Finding reliable home healthcare agencies near me often happens at the worst possible moment, like after a hospital discharge or when a family caregiver is stretched thin. This practical guide gives a short, actionable checklist to compare services, verify licensing and staff credentials, interpret reviews and complaints, and evaluate costs and funding so you can shortlist safe, competent providers quickly. You will also get call scripts, an in-person visit checklist, and a simple scoring matrix to make the final choice with confidence.
How to search for home healthcare agencies near me and shortlist candidates
You can build a credible shortlist in an afternoon by running three parallel searches: map listings, clinical referrals, and official registries. Use each source to cross-check names, then narrow to five candidates you will call and vet directly.
Search channels to use right now
Fast channel: Start with Google Maps using the query home healthcare agencies near me, then filter by proximity and recent reviews. Clinical channel: Ask the hospital discharge planner or the patient’s primary care clinic for their top three local referrals. Registry channel: Verify Medicare certification on Medicare Care Compare and check state license lookups if available.
- Collect five names from the three channels (map + clinical + registry) and add anything that appears on at least two sources.
- Record license or Medicare certificate numbers during the first call to speed verification.
- Flag agencies that explicitly state they handle your immediate need (palliative care, post-surgery skilled nursing, Passport funding support).
Practical tradeoff: National brands are reliable for standardized onboarding but may have less scheduling flexibility. Local providers often bend on shift timing and trial visits, but you must verify clinical oversight and insurance coverage more carefully.
Concrete example: A family arranging post-surgery care used Google Maps to find six nearby agencies, called the hospital discharge planner for two clinical referrals, and then checked Medicare certification for each. Within three hours they had a five-agency shortlist: Cedar Home Health Care, Home Instead, Bayada Home Health Care, Right at Home, and VNA Health Group — chosen because each appeared in at least two sources and explicitly listed post-surgery skilled nursing.
Short call script (use verbatim): Hello, my name is [your name]. I need short-term in-home care for [patient name]. Can you confirm (1) services offered, (2) are you licensed in this state and what is your license/Medicare number, (3) do you provide RN oversight and written care plans, (4) can you accept Passport or assist with funding paperwork, (5) earliest start and trial visit availability?
Record answers in the same spreadsheet row for each agency so you can compare availability, licensing proof, RN oversight, funding help, and references quickly.
Judgment call that matters: Prioritize agencies that give specific, verifiable answers over those that promise everything but are vague about license numbers or RN coverage. Specificity predicts follow-through.

Next consideration: After you have five candidates, schedule short calls (15 minutes) and request license copies and two recent local references before arranging any in-person trial. For verification help, see Cedar Home Health Care services at Cedar Home Health Care and confirm Medicare status on Medicare Care Compare.
Services to compare and specific questions to ask for each service
Start with services, not sales copy. When you search for home healthcare agencies near me you will see broad service menus. What matters is the operational detail: who delivers the care, who supervises it clinically, and what written outcomes you will receive. Focus your calls and visits on those specifics.
Targeted questions and red flags by service
| Service | Three focused questions to ask | Quick red flags to watch for |
|---|---|---|
| Skilled nursing (wound care, IVs) | 1) Who will provide the wound care and what are their credentials? 2) How often will an RN review the wound and where is that documented? 3) Can you show a recent sample written care plan and outcome goals? | Vague answers about RN oversight; refusal to share a sample care plan; no protocol for escalation if wound worsens |
| Physical / Occupational / Speech therapy | 1) Are therapists licensed locally and employed or subcontracted? 2) What is the typical visit frequency and measurable goals? 3) How do you coordinate therapy notes with the primary provider? | Therapists only available by referral from a third party; no measurable goals; notes not shared with physician |
| Palliative and symptom management at home | 1) Do you have an interdisciplinary palliative team (RN, social work, bereavement support)? 2) How do you handle urgent symptom calls after hours? 3) Will you provide family counseling and advance care planning support? | No after-hours plan; only one clinician listed for all palliative needs; avoids talking about family support |
| Medication management | 1) Who reconciles meds after discharge and how soon after start? 2) Do you provide blister packs/med reminders and who documents administration? 3) How do you handle medication errors or missed doses? | No standardized reconciliation process; ambiguous documentation of administration; blaming caregivers for errors |
| Personal support / PSW and companion care | 1) What training and background checks do your PSWs have? 2) How is shift continuity enforced and what is your replacement policy? 3) Can you do a trial visit and provide local references? | High staff turnover; unwillingness to guarantee consistent caregiver; no recent local references |
| 24-hour/private duty/respite care | 1) Is overnight coverage awake or sleep-in and how is overtime billed? 2) How do you staff continuity for multi-night assignments? 3) What is your emergency escalation process? | Unclear about overnight status or overtime; schedules showing multiple different staff same week; no documented escalation path |
Concrete example responses you should expect
Concrete Example: For wound care a strong provider answers: Our RN wound specialist conducts the first visit within 24 hours, documents a 2-week healing plan with photos in the client chart, and performs an RN review every 48 hours with escalation to the physician if sloughing increases. Here is a redacted sample care plan and the RN’s license number. A weak provider answers: We have nurses who do wounds; we will visit as needed. That vagueness predicts missed timelines and poor documentation.
Another use case: For medication management a competent agency will describe a specific reconciliation process, supply blister packing if needed, and name who calls the primary physician when discrepancies arise. A less competent agency will insist family handle reconciliation without supervision. In practice that gap causes the most preventable hospital readmissions.
Practical tradeoff to weigh: Agencies that offer everything in-house reduce coordination friction but often charge more. Smaller local providers can be flexible with scheduling and Passport funding navigation, yet they sometimes subcontract specialty therapies — which requires extra verification of credentials and documentation.
Ask for a sample written care plan and one recent local reference per service. Vague or evasive answers on those two requests are the single best early warning sign.
Licensing, accreditation, staff credentials, and how to verify them
Treat licenses and credentials as paperwork you must collect and verify — not marketing copy. When you search for home healthcare agencies near me, the next step is not a sales call but a document check: license numbers, Medicare certification status, insurance certificates, and named clinical supervisors.
A practical verification workflow
- Find the official records. Look up Medicare status on Medicare Care Compare, check accreditation on The Joint Commission or ACHC, and run your state or provincial health licensing lookup for the agency license and RN/RPN numbers.
- Match names to numbers. Ask the agency for the supervising RN/RPN name and license number. Verify each clinician on the regulator site — a license number that returns nothing is a red flag.
- Request evidence, not promises. Email a short checklist (see template below) asking for copies of the agency license, a sample care plan, proof of liability insurance, criminal background policy, and a recent training log for PSWs and nurses.
- Validate clinical oversight. Confirm how often an RN does supervisory visits, who handles after-hours clinical escalation, and where supervision is documented in the client chart.
- Check staff-level proof points. For each assigned caregiver, verify background check completion, immunization/TB clearance policy, medication administration training, and date of competency assessment.
Limitation and tradeoff: National accreditation signals process maturity but does not guarantee day-to-day quality. In practice, small local agencies often outperform larger brands on continuity and responsiveness — provided they can show current RN oversight records and up-to-date staff competency logs. If accreditation is absent, ask for more frequent documentation (daily notes, photo-wound tracking) to compensate.
Concrete example: A caregiver team was rostered for a post-surgery client whose chosen agency listed an RN supervisor on its website. The family verified the RN number on the provincial registry and found the license active but held by a different clinic. They then requested the agency provide the actual supervising RN schedule and a redacted sample care plan; the agency supplied both and the family proceeded. That extra verification prevented a staffing mismatch during a critical first 72 hours.
Sample verification email (copy and send)
Email subject: Request for license and staff verification documents for [client name] start date
Hello, my name is [your name]. We are considering your agency to start care on [date]. Please provide copies or scans of the following before our trial visit:
1) Agency license and license number
2) Medicare certificate (if applicable) or certification number
3) Certificate of liability insurance (limits and expiry)
4) Name and license numbers of supervising RN(s)/RPN(s)
5) Sample written care plan for a post-surgery client (redacted OK)
6) Current policy for background checks, immunizations, and TB screening
7) Recent staff competency/training log for PSWs and nurses
Please respond within 48 hours so we can schedule a trial visit. Thank you.
If an agency hesitates to send license numbers or only offers verbal assurances, treat that as a disqualifier. Verifiable documentation is non-negotiable.
Next consideration: If you need Medicare-billable skilled nursing or wound care, confirm Medicare certification first — otherwise the agency may be unable to bill and you will face unexpected private charges.
How to read and weigh reviews, complaints, and testimonials
Star scores are a headline only. What separates reliable home healthcare agencies near me from mediocre ones is how reviews describe follow-through, clinical detail, and how the agency responds to problems — not whether they have 4.7 or 4.9 stars.
Begin with the obvious tradeoff: high quantities of short, generic five-star reviews are easy to fake or incentivize. Conversely, a small number of detailed reviews from local families that name clinicians, dates, and outcomes is high-signal. Quantity helps only when paired with quality of content and diversity of platforms.
A six-point framework to evaluate what reviews actually mean
- Recency and cadence: Prefer recent, steady reviews over a burst from several years ago; staffing and management change fast in home care.
- Provider response and resolution: An agency that acknowledges a complaint, explains remedial steps, and documents outcomes shows operational maturity.
- Cross-platform patterns: If the same issue appears on Google, Yelp, and the Better Business Bureau, treat it as a real operational gap.
- Named staff and concrete incidents: Mentions of RN names, missed shifts on specific dates, wound complications, or successful hospital-avoidance are highly informative.
- Clinical vs. hospitality complaints: Miscommunications or meal issues are different from repeated clinical incidents like medication errors or wound deterioration; weight them accordingly.
- Corroboration: Ask the agency for a recent local reference who consented to be contacted and compare that reference story to the written reviews.
Concrete example: A caregiver team flagged multiple complaints about overnight caregiver no-shows on Google and Yelp. The family called two references listed in the reviews and asked specifically about night coverage continuity. One reference confirmed the problem and named the agency manager who resolved it; the other said the agency had since changed scheduling software. That follow-up turned a vague red flag into a decision point: either require a written replacement guarantee or move to a different agency.
Annotated excerpts:
Positive excerpt: A local family writes that an RN conducted a post-op assessment within 24 hours, included dated wound photos in the chart, and the agency emailed the physician the same day. Why it matters: shows timely clinical action, photo documentation, and physician communication.
Negative excerpt: A reviewer reports three missed evening shifts over two weeks and says calls to dispatch produced only vague apologies with no replacement schedule. Why it matters: repeated service gaps plus lack of operational remedy indicate a staffing or scheduling system failure rather than an isolated incident.
Final judgment: treat star averages as an entry check but make hiring decisions based on patterns, provider responses, and at least one corroborated local reference. If you want a faster route, request a redacted recent care note or incident follow-up from the agency — agencies that have tidy documentation will provide it; those that cannot usually rely on marketing rather than operations.
Costs, funding options, contracts, and Passport funding assistance
Start with the invoice, not the brochure. When comparing home healthcare agencies near me the single most practical decision is how charges will flow to you or a funding program. Ask for an itemized sample invoice before the trial visit so you know what is billed hourly, what is billed per visit, and what looks like an add-on.
How common payers actually work and what to verify
Quick reality: Medicare, Medicaid, Passport-style local programs, private long-term care insurance, and private pay all follow different rules. Do not assume an agency that says they accept a program can immediately bill it. Verification steps are operational and take time.
| Funding source | Typical services covered | Key verification you must get in writing |
|---|---|---|
| Medicare (CMS) | Skilled nursing, therapy visits, homebound services when physician-certified | Physician certification note, Medicare provider number, expected billing start date; check Medicare Care Compare |
| Passport-style local funding | Often nonmedical PSW, respite, community supports depending on region | Authorization or benefit letter, scope of services approved, provider enrollment requirements, prior approval process |
| Private long-term care insurance | Personal care and some skilled services per policy terms | Pre-authorization, eligible provider list, daily or hourly caps, required receipts |
| Private pay | Any service the agency offers; fastest start | Itemized rate sheet, overtime rules, deposit or minimums |
Practical process to confirm Passport funding for your case. 1) Obtain a written authorization or case number from the Passport program administrator. 2) Ask the agency to confirm they are an approved vendor or to supply instructions to enroll. 3) Get the billed service codes and a sample invoice that matches Passport line items. 4) Confirm turnaround time for payments and whether you may be asked to cover temporarily and seek reimbursement.
- Contract items to insist on: a clear billing cadence (weekly or monthly), an explicit staff replacement SLA for missed shifts, transparent overtime rates, and an invoice detail format that matches your funding source requirements
- Administrative proof: include a clause requiring the agency to provide the authorization number on each invoice when billing Passport or insurer
- Dispute and termination: a short window for billing disputes (30 days) and a reasonable termination notice (usually 48 to 72 hours for private pay)
Trade-off that matters: Agencies that help with funding navigation reduce your administrative burden but can slow starts because they wait for approvals. If you need immediate care, expect to pay privately for the first few days and have the agency submit paperwork for reimbursement.
Concrete example: A family needed overnight PSW coverage and had a Passport authorization for personal support. Cedar Home Health Care prepared the enrollment packet, confirmed provider acceptance with the Passport administrator, and issued an invoice containing the authorization number. The family paid a short private deposit to secure the first two nights while Passport finalized enrollment; reimbursement occurred after authorization took effect.
Always get the funding authorization number and the expected billing start date in writing before the first billed visit. That single detail prevents most surprise invoices.

Next consideration: Before signing, confirm who will handle appeals if a Passport or insurer denies a claim. Agencies that provide this assistance and document the appeals process save weeks of delay and are worth a modestly higher hourly rate.
In-person evaluation: what to observe during the initial visit and trial period
What you see in the first 48 to 72 hours matters more than any brochure. An in-person trial is the fastest way to test punctuality, clinical follow-through, documentation habits, and whether the caregiver actually fits the client. Treat the trial like a short audit with specific checkpoints, not a courtesy visit.
- Arrival and timing: Did the caregiver arrive within the agreed window? Late arrivals on day one almost always predict ongoing scheduling problems.
- Identification and orientation: Confirm photo ID, agency badge, and that the caregiver can state their role and supervisor by name and license number.
- Infection control: Watch hand hygiene, glove use, mask policy if required, and whether surfaces and equipment are cleaned between tasks.
- Care plan clarity: The caregiver should reference a written care plan with tasks, goals, and measurable notes – not only verbal instructions from family.
- Medication handling: Observe how medications are stored, prepared, and recorded. Blister packs, MAR charting, and double checks matter.
- Clinical skill and escalation: For skilled needs watch for correct technique and whether the caregiver knows when and how to call the supervising RN or the family.
- Documentation practice: Expect dated notes, time-stamped entries, and photo documentation for wounds or therapy milestones when applicable.
- Equipment and supplies: Check that lifts, oxygen, wound supplies, and mobility aids are clean, functional, and that caregivers know basic troubleshooting.
- Respect and preferences: The caregiver should follow client routines, privacy preferences, and basic dignity cues without being prompted.
- Continuity signals: Ask who will cover missed shifts, view that replacement policy, and confirm the names of likely standby staff.
Suggested wording to request a trial and shadowing: Hello, my name is [your name]. We would like a 48 to 72 hour trial starting on [date]. Please assign the regular caregiver and have the supervising RN perform an intake within 24 hours. Will you confirm the caregiver and RN names and license numbers in writing and bring a printed care plan for the first visit? We will schedule a 24-hour debrief with the coordinator.
Practical tradeoff: Short trials reveal punctuality and documentation but can be staged by agencies preparing for a visit. To reduce that risk, require the actual assigned caregiver for all trial shifts, insist on an RN intake within 24 hours, and schedule at least one unannounced check-in by a family member or friend. Expect smaller agencies to be more flexible about trials but verify clinical oversight more aggressively.
Concrete example: A family arranged a 72 hour trial for post-surgery support and noted the daytime PSW consistently performed mobility transfers correctly while the first-night caregiver was 90 minutes late. The agency replaced the overnight worker within two hours and the supervising RN conducted a wound review on day two with photo entries. The family proceeded to a longer contract because the agency corrected the gap promptly and documented the fix.
Run a 48 to 72 hour trial, insist on a same-day RN intake and written notes, and schedule a structured debrief at 24 and 72 hours.
Next consideration: After the trial, compare notes against your checklist, request redacted care notes from the trial period, and decide whether to require a written replacement SLA in the contract before committing to ongoing care. For documentation examples and support with funding questions see Cedar Home Health Care services and verify Medicare-certified skilled nursing status on Medicare Care Compare.
Comparison checklist and sample scoring matrix with example comparison
Use a weighted scoring matrix to convert impressions into decisions. A short checklist plus numeric scores forces you to trade off cost, clinical depth, and reliability instead of picking the loudest salesperson. Below is an actionable matrix you can copy, adapt the weights for your priorities, and use during calls and trial visits when searching for home healthcare agencies near me.
How the scoring works and one important limitation
Score each agency 0 to 10 on the criteria below and multiply by the criterion weight to get a weighted total out of 100. Weights reflect what matters most for most families: services and clinical oversight carry the largest share. Limitation: brand-level scores mask local variability — many national names are franchises with different quality at the branch level. Always verify the specific local office’s license and recent references before treating a brand score as definitive.
| Criterion (weight) | Cedar Home Health Care (sample score + rationale) | Home Instead (sample score + rationale) | Bayada Home Health Care (sample score + rationale) | Right at Home (sample score + rationale) | VNA Health Group (sample score + rationale) |
|---|---|---|---|---|---|
| Services offered (25) | 9 — Strong mix of skilled nursing, palliative options, and PSW services; documented sample care plans provided by Cedar. (Weighted = 22.5) | 7 — Excellent companion and personal support services; skilled nursing availability varies by local franchise. (Weighted = 17.5) | 8 — Broad skilled services and therapy options; typically strong for post-surgical nursing. (Weighted = 20) | 6 — Good for nonclinical companionship and basic PSW; specialized skilled services sometimes limited locally. (Weighted = 15) | 8 — Large community nursing background with strong clinical services for complex cases. (Weighted = 20) |
| Licensing & accreditation (20) | 9 — Clear agency license and named RN supervisors available on request; Medicare-checkable. (Weighted = 18) | 9 — Franchise network generally shows state licensure; verify branch-level certificates. (Weighted = 18) | 9 — Nationally recognized for clinical programs; Medicare-certification common. (Weighted = 18) | 8 — Licensed franchises but accreditation varies; confirm local credentials. (Weighted = 16) | 9 — Often affiliated with public health nursing networks and easily verifiable. (Weighted = 18) |
| Staff credentials & continuity (20) | 9 — Low turnover in local teams, documented competency logs and RN oversight. (Weighted = 18) | 7 — Many caregivers excellent at companionship; higher turnover reported in some markets. (Weighted = 14) | 8 — Strong clinician training programs and clinical supervision models. (Weighted = 16) | 6 — Staff continuity can be uneven depending on branch; ask about replacement SLA. (Weighted = 12) | 8 — Clinical continuity good but may be structured more for short-term episodes than long overnight coverage. (Weighted = 16) |
| Reviews & reputation (15) | 8 — Local reviews describe timely RN responses and good documentation; corroborate on Better Business Bureau. (Weighted = 12) | 8 — High volume of consumer reviews for PSW work; look for named references and dates. (Weighted = 12) | 8 — Positive clinical outcomes cited in public sources; verify individual branch reviews. (Weighted = 12) | 6 — Mixed reviews across platforms; investigate recent complaints about night coverage. (Weighted = 9) | 7 — Solid clinical reputation but fewer consumer-facing reviews; check hospital referrals and local feedback. (Weighted = 10.5) |
| Cost & funding assistance (10) | 8 — Transparent sample invoices and Passport enrollment support offered; may require short private deposit for immediate starts. (Weighted = 8) | 7 — Competitive for companion care; less hands-on with funding navigation in some markets. (Weighted = 7) | 6 — Clinical strength can come with higher rates; funding navigation available but verify timelines. (Weighted = 6) | 7 — Reasonable pricing for personal care; funding support varies branch to branch. (Weighted = 7) | 6 — Rates can be higher for clinical visits; offers some funding assistance but slower administrative turnaround. (Weighted = 6) |
| Communication & responsiveness (10) | 9 — Named coordinator, structured 24-72 hour debriefs during trials, fast escalation pathways. (Weighted = 9) | 7 — Good client communication for daytime services; after-hours processes vary. (Weighted = 7) | 7 — Clinically responsive but administrative response times can be slower in peak periods. (Weighted = 7) | 6 — Variable; smaller branches may be quick but larger coordination gaps possible. (Weighted = 6) | 7 — Professional clinical communications; family liaison may be less consistent for long-term assignments. (Weighted = 7) |
Sample totals (illustrative): Cedar = 87.5 (~88), Home Instead = 75.5 (~76), Bayada = 79, Right at Home = 65, VNA Health Group = 77.5 (~78). These are example scores based on common real-world patterns and public reference checks such as Medicare Care Compare and Better Business Bureau; always verify the local office.
Concrete example / use case: A recently discharged post-surgery patient who needs wound care and daily RN oversight will favor an agency with higher Services and Staff scores (Cedar or Bayada in this sample) even if cost is higher. Conversely, an older adult needing full-time companion care and social support with occasional PSW help might reasonably choose a provider scoring higher on continuity and cost-efficiency (Home Instead in this sample).
- How to adapt this matrix: Change weights to suit your situation (for example, raise Cost to 20 if budget is limiting); rerun scores after checking branch licenses and getting sample invoices.
- Verification step: For any top-scoring agency, demand a copy of the branch license, a recent redacted care note from a similar case, and two local references before a trial.
- When tradeoffs are required: If the highest-scoring agency is costly, negotiate a defined trial and a 30-day review clause in the contract to reassess fit and cost-effectiveness.
Scoring converts bias into measurable trade-offs, but it does not replace document verification. Treat the matrix as a decision aid, not a proof of quality.
Next steps when you have selected a preferred agency
Immediate shift in focus: Once you choose a preferred provider, stop treating calls as discovery and treat them as contract and operations work. The goal is to convert intention into predictable, auditable care: documented start commitments, clear funding authorizations, named staff, and measurable short-term goals.
Operational steps to complete before day one
Lock the logistics: Get a confirmed start date, the exact names and shifts of assigned staff, arrival windows, and the agency backup plan for missed shifts. If the agency asks for a deposit to hold shifts, get the deposit policy and refund conditions in writing.
Obtain the written care plan and service agreement: The care plan must show tasks, frequencies, measurable goals (for example wound dressing frequency and target healing timeline), and who is clinically responsible for escalation. The service agreement should list billing cadence, overtime rates, and the termination notice period.
Secure funding and billing details in writing: Ask for the authorization or case number for any Passport, insurer, or Medicare billing; confirm the invoice format they will use and the exact start date they will bill. If reimbursement is pending, get a written acknowledgment that you may be required to cover short-term charges and the expected refund timeline.
Measure and manage performance during onboarding
Set short-term, objective checkpoints: Schedule a 7-day operational check, a 30-day clinical and satisfaction review, and a 90-day program review. Define two to four metrics you will track, for example: percentage of scheduled visits completed, timeliness of documentation (notes within 24 hours), change in wound size or pain score, and family satisfaction rating.
Escalation and remedies: Agree the escalation path and expected response times in writing (who responds within 2 hours, who reviews clinical incidents within 24 hours). If agreed metrics are missed, the contract should allow corrective action such as replacement staffing, a remedial care plan, or short-term credit.
| Onboarding packet field | Why it matters |
|---|---|
| Client identifiers and emergency contacts | Prevents administrative errors and speeds emergency response |
| Complete medication list with doses and administration times | Enables accurate MARs and prevents medication errors |
| Allergies and alerts | Critical for clinical safety and any therapy planning |
| Mobility and transfer needs (equipment and weight bearing) | Ensures proper staffing and correct equipment on day one |
| Advance directives and decision maker names | Clarifies clinical authority and reduces delays in urgent decisions |
| Funding authorization numbers and billing start date | Prevents surprise invoices and clarifies who pays when |
| List of required supplies and who supplies them | Avoids missed supplies that stop treatment |
Practical tradeoff to plan for: Fast starts often require a short private payment or deposit while administrative enrollment completes. That is usually preferable to delayed care, but insist on a repayment or credit clause tied to the funder authorization date so you do not absorb avoidable costs.
Concrete example: A family selected an agency for overnight PSW coverage and secured a start by paying a two night deposit. They required the agency to obtain the Passport authorization within 10 days and to apply that authorization number to all invoices. The agency provided the RN intake within 24 hours, documented the first three nights, and then applied the Passport authorization retroactively when approved, issuing a credit for the deposit week once reimbursement arrived.
Key step: get the funding authorization number and billed start date on agency letterhead before the first billed visit. It prevents most disputes.
Next consideration: Schedule the 30 day review on the agency calendar now and confirm who will deliver the review. If you want help preparing the onboarding documents or verifying funding paperwork, contact Cedar Home Health Care for a no obligation assessment at Cedar Home Health Care.