensed and insured?
• What services do you provide?
• What areas do you cover?
• What's your availability?
• What's the cost structure?
• How soon can we schedule an assessment?

Red Flags:#

• Won't provide license information
• Avoids questions about background checks
• Pushes for commitment before assessment
• Can't explain their process clearly

The In-Home Assessment#

This is the critical meeting. An RN, care coordinator, or case manager visits to evaluate care needs.

Who Should Be Present:#

• Required: The person needing care
• Strongly recommended: Primary family caregiver or decision-maker
• Helpful: Other family members involved in care
• If applicable: Current caregiver, healthcare provider notes

What They Evaluate:#

Physical Assessment:

• Mobility (walking, transfers, balance)
• Personal care abilities (bathing, dressing, toileting)
• Eating/swallowing
• Medication management
• Chronic conditions and their management
• Fall risk

Cognitive Assessment:

• Memory and orientation
• Decision-making ability
• Communication skills
• Behavioral considerations
• Safety awareness

Home Environment:

• Layout and accessibility
• Safety hazards
• Equipment needs
• Where care will be provided

Social/Support Assessment:

• Current support system
• Family involvement
• Community connections
• Emergency contacts

Common Assessment Tools Used:#

Tool	What It Measures
Katz ADL Index	Activities of daily living (bathing, dressing, etc.)
Lawton IADL Scale	Instrumental activities (cooking, finances, etc.)
MMSE/MoCA	Cognitive function
Fall Risk Assessment	Likelihood of falls
Braden Scale	Skin/pressure sore risk
PHQ-9	Depression screening

Questions They Will Ask#

About Daily Activities:#

• Can you bathe yourself without help?
• Do you need assistance getting dressed?
• Can you use the toilet independently?
• How do you prepare your meals?
• Can you do your own laundry?
• How do you manage your medications?
• Can you drive or use transportation?
• Do you handle your own finances?

About Health:#

• What medical conditions do you have?
• What medications do you take?
• Have you fallen in the past year?
• Have you been hospitalized recently?
• Do you have any pain? Where?
• How's your appetite?
• How's your sleep?
• Do you have any allergies?

About Memory/Cognition:#

• What day is it today?
• Where are we right now?
• Can you remember three words I'll tell you?
• Do you have trouble finding words?
• Have you gotten lost in familiar places?

About Home and Safety:#

• Do you feel safe at home?
• Are there stairs? Can you manage them?
• Do you have grab bars in the bathroom?
• Is there someone you can call in an emergency?
• Do you have working smoke detectors?

About Preferences:#

• When do you like to wake up?
• What time do you prefer to shower?
• Do you have any dietary restrictions or preferences?
• Do you have pets?
• Do you smoke?
• Are there things you definitely want/don't want in a caregiver?

How to Prepare#

Documents to Have Ready:#

• Insurance cards (Medicare, Medicaid, private)
• List of current medications (with dosages)
• Recent medical records or discharge summaries
• Primary care physician contact information
• List of diagnoses
• Power of attorney documents (if applicable)
• DNR/POLST if exists
• Previous care plans (if any)

Information to Know:#

• Complete medical history
• Hospitalization dates and reasons
• Current therapies (PT, OT, speech)
• Specialist appointments
• Daily routine preferences
• Likes and dislikes
• Cultural or religious considerations

Environment Preparation:#

• Have good lighting in the main living areas
• Clear a space for the assessor to sit
• Don't "clean up" safety hazards—they need to see reality
• Have the person wear regular daily clothes (not dressed up)

Honest Assessment:#

Don't minimize challenges. The intake assessment determines your care level. If you downplay difficulties:

• You may get fewer hours than needed
• Care plan won't address real issues
• Safety risks go unaddressed

Be honest about:

• Bad days vs. good days
• What family is actually doing now
• Safety concerns
• Behavioral issues

After the Assessment#

Care Plan Development#

Based on the assessment, the agency creates a care plan including:

Goals:

• Short-term objectives (e.g., safe transfers within 2 weeks)
• Long-term goals (e.g., maintain independence at home)

Services:

• Specific tasks caregivers will perform
• Frequency and duration
• Who is responsible for what

Schedule:

• Days and times of service
• Number of weekly hours
• Caregiver rotation plan

Caregiver Matching#

Agencies match you with caregivers based on:

• Skills needed for your care
• Personality compatibility
• Schedule availability
• Location proximity
• Language/cultural preferences
• Specialized training (dementia, etc.)

You should be able to:

• Meet the caregiver before they start
• Request a different caregiver if not a good fit
• Provide feedback on matching preferences

What Affects Your Care Hours#

For Private-Pay:#

You decide hours based on:

• Budget
• Care needs
• Family availability
• Physician recommendations

For Medicaid Programs:#

Hours are determined by:

• Assessment scores (ADL/IADL limitations)
• State-specific algorithms
• Available funding
• Program caps

You can appeal if you think hours are insufficient.

For Insurance/Medicare:#

Coverage depends on:

• Medical necessity
• Type of policy
• Skilled vs. non-skilled needs
• Prior authorizations

First Day of Care#

When your caregiver arrives for the first time:

Expect:#

• Introductions and getting to know each other
• Tour of the home
• Review of the care plan
• Going over daily routines
• Emergency procedures
• Communication preferences

Have Ready:#

• Written care instructions
• Emergency contact list
• Medication list with schedule
• Keys or access codes
• Parking information
• WiFi password (if needed for documentation)

First Week Goals:#

• Establish routine
• Build rapport
• Fine-tune the schedule
• Address any concerns immediately
• Confirm communication channels

Common Intake Concerns#

"What if I don't like the caregiver?"#

Every reputable agency allows caregiver changes. Speak up early—good fit matters for long-term success.

"What if my needs change?"#

Care plans are reassessed regularly (typically every 60-90 days or after hospitalizations). You can also request reassessment anytime.

"What if I qualify for fewer hours than I need?"#

Options:

• Appeal the decision (Medicaid)
• Supplement with private-pay hours
• Explore additional programs (VA, state assistance)
• Adjust care plan priorities

"What if the agency is unresponsive?"#

Red flag. Good agencies communicate clearly. If you can't reach them during intake, imagine during an emergency. Consider other options.

The Bottom Line#

The intake assessment is your foundation for successful home care. Come prepared, be honest about needs, and don't hesitate to ask questions.

A thorough intake means:

• Care matched to actual needs
• Caregivers prepared for the situation
• Fewer surprises and adjustments later
• Better outcomes for everyone

Take it seriously—this meeting shapes everything that follows.

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