There are several options to choose from when deciding on non-medical home care...agencies, registries, and independent caregivers. The following information will help you to understand the differences between a professional home care agency and a registry or independent hire.
Using an agency will allow the client to skip the process of seeking, selecting, and screening a caregiver. It is difficult to find a caregiver that is not only well qualified, but is a good personal match for the client as well. An agency not only checks references, performs thorough background and driving record checks, but also takes care to find a good caregiver match for each client, taking into account personality, hobbies and common interests in addition to requested schedule and geographic location. With a professional home care agency, clients can be confident in their caregiver’s competency for the job. An agency often provides ongoing caregiver training as well as an orientation. Ongoing monitoring means that any needed changes or assistance can be identified and corrected. Registries often conduct background check and have a screening process...however they do NOT employ their caregivers, this means that there are none of the safeguards in place once the client has hired the caregiver. Always ASK if the company is an agency or registry!
It is certain that at some point a regular caregiver will become ill or desire to take a vacation. An agency will often provide a "team" for each client that includes a backup caregiver or two if your regular caregiver is ill, on vacation or does not show up for work. Additionally, an agency handles all worker discipline, to assist with situations such as showing up late for work or should any conflicts arise.
An agency provides supervision of all caregivers by a qualified individual. With a registry or independent hire, there is no oversight of care, opening up a client to potential financial, mental or physical abuse. Agencies check in with their client's on a regular basis to ensure quality care.
A home care agency carries liability insurance. This means that if something happens for which a liability is incurred, the agency’s insurance policy will likely cover it. An example of this is if the caregiver were to slip while helping your loved one bathe. While an agency would have liability insurance to cover this event, if the caregiver were from a registry or an independent hire, the client would be liable for the employee's injuries incurred while working...futher the client's homeowner's insurance may or may not cover the injury making the client financially responsible.
It can be time consuming and confusing to schedule, administer payroll, and withhold taxes appropriately as an employer. With an agency, all of the worker’s timesheets, tax withholding, as well as billing and payroll, are taken care of for the client.
A home care agency takes care of carrying and covering workers’ compensation and unemployment insurance. If a worker is injured on the job, or is unable to work due to medical reasons, the agency’s policy will cover the medical bills and any incurred expenses. Further, if a worker is laid off from a job, the worker may file for unemployment. With a registry or an independent hire, the client would be responsible for not only the medical bills and potential disability payments, but the unemployment payments as well.
It is important to realize that when you enlist a registry or hire an independent caregiver you are not just the client...you are also the employer and expected to take on all the responsibilities that being an employer entails. Caregivers often do not meet the criteria of an "independent contractor", so simply handing them a 1099 form to fill out will not satisfy the IRS. And of course paying "under the table" has its own inherent (not to mention illegal) risks.
While it is always tempting to seek out the cheapest alternative, it is important to realize that a few extra dollars spent on a professional home care agency may save many, many more dollars in the long run.