Using a home care agency, a registry or hiring directly
Remaining at home with the assistance of a caregiver is the preferred living arrangement for many seniors and others who need help but wish to retain their independence. A critical question is whether you intend to directly hire a caregiver, or do it through a home care agency or a registry.To find the right caregiver, most people turn to a full-service home care agency like Assisting Hands, which screens, hires and trains its employees.
Families sometimes believe they will save money by hiring a caregiver directly, rather than retaining the professional services of an agency. When they hire someone directly, they become the employers and are fully responsible for their employees. There are important considerations to be aware of before making this important decision.
- A home care agency that employs caregivers is bonded, insured and covers their employees under worker’s compensation. Independent (direct hire) caregivers who do not work for an agency do not carry their own liability insurance or worker’s compensation. If an accident or other incident occurs on the job, the employer would likely be responsible.
- A home care agency provides a replacement if the caregiver it employs cannot make it to work. If an independent caregiver calls off or doesn’t show up, the direct employer will need a back-up plan, since there won’t be an agency involved to send a replacement.
- Independent caregivers cannot be bonded. Bonding provides theft protection for the client.
- If hiring directly, the client is the employer and is therefore responsible for training, disciplinary action, and terminating the caregiver if necessary. If using a home care agency, the agency handles these responsibilities.
- If hiring a caregiver directly, the client needs to be able to assess the quality and skill level of the caregiver. This is especially important if the client requires hands-on personal care, has limited mobility, dementia or Alzheimer’s. A high-quality home care agency trains their caregivers, run all necessary background checks, and test their skill levels prior to hiring.
- By law, the client (employer) is responsible for filing payroll taxes, tax forms, and verifying that the employee can legally work in the U.S.
Anyone considering directly hiring a caregiver should carefully take into account the risks associated with bringing a stranger into their homes. At Assisting Hands Home Care, we manage the all activities related to hiring, training and paying caregivers’ wages and taxes, as well as supervising the quality of the services they deliver.
Agency or Registry? Or a live-in?
Once you, your healthcare providers or members of your family decide it is time to start hiring support at home, or supplementary assistance at a healthcare facility, and you have concluded you prefer not to hire an aide directly, it is important to differentiate among existing alternatives to choose the services that best match your needs, expectations and budget.
Prices and quality vary significantly, and we recommend doing some research on the different options you may find. See a few reliable information-source suggestions at the bottom of this page.
The distinction between agency and registry is fundamental. While the former is legally obligated to perform various safety, certification and compliance checks, and directly hires and insures caregivers, the latter acts as a staffing company, with less stringent quality-control and risk-management requirements. Registries do not necessarily bear responsibility for quality nor must they replace an under-performing or absent aide.
Another care option, which often leads to some legal and financial confusion, is a live-in. Under this modality, an aide resides with the client, and regulations permit that certain overtime-related costs be avoided while long service shifts are performed. But live-ins are not a universal solution for all families or individuals who need extensive in-home care.
Please request our live-in fact sheet for more information, and check the websites below for information on regulations and important aspects to consider when you hire in-home support.
CARIE – Home Care Guide
Still undecided? Call us for a free consultation.