What Should a Home Care Client Service Agreement Include?
Services, rates, minimums, cancellations, billing, overtime and termination, with a fill-in template and the state disclosure rules that shape it.
By Caregiver Scheduling Team ·
A home care service agreement is the contract between your agency and a private-pay client. It should list the services you’ll provide, the hourly rate and any minimum visit length, cancellation and holiday terms, how and when you bill, what happens with unpaid invoices, and how either side can end the arrangement. Have it signed before the first visit. Several states require most of this in writing before care starts.
What should the agreement cover?
Twelve sections cover almost every dispute an agency runs into. Decide each one before you write the template.
| Section | Decide |
|---|---|
| Parties | Client, responsible party (who pays), agency |
| Services | From the care plan; what caregivers don’t do (e.g. medication administration) |
| Schedule | Starting schedule; how changes are requested |
| Rates | Hourly rate, minimum visit length, weekend/holiday/overnight rates, live-in rate |
| Overtime | Rate for hours over 40/week when the client asks for one caregiver |
| Cancellations | Notice required; fee if late |
| Billing | Weekly or biweekly; payment method; due date; deposit |
| Late payment | Late fee, when service may be suspended |
| Rate changes | Written notice period |
| Termination | Notice by either party; immediate termination for safety reasons |
| Non-solicitation | Fee if the client hires the caregiver directly, where your state allows it |
| Signatures | Client or legal representative, date |
What do states require you to disclose?
Licensing rules in many states set a floor for what the client must get in writing before service starts. Pennsylvania’s 28 Pa. Code 611.57 requires agencies to give consumers, before services begin, a written list of services, the hours they’ll be provided, fees and total costs on an hourly or weekly basis, the state complaint hotline, and a statement of whether the caregiver is an employee or an independent contractor. The same section requires 10 calendar days’ written notice before the agency terminates services.
Texas takes a similar approach. Under 26 TAC 558.282, a client has the right to be informed, before care is initiated, of how much payment is expected from the client and from any third-party payer. The agency must give written notice of its client-rights policy in advance of care and a written complaint statement at admission, and it must hold a signed informed consent for every client.
Attach your state’s client-rights statement and complaint information to the agreement. See home care client rights and the licensing lookup.
Template
Home Care Service Agreement
Between ______ (“Agency”) and ______ (“Client”). Responsible party: ______.
1. Services. Agency will provide the non-medical services listed in the attached care plan. Caregivers do not provide medical services or administer medication. Caregivers are employees of Agency.
2. Schedule. Starting schedule: ______. Changes may be requested with 48 hours’ notice.
3. Rates. Standard: $/hour. Minimum visit: ____ hours. Weekends: $/hour. Holidays (listed in Schedule A): $/hour. Overnight: $/hour. Live-in: $____/day.
4. Overtime. When Client requests that one caregiver work more than 40 hours in a week, hours over 40 are billed at $____/hour.
5. Cancellations. Client will give ____ hours’ notice to cancel a visit. Visits cancelled with less notice are billed at the minimum visit length.
6. Billing and payment. Agency invoices every ______. Payment is due within ____ days by __. A deposit of $ is due before the first visit and applied to the final invoice.
7. Late payment. Balances unpaid ____ days after the due date incur a fee of ____. Agency may suspend service after ____ days’ written notice.
8. Rate changes. Agency will give 30 days’ written notice of any rate change.
9. Termination. Either party may end this agreement with ____ days’ written notice. Agency may stop service immediately if caregiver safety is at risk.
10. Hiring caregivers. If Client hires an Agency caregiver directly within ____ months, a placement fee of $____ applies, where allowed by law.
Client or representative: ______ Date: ______ Agency: ______ Date: ______
Can you bill by automatic bank draft?
Yes, with a signed authorization. Under Regulation E, 12 CFR 1005.10(b), recurring electronic debits from a consumer’s account may be authorized only by a writing signed or similarly authenticated by the consumer, and you must give the client a copy. If the amount varies from one draft to the next, which it will when hours change, 1005.10(d) requires written notice of the amount and date at least 10 days before the transfer, unless the client agrees to be notified only when the amount falls outside an agreed range. Build that range option into the ACH authorization form.
What else should the agreement handle?
- Long-term care insurance clients sign the same agreement; the client pays whether or not the insurer reimburses. See long-term care insurance billing.
- Match the cancellation and deposit terms to your cancellation policy and deposit policy.
- Have an attorney review the template for your state.
How Caregiver Scheduling handles this
Verified check-in and check-out times, GPS location and the client’s signature are stored with every visit, so a disputed bill can be answered with the visit record. Private-pay invoices generated from those approved visits are coming soon. $199/month for up to 10 caregivers or $299/month for up to 50, free for 30 days.
FAQ
Do I need a written agreement with private-pay clients? Yes. Many states require written disclosure of services and fees before care starts, and the signed agreement is your basis for collecting payment.
Can I charge a cancellation fee? Yes, if it’s in the signed agreement and your state’s licensing rules don’t restrict it.
Should I take a deposit? Many agencies take one or two weeks of care in advance to reduce collection risk.
How much notice do I have to give before stopping service? It depends on the state. Pennsylvania requires 10 calendar days’ written notice from the agency.
This article is general information, not legal advice. Check your state’s home care licensing rules.