Red flags when hiring a home caregiver

Sheet 12 · Walk away if

Published September 11, 2026. Desk byline, no clinician. Every fact links to its source.

A red flag is not a feeling. It is an answer you cannot write down. Red flags when hiring a home caregiver are the blanks on the pad after the call in St. Louis County, not a vibe from a website. Print this page. Mark each flag as it happens. This desk does not score a company, including the paid placement at the bottom.

The National Institute on Aging tells you to get as much information as you can about a service before you sign an agreement. Family Caregiver Alliance says always check references, always do a background check, ask to meet the person, and request a packet that describes services, fees, and a list of references. FCA’s own line on gut is allowed here as a question of comfort, not as a medical claim: if you feel uncomfortable about a screening procedure, the tip sheet says it may be best to use a different provider.

What are red flags when hiring a home caregiver?

Nine answers you cannot write down. One is enough to keep looking.

1. They will not say how they screen

   How do you screen, at this company, in this state? What background check, which registry, which references?

   FCA says ask about caregiver background checks and what methods they use, and ask about training. In Missouri, ask whether they use the Family Care Safety Registry. Walk away if They will not say what they check, or “we handle that” is the whole method.
2. They will not give an after-hours number

   What number do I call after hours, who picks it up, and how long until someone is in the house if my parent cannot be left alone?

   Write the number while they are still on the line. Call it once before you need it. Walk away if “Leave a message” is the whole after-hours plan, or they will not give you a number until you sign.
3. They will not let you meet the person

   Can I meet the caregiver before the first shift?

   FCA says ask to meet potential caregivers and talk about a care plan, and to be present at first. Walk away if A stranger will just show up, and there is no plan on paper.
4. They treat Missouri’s three types as a trick

   Which of Missouri’s three types of care in the home are you? Home health, Medicaid in-home care, or private duty and private pay?

   DHSS says no license is issued in Missouri for private duty and private pay companion and personal care. Home health is a different type and requires a state home health license. Walk away if They blur home health and companion hours into one product, or they will not say which type they are.
5. They want health details in a web form

   What do you need from me before anyone comes to the house, and where does that information go?

   A fridge sheet in the kitchen is a handoff. A form that wants diagnoses and medications before you have a packet is not. NIA’s getting-started list is the job: personal care, household tasks, food, transportation. Walk away if They will not talk until a web form is full of health information, or they will not say who sees that form.
6. They push you to skip references

   Who can I call this week who saw the work?

   FCA says always check references. Ask about care competency, compassion, and reliability, in FCA’s words. You place the call. Walk away if They stall, they give only a friend, or they tell you not to call.
7. The person will not register with the Family Care Safety Registry

   Are you registered? If you are a company, do you use FCSR, and can I see that the worker is registered before the first shift?

   DHSS says people who will care for children, seniors, or disabled persons must register with the FCSR. An employer can request a background check. A person who will not register cannot be screened through that registry. Walk away if They will not register, the company will not say whether it uses the registry, or a check “was fine” with no paper in the folder.
8. They want a signature before the packet

   What is in the agreement before I sign: duties, hours, backup, who employs the worker, how either side ends it?

   FCA says request a packet that describes services, fees, and a list of references. Read it. This sheet still does not print a rate. Walk away if They want a signature before you have seen the paper, or the paper will not name backup or duties.
9. “It has never happened” for a no-show

   If the caregiver does not arrive, who comes, from where, and what time should I expect them?

   FCA says an agency can provide a substitute if a worker is sick, and that if the person cannot be left alone, coverage for absences must be clarified before care starts. Walk away if They tell you it has never happened, or that you should call a neighbor.

FCA also says to evaluate supervision, including drop-in visits, and whether the agency supervises its employees on a regular basis at the care recipient’s home. “We trust our people” is not a supervision plan. If you hired and it is already not working, that is a different sheet.

What if they will not use the Family Care Safety Registry?

Stop. The registry is the background check Missouri built. DHSS says people who will care for children, seniors, or disabled persons must register. An employer can request a background check through the FCSR and use the results to choose who to hire. If you are hiring on your own, you are the employer in that sentence. A worker registers first: online, which DHSS prices at $15.00 plus a $0.55 processing fee, or a mailed form. Those figures are the state’s worker-registration fees, not a care rate. If the person is not registered, they cannot be screened through FCSR until they are.

DHSS says the FCSR checks seven sources of Missouri information: Highway Patrol criminal records, the sex offender registry, child abuse and neglect records, the DHSS Employee Disqualification List, the Department of Mental Health Employee Disqualification Registry, child-care facility licensing records, and foster parent licensing records. It is Missouri data only. There are three ways to request a check: by calling 866-422-6872 weekdays between 9:00 a.m. and 3:00 p.m. except state holidays, by mailing the Employer Background Screening Request form, or through online access after submitting needed forms. A registry check is not a license. Fill the blank or walk.

Who do I call in Missouri if I already suspect abuse or neglect?

This page does not accuse anyone. It does not invent a story and it does not print a crime statistic. If you already suspect mistreatment, you are past the hiring pad. The National Institute on Aging says that if you suspect an older person is being mistreated, family and friends must step in and report what you see to an authority.

Call Missouri’s Adult Abuse and Neglect Hotline. DHSS prints the number as 1-800-392-0210 (Relay Missouri 1-800-735-2966), with hotline hours 7 days a week from 7:00 a.m. to 8:00 p.m., and reports can also be made online at moapss.health.mo.gov. The Attorney General’s seniors page prints the hours as 7 a.m. to Midnight. DHSS prints 7:00 a.m. to 8:00 p.m. This desk quotes both pages. It does not pick a winner. Call the DHSS number for an abuse or neglect report. Call local police for a theft.

Missouri statute defines an eligible adult as a person 60 years of age or older who is unable to protect his or her own interests or adequately perform or obtain services necessary to meet essential human needs, or an adult with a disability between ages 18 and 59 in the same situation. If you have reasonable cause to suspect, you call. For a billing or contract dispute, the Attorney General mediates complaints between businesses and consumers and prints a Consumer Protection Hotline at 1-800-392-8222.

FCA’s hiring sheet is blunt about the house while you are still learning the person: lock up or take out heirloom jewelry, and keep track of cash, checks, and credit cards. That is prudence, not an accusation, and it is not a statistic. Do it before the first shift. If cash is already missing or jewelry is not where it was, treat it as a possible crime and as a possible adult-protective issue. Tell the office the same day you call the police or the hotline. If you need a different door for services: the Eldercare Locator at eldercare.acl.gov or 800-677-1116, Aging Ahead for the county, and the St. Louis Area Agency on Aging for the city. Those are directories. They do not rank companies.

What to do tonight

1. Print this page. Mark any flag you already heard this week.
2. Call the after-hours number they gave you, tonight, to see who picks up. If they never gave one, that is flag two.
3. Ask, in writing, whether they use the Family Care Safety Registry. Write the answer or write “would not answer.”
4. Do not sign anything until the packet is in your hands.
5. Lock up or take out heirloom jewelry. Keep track of cash, checks, and credit cards. If you already suspect abuse or neglect, call 1-800-392-0210.

When to ask the care team or the doctor

Which tasks need a nurse, whether a parent is homebound, and whether home health is in the plan are questions for the physician. Do not let a sales call decide them. A sudden change in confusion, walking, eating, or mood can look like a hiring problem and be a medical problem. Call the physician who treats them. Clinical questions leave this page.

Featured, and paid for

New Plan Care

New Plan Care is independently owned non-medical in-home care, Chesterfield, serving Ballwin, Chesterfield, Eureka, Glencoe, Grover, Pacific, Valley Park and St. Louis. Put every walk-away line on this page to them before anyone comes to the house. Call (314) 405-0887. This desk does not score the call.

New Plan Care pays for this spot. It is a client of OwnersFirm, which publishes this site, so read it as an advertisement with a phone number rather than as a result, a rank or a recommendation drawn from any of the articles on this page.

Next sheets

• Missouri Family Care Safety Registry: how to check a caregiver
• What to do if the caregiver is not working out

Sources opened 11 September 2026. Full list on the sources page.