Licensed Home-Care Agencies: Partner With Wound House

Wound House LLC is building a national network of licensed home-care agencies that can accept service orders and provide trained caregivers for non-skilled in-home dementia respite and personal-care needs. We are not seeking patient referrals from home-care agencies, and we are not purchasing or selling referrals. We are looking to contract with licensed agencies that will employ or properly engage, assign, supervise, and provide caregivers in their authorized service areas.

Exact legal entity name and DBA. License type, number, status, issuing state, and expiration date.

States, counties, and ZIP codes served. Whether caregivers are W-2 employees or independently contracted or referral caregivers. Services the agency is legally permitted to provide.

Minimum shifts and hourly, evening, weekend, holiday, mileage, and cancellation rates. Dementia training and caregiver background-screening requirements.

Intake turnaround time and backup-caregiver availability. EVV, visit-note, incident-reporting, and invoicing capabilities. Availability of a W-9, certificate of insurance, license, rate card, service-area list, and sample service agreement.

ZOHO AGENCY COVERAGE AND CONTRACTING QUESTIONNAIRE WILL BE EMBEDDED HERE. Submitting this questionnaire does not create a contract, referral relationship, or guarantee of patient volume, service orders, payment, or approval. Each agency is subject to independent licensing, compliance, insurance, service-area, pricing, and contracting review. Do not submit patient information through this questionnaire. Where services may later be furnished through a CMS model, applicable partner-organization, contracting, roster, payment, and program requirements will be handled separately.