Interview guide for home care roles: a loop for home health aides, caregivers and care coordinators

A home care hire works where no one can see them. The aide or caregiver arrives alone, helps a client bathe, notices that the client is more confused than last week, finds the stairs cluttered and decides whether to call the office. Clients and families judge the agency by whether the right person shows up on time and treats them with respect. Turnover is high, so agencies are tempted to hire anyone with a certificate. A better loop checks the qualification that applies to the role, watches the candidate perform core skills, tests judgment in a home setting and takes reliability seriously.

This guide covers home health aides at Medicare-certified home health agencies, caregivers and personal care aides at non-medical home care agencies, and care coordinators. First calls are in caregiver screening questions and home health aide screening questions. For medical assistants and CNAs in clinics and facilities, use the interview guide for healthcare roles; for assisted living and memory care staff, use the interview guide for senior living roles.

The loop at a glance

Stage 0: the qualification check

For Medicare-certified home health agencies, 42 CFR 484.80(a) says a qualified home health aide has completed one of four routes: a training and competency evaluation program; a competency evaluation program; a state-approved nurse aide training and competency evaluation program, with the person currently listed in good standing on the state nurse aide registry; or a state licensure program meeting the same standards. Check:

• Which route, with documents. Ask for the certificate or registry listing and verify the registry status directly.
• The 24-month lapse rule. Under 484.80(a)(2), a program no longer counts if there has been a continuous 24-month period without providing covered services for compensation. Ask for recent paid aide work and verify it.
• Competency before service. Under 484.80(c), an individual may furnish home health services for the agency only after successfully completing a competency evaluation, performed by a registered nurse. Your stage 3 skills station is a hiring tool, not a substitute for that evaluation.
• Non-medical home care. Personal care and companion roles are regulated by states, which may set training hours, registry checks and background screening. Read your state licensing rules for home care agencies before you write the job post.
• Exclusions. Agencies that bill federal health programs should screen against the HHS OIG exclusion list.

Stage 1: the screen (15 minutes)

• "Our clients are in [example: the north and east of the county], with visits from 2 to 8 hours. Which areas and hours can you cover reliably?"
• "How do you get between visits? If driving, do you have a license and insurance?" Explain mileage and travel time pay.
• "Have you cared for clients with dementia, mobility limits or end-of-life needs?" Match the client mix, not a general preference.

Stage 2: structured interview (30 minutes)

1. "Tell me about a time you noticed a change in a client's condition. What did you notice and who did you tell?" Listen for: specific observations, such as new confusion, swelling or not eating, reported the same day to the nurse or office.
2. "A client asks you to keep a fall from their daughter. What do you do?" Listen for: kindness, and reporting the fall to the agency regardless.
3. "Tell me about a time you were going to be late or could not make a shift. What did you do?" Listen for: calling the office early, not the client directly or not at all.
4. "A family member offers you cash to work extra hours privately. What do you say?" Listen for: declining and telling the office.
5. "What do you do when a client refuses a bath?" Listen for: respecting the choice, trying another approach or time, and documenting and reporting a pattern.

Stage 3: the observed skills station (30 minutes)

A registered nurse watches the candidate perform core skills on a volunteer or a manikin in a mock room. Choose the skills from the agency's checklist for the role. The federal competency rule is a useful guide: 484.80(c)(1) requires that communication skills, reading and recording temperature, pulse and respiration, personal hygiene and grooming tasks, safe transfer and ambulation, and range of motion and positioning be evaluated by observing the aide with a patient or pseudo-patient.

Suggested stations

• Hand hygiene and gloves before and after care.
• Bed to chair transfer with a gait belt, explaining each step to the client.
• One personal care task, such as mouth care or a partial bed bath on a manikin, with privacy maintained.
• Vital signs, for home health aides: take and record a pulse and respiration rate and say which values they would report.

Score technique, safety, communication with the client and dignity. Any unsafe transfer, such as lifting under the arms, is an automatic fail for the station.

Stage 4: home scenarios (15 minutes)

Show a photo or description of a home and read three short situations:

• Hazards: a loose rug, a space heater near curtains and pill bottles on the floor. Listen for: fixing what they safely can, reporting the rest and not moving medications into a new system on their own.
• Emergency: the client is on the floor, awake but in pain, when the aide arrives. Listen for: not lifting the client, calling emergency services if needed, then the office.
• Family conflict: two adult children give opposite instructions about the client's diet. Listen for: following the care plan and asking the office to resolve it.

Adjusting the loop

Scorecard competencies and weights

Example weights for a home health aide. Lock yours before the first candidate.

Legal and regulatory points to check

Checked against the linked primary sources as of October 2026. Not legal advice; your state's home care rules and your counsel decide.

• Aide training and competency. Under 42 CFR 484.80(b), classroom and supervised practical training must total at least 75 hours, with at least 16 hours of classroom training before at least 16 hours of supervised practical training. Paragraph (d) requires at least 12 hours of in-service training in each 12-month period.
• Supervision after hire. For patients receiving skilled services, 484.80(h)(1) requires a supervisory assessment of aide services at least every 14 days; for patients who are not, (h)(2) requires an in-person registered nurse visit every 60 days. Tell candidates they will be observed on visits.
• Background checks. Many states require criminal history or registry checks for home care workers; read your state's rules. When a consumer reporting agency runs a criminal or driving record check, 15 U.S.C. 1681b(b) requires a stand-alone disclosure, written authorization and pre-adverse action notice. See the FCRA background check process.
• Physical demands. Describe lifting and transfer demands and ask whether the candidate can perform them with or without accommodation; do not ask about health conditions before an offer, as 29 CFR 1630.13 provides.

The decision rule

1. Gate: qualified for the role under federal or state rules, with registry status verified where it applies.
2. Floor: no unsafe technique in the skills station and at least 3 on reporting changes.
3. Weighted total: in this example, 2.7 or higher on a 1–4 scale is an offer.
4. Contingencies: background checks, exclusion screening, the agency's competency evaluation and two work references.

Mistakes that weaken home care loops

• Hiring on the certificate alone. Watch the transfer before the first client does.
• Skipping the lapse question. A 24-month gap in paid aide work changes the qualification.
• Treating reliability as soft. A missed visit is a client without care.
• Not asking about money and gifts. Financial boundaries protect clients and staff.