Senior living · Home care

Home care answering service for call-offs, families and referrals

A home care answering service works the hours your office doesn’t: caregivers call off at 5 a.m., and families ask about care at 9 p.m. 365vox takes each call the way your rules say and puts call-offs and missed visits through to your on-call scheduler. Every staffing and care decision stays with your team.

Free 7-day trial, no card. $0.75 a conversation minute, billed by the second.

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Home care agency phone calls: who calls, and what each one needs

Your AI virtual receptionist answers the calls you send it and treats each kind of caller differently.

Families looking for care

Usually an adult child after a fall or a hospital stay, asking your rate and how soon you can start. Answered from your rules, then your intake questions and the care assessment booked.

Clients changing their schedule

An extra visit, a hospital stay, a week away. The agent takes the change and the dates, and they go straight into your scheduling software if it has an open API. Who covers a new visit is your scheduler’s call.

Caregivers calling off

Often before dawn, for a shift hours away. Taken with the shift, the client and the reason, then put through to your on-call scheduler.

Discharge planners and case managers

Hospital discharge planners, and case managers from Medicaid waiver programs and the VA.

Hospital referral intake

A missed visit or a concern about care

A caregiver hasn’t arrived, or a family member is worried about care. Put through as urgent, by your rules.

Job applicants

Caregivers answering your ads. Told how to apply; their details taken for your recruiter.

After-hours answering service for home care: where each call goes

Safety first, then the calls that can’t wait for the morning.

A call comes in after hours. The greeting says it’s an AI and that the call is recorded.

1Is someone describing a life-threatening emergency, such as a client who is hurt or not breathing?

Yes911 Set up to tell the caller right away to hang up and call 911. The agent can’t call 911 or send help itself.
2Is a caregiver calling off a shift that starts in the next 12 hours (your rule)?

YesPut through Takes the name, each shift, the client and the reason, flags the call urgent and puts it through to your on-call scheduler. If nobody answers within 20 seconds, it takes a message with the shifts.
3Is a client or family member saying a caregiver hasn’t arrived?

YesPut through Takes who is calling, the client and the visit time, flags the call urgent and puts it through to your on-call scheduler. If nobody answers within 20 seconds, it takes a message.
4Is it a new client inquiry?

YesAssessment booked Answers from your rules, asks your intake questions and books the in-home care assessment in your connected calendar. The start date the family hopes for is noted, not promised.

Everything elseAnswered from your rules, or a message for the morning: a schedule change, a billing question, an applicant, a vendor.

One agent has one transfer number: after hours, all of these reach the same on-call phone. If nobody answers within 20 seconds, the agent takes a message, and calls your rules mark urgent get their own email.

Caregiver call-offs when turnover runs near 75%

A call-off is a client who may go without a visit unless someone finds cover.

Caregiver turnover fell from 79% to 75% in Activated Insights’ 2025 benchmarking, and 39% of providers turned down cases for lack of staff (Home Health Care News). PHI puts home care turnover at nearly 75% in 2024 and the median direct care wage at $17.99 an hour in 2025 (PHI).

On a call-off, the agent takes the caregiver’s name, each shift, the client and the reason in a few words. It reads the shifts back, then puts the call through to your on-call scheduler. If nobody answers within 20 seconds, the agent takes a message with the shifts: your scheduler gets the urgent email, and the call-off goes into your scheduling software if it has an open API. The call, with the shifts read back, is in your portal too.

A person makes every staffing decision: who covers, whether the family hears, how your attendance policy applies.

A 5:40 a.m. call-off

Two shifts, read back. A reason, without medical details. Then the call is put through.

Sample call · Comfort Hands Home Care (example agency). Example call with made-up names. The recording, transcript and summary are in your 365vox portal for the days you choose.

AI receptionistThanks for calling Comfort Hands Home Care. I’m an AI assistant. This call is recorded and transcribed so we can handle your request. How can I help you today?
CallerHi, it’s Rosa Diaz, one of the caregivers. I’m sick and I can’t do my seven o’clock.
AI receptionistI’m sorry you’re unwell, Rosa. Which client is the 7 a.m. visit with, and when does it end?
CallerMr. Okafor, seven to eleven. And I have Mrs. Lin at one.
AI receptionistSo that’s two shifts today: Mr. Okafor from 7 to 11 a.m., and Mrs. Lin at 1 p.m. Is that right?
CallerYes.
AI receptionistIn a few words, what’s the reason?
CallerA fever since last night.
AI receptionistThank you. I’m putting you through to Dee, our on-call scheduler, so she can arrange cover. If she doesn’t pick up, I’ll come back on the line and take a message for her with both shifts.

The call record your scheduler opens

For an agent that hears health information, the call email only says that a call came in. The details stay in your 365vox portal, behind your sign-in. Calls your rules mark urgent are flagged urgent in the portal and get their own email. For a health agent, that email only says an urgent call came in; the details stay in the portal.

The record holds the caregiver, shifts, client and reason, with the recording and transcript.

Call record · 365vox portalExample

Call-off: Rosa Diaz, 2 shifts today

Caller: Rosa Diaz · caregiver · (412) 555-0142
Received: Saturday, 5:41 a.m. · 1 min 48 s
Shifts: Mr. Okafor, 7:00–11:00 a.m. · Mrs. Lin, 1:00 p.m.
Reason: A fever since last night (in her words)
Outcome: Put through to the on-call scheduler
Flag: Urgent, by your rule: a shift starts within 12 hours
Summary: Caregiver called off two shifts today. Both read back and confirmed.

Example with made-up names.

Home care, home health or hospice: three different phones

Families mix up the words. Payers, regulators and callers don’t.

Non-medical home care helps with daily activities such as bathing, dressing, meals and housekeeping. Home health is skilled care at home to treat an illness or injury. For Medicare to pay, the patient must be homebound and the agency Medicare-certified (Association of Health Care Journalists). Hospice serves a person whose life expectancy is 6 months or less if the illness runs its normal course (42 CFR 418.3); see the hospice answering service.

Home care is paid privately, through long-term care insurance, through Medicaid home and community-based services (HCBS) waivers, which can cover personal care, homemaker and respite services, and through the VA. In 2024, 40 states reported HCBS waiver waiting lists, about 710,000 people (Congressional Research Service). The VA’s Aid and Attendance benefit adds a monthly payment to a VA pension for veterans and survivors who need help with bathing, eating or dressing. Medicare generally won’t pay for personal care alone.

General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours.

Hospice answering service

Calls at home care, home health and hospice agencies, compared

Many agencies run more than one. Each has different callers and rules.

Callers, urgent calls, rules and agent behavior at home care, home health and hospice agencies
Item	Home care	Home health	Hospice
Typical callers	Families, clients, caregivers, case managers, applicants	Physician offices and hospitals, skilled patients	Families at any hour, facilities, bereaved families
The urgent after-hours call	A call-off for a morning shift, or a caregiver who hasn’t arrived	A skilled patient with a question for a nurse	A symptom crisis, or a death at home
The rule behind the on-call phone	Your state’s licensing rules and your client agreements	Patients get the clinical manager’s contact information (42 CFR 484.60(e)); some states add 24-hour nurse access, such as Florida	Nursing, physician services and drugs “routinely available on a 24-hour basis 7 days a week” (42 CFR 418.100(c)(2)); bereavement services up to a year (418.64(d))
Medicaid visit verification (EVV)	Required for Medicaid personal care services by January 1, 2020 (Medicaid.gov)	Required for Medicaid home health services by January 1, 2023	Not one of the two services the federal rule names
What the agent does	Puts call-offs and missed visits through to the on-call scheduler	Puts patient calls through to the on-call nurse by your clinicians’ rules	Puts symptom and death calls through to the on-call nurse at once

General information, not legal or clinical advice. Rules differ by state and province and change over time, so check yours. An agency running home care and home health can give each its own line: two agents in one account.

Starter rules for a home care answering service

Paste these into step 9, Business rules, and change the parts in brackets. They tell the agent which calls to treat as urgent, when to put a call through and what to say first.

Like any AI, it can mishear, so read your first week of calls in the portal.

Business rules · step 9 · home care agency

Starting point only: review with your care manager, your scheduler and your privacy officer before you use it.

About us: [Agency name] provides non-medical home care: bathing, dressing, meals, housekeeping and companionship. No skilled nursing. Office hours: [Monday to Friday, 8 a.m. to 5 p.m.]. Service area: [towns or ZIP codes]. Minimum visit: [hours]. Rates start at [rate] an hour; the final rate is set after our care assessment.

Emergencies: if a caller describes a life-threatening emergency, tell them to hang up and call 911.

Caregiver call-offs: ask for the caregiver's name, the date and time of each shift they can't work, the client, and the reason in a few words. Don't ask for medical details. If any shift starts within 12 hours, treat the call as urgent and put it through to the on-call scheduler. Never say whether the call-off is accepted.

Missed or late visits: if a caregiver hasn't arrived, ask for the caller's name, the client's name and the visit time, treat the call as urgent and put it through to the on-call scheduler.

Concerns about care: if a caller says a client may have been harmed, mistreated or neglected, or had money or belongings taken, treat the call as urgent and put it through to the on-call scheduler. Before you put it through, tell the caller: if someone is in danger, hang up and call 911. Don't say what we will do.

New clients: answer from these rules, then ask our intake questions. Offer to book the in-home care assessment at a time that suits them, and read the day and time back. Never say whether we can start on a date or whether the person qualifies for Medicaid, VA or insurance benefits.

Referrals from hospitals and case managers: ask for the caller's name, organization and phone number, the client's name, the expected start date and the payer as stated. If the start is within 48 hours, put the call through to the on-call scheduler. Otherwise take a message for intake.

Schedule changes: take the change and the dates. Never promise a caregiver: the scheduler arranges cover.

Job applicants: explain how to apply: [website]. Take their name, phone number and the areas they can work.

Questions about a client: don't confirm whether someone is a client. Take a message for the care manager.

Billing: take a message. Never take card or bank details.

Under the 4,000-character limit. Example rules, not legal or clinical advice.

What it never does at a home care agency

Never accepts, refuses or covers a shift

It gets the call-off to your scheduler. Who covers is your team’s decision.

Never calls caregivers or families

It sends no text messages and makes no outgoing calls: it answers the calls that come in. So it can’t fill a shift or warn a family about a late visit.

Never promises a start date or a caregiver

Staffing a new client by Friday depends on your roster. It takes the date the family hopes for.

Never says who qualifies for benefits

Waivers, VA benefits and insurance coverage go to your intake team.

Never discusses a client

It can’t verify callers, so it doesn’t confirm whether someone is a client. It takes a message.

Never stands in for EVV

Electronic visit verification is its own system. A call to the agent isn’t a check-in or a check-out.

Build it yourself

Build your answering service for home care agencies

Families describe health conditions, so when you create the agent, answer Yes to “Will callers share health information with this agent?” and accept the agreement. Then set these on the Customize screen.

Build yours free for 7 days

You set all of this yourself in the 365vox portal, on the Customize screen. Everything saves as you type; then you submit, test the agent with a real call and activate it.

Customize · your agent

Step 1, IndustryOther. Your business rules describe your services, area and hours.
Step 3, Questions to askName, phone and email are there. The rest go in your business rules.
Step 4, Forward to a personYour on-call scheduler’s phone. After hours it takes call-offs, missed visits and urgent referrals. If nobody answers within 20 seconds, the agent takes a message.
Step 5, IntegrationsConnect your intake calendar, so the agent books care assessments during the call. If your home care scheduling software has an open API, connect it too: call-offs, callers’ details and call notes go straight into it. A call to the agent is never an EVV check-in.
Step 7, When your agent answersAfter hours and weekends, or Overflow: your office phone rings first, and the agent answers if nobody picks up within 20 seconds.
Step 8, Call notificationsThe scheduler, the care manager and the owner, up to 10 emails. Each says only that a call came in. Calls your rules mark urgent, like a call-off for this morning, get their own email.
Step 9, Business rulesThe starter rules above, plus up to 3 documents.
Step 10, Things your agent will never doAdd Never accept or refuse a call-off and Never say whether someone qualifies for benefits.
Step 13, Test your agentCall it as a caregiver calling off at 5 a.m., then as a son asking about care.

The cost, worked out for an agency with 80 caregivers

$0.75 a conversation minute, billed by the second. No monthly plan, no setup fee and no long-term contract. Taxes where applicable.

See AI receptionist pricing Estimate your cost

Example: an agency with 80 caregivers

Calls outside office hours: evenings, nights and weekends.

Caregiver call-offs: 50 calls × 1.5 min
Late or missed visits: 10 calls × 2 min
Client and family calls: 60 calls × 2.5 min
New client inquiries: 25 calls × 4 min
Referrals from planners and case managers: 10 calls × 3 min
Job applicants: 40 calls × 1.5 min
Total: 195 calls · 435 min

Monthly cost$326

435 minutes × $0.75 = $326 a month. Illustrative assumptions chosen by 365vox, not a customer result. Taxes where applicable.

Comparing virtual receptionist services?

Live answering services usually sell monthly plans of minutes or calls. 365vox is an AI virtual receptionist that answers forwarded calls on the first ring, day and night, follows your approved answers and costs $0.75 a minute, billed by the second, with no plan.

The virtual receptionist, minus the call center

Home care answering service FAQs

What does a home care answering service do with a caregiver call-off at 5 a.m.?

It takes the caregiver’s name, each shift they can’t work, the client and the reason in a few words. It reads the shifts back and puts the call through to your on-call scheduler. If the scheduler doesn’t pick up within 20 seconds, it takes a message with the shifts: the scheduler gets an urgent email, and the call-off goes into your scheduling software if it has an open API. For a health agent the email only says an urgent call came in; the shifts are in your portal. Who covers the shift is your scheduler’s decision.

Can it find a replacement caregiver or let the client’s family know?

No. It sends no text messages and makes no outgoing calls: it answers the calls that come in. So it can’t ring caregivers to fill a shift or warn a family that a visit will be late. It gets the call-off to your scheduler with the shifts and the client in one place, so your team can start those calls.

Is a private-pay home care agency covered by HIPAA, and does it change the setup?

Under HHS guidance, a provider is covered when it submits HIPAA transactions, like claims, electronically, so a private-pay agency may not be, and one billing Medicaid electronically may be. Check with your privacy adviser. The setup doesn’t change: families describe health conditions either way, so answer Yes to the health question.

How does it answer families asking whether Medicaid or the VA will pay for home care?

From your rules only. It can name the programs you work with, such as your state’s Medicaid waiver program, long-term care insurance or VA programs. It never says whether someone qualifies or how long a wait is: in 2024, 40 states reported waiver waiting lists (CRS). Your intake team gets the details.

Does it connect to our EVV or home care scheduling software?

Scheduling software, yes, if it has an open API. Connect it in step 5, Integrations: call-offs, callers’ details, call notes and messages go straight into it, and booked assessments go into your connected calendar. EVV is different. Electronic visit verification is a separate Medicaid requirement for personal care and home health visits (Medicaid.gov), and a call to the agent is never a visit check-in or check-out.

Can a hospital discharge planner reach a person at our agency after hours?

Yes, if your rules say so. The agent takes the planner’s name, organization and number, the client, the start date and the payer as stated, then puts the call through to your one transfer number. If nobody answers within 20 seconds, it takes the referral as a message: your team is emailed, and the details go into your scheduling software if it has an open API, as well as your portal. See hospital referral intake.

How is a home care agency’s phone line different from a home health agency’s?

Home health is skilled care to treat an illness or injury. Its calls include physician and hospital referrals, and patients with questions only a nurse can answer. Those go to the on-call nurse, by rules your clinicians write. Florida, for example, requires written policies for 24-hour nurse access for skilled patients. Home care calls are about daily help and schedules.

What would after-hours calls cost an agency with 80 caregivers?

In our worked example, an agency gets 195 calls a month outside office hours: call-offs, missed visits, family calls, inquiries, referrals and applicants. That’s 435 minutes, or $326 at $0.75 a minute, billed by the second. There’s no monthly plan, no setup fee and no long-term contract. Taxes where applicable. See pricing.

Call-offs at 5 a.m., taken in full and put through.

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