Ask for references in writing. Request the names of families who agreed to speak with a prospective client, along with a way to reach each one. Say plainly that you will call them, not only the agency's chosen sales contact. The list an agency hands over is chosen by the agency, so treat it as the agency's selection, not a neutral sample.

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.

Write the questions before you dial. Use three: how the family found the agency, what the family had to set up before service started, and what the family checks now that service is running. Leave space on the sheet for the answer, the reference's name, and the agency's name.

Listen for the shape of the answer. Note whether the reference answers each question directly or moves to a different subject. Note whether the answer describes specific tasks or stays general. Note whether the family says what it had to fix on its own. A vague answer is a note, not a verdict. Do not ask about anyone's health. If health comes up, write that the family's doctor is the person for those questions.

Check the reference against the public record. A call tells you about one household. The public lookups tell you what a file says. Before you weigh a reference, run the agency through the steps in how to check any home health agency in five federal lookups, and confirm which category the agency is filed under. The guide on home health and home care in Missouri as two different categories explains why the category matters before you compare two offers.

Keep the sheet as notes, not stars. Do not turn the calls into a score. A reference that sounded warm is one data point, and a reference that sounded hesitant is another. Put both on the sheet beside the lookup result, and let the sheet, not the tone of one call, decide what happens next.

Mark what is editorial. The steps here are the desk's procedure. They do not name any provider, and nothing in this guide rates an agency.