Some shifts in a home are full. Others are long stretches where the caregiver is in the house, nothing needs doing, and the clock keeps running. Before you compare rates, find out which of those hours you pay for and what the bill calls them.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Step 1: Map the waiting hours

Write down one normal day in the house. Mark each block as a task (a meal, a transfer, a walk, a call to the family) or a wait (the parent is asleep, the parent is out with a family member, the caregiver is waiting for a delivery to arrive). Add up the wait blocks. That is the number you are pricing, not the task hours alone.

Write here: Task hours per shift: ____ Wait hours per shift: ____

Step 2: Ask whether a waiting hour is a billed hour

  • Is every hour of the scheduled shift billed at the shift rate, including hours with no task?
  • Is there a separate standby or on call rate, and what starts it?
  • If the parent goes out and the caregiver waits in the car, is that time billed?
  • If the parent is asleep and the caregiver is in the house and ready, is that time billed?

Listen for a rule that names the rate for waiting time, the event that triggers it, and who decides when a wait begins. A usable answer sounds like this: waiting time inside the scheduled shift is billed at one stated rate, and standby time is billed at another stated rate and only starts when you call them in. An answer that depends on how the day goes, with no example, is not a rule yet.

Step 3: Check the clock rules

  • Does billing start when the caregiver leaves their home, or when they walk through your door?
  • Is time rounded, and if so, to what unit?
  • Who writes the start and stop times, and can you see them each week?
  • If the shift ends early because the parent is out, is the rest of the block still billed?

Write here: Billing starts at: ____ Rounding unit: ____ Start and stop record kept by: ____ Family can see it: yes / no

Step 4: Get the answer on the page

Ask the provider to put the waiting rule, the standby rule, and the clock rule in the quote or the service agreement, not only in a phone call. Line up each provider's written answers side by side, so the comparison is between the same terms. The Start Here: Five Steps to Hiring page lays out the order for the rest of the decision. For how this desk treats each claim, see How We Write the Sheets.

Signs to walk away

  • The waiting rule is 'it depends' with no example given.
  • The bill charges for hours the caregiver was not in the house, and no written reason is given.
  • Rounding always moves up, and no unit is stated.
  • Standby charges start without your call and cannot be switched off.
  • The start time for the clock is not written anywhere you can read.

What to write down

Keep one page with your task hours and wait hours per shift, the answers to the four billing questions in Step 2, the clock answers from Step 3, and the page or section of the written terms where each answer appears. When the first bill arrives, compare its hours against your start and stop record before you pay it.