Hiring Independent Caregivers Vs. Hiring a Licensed Home Care Agency

As our population ages, the issue of caring for aging loved ones grows. True, having family care for a loved one at home is an option. But with the weight and demand of that responsibility, many families quickly find themselves turning to hiring independent caregivers or looking at agencies. The two are very different so it is important to recognize those differences before you make a decision. Everyone likes a bargain, but when it comes to home care, selecting the cheapest price for care can result in expensive implications.


Payroll Taxes

Hiring an independent caregiver for a low rate per hour would seem less than paying an agency’s rate.  But consider what might be required of you under IRS employment rules and liability insurance. If you don’t conform to the IRS’s rules, you could be exposing your family to an IRS audit and tax penalties. When the client is considered the employer of the independent caregiver, the client is responsible for the appropriate employer-paid Social Security, Medicare, federal and state payroll taxes for the independent caregiver. If these taxes are left unpaid, the government can sue the client or their estate for back taxes, interest and penalties, as well as potential civil fines and criminal penalties.

 A fully licensed home care agency conforms to the IRS employment rules and takes out taxes for their caregivers.


Worker-Related Injuries

Workers’ compensation protection is required by law in nearly every state, and it may be surprising to learn homeowner’s insurance does not typically cover an employee in the home. If a worker sustains an on-the-job accident, such as back issues from heavy lifting, the medical cost and disability payment for that worker could cause financial hardship for even a very wealthy individual. Keep in mind that should you choose to hire an independent caregiver, as the employer, you will be responsible for the liability risk of both the caregiver and the care recipient.

 A fully licensed home care agency provides workers’ compensation protection.


Supervision of the caregiver

Without a home care agency in place, who supervises the person providing care? Regrettably, this is the responsibility of the client. The individual you hire might have some clinical experience, but it is unlikely he or she will have a nursing degree.  Without such clinical oversight, the care of your loved one is not going to be at the highest level.

 A fully licensed home care agency  provides supervision, training and manages the schedule of  their caregivers. 



What would happen if the person you hired did not show up for work, wanted to take time off, or was sick?  As the client and employer you are responsible for staffing your own care. If the employee has been hired to care for you/your family member, but that person is unable to make it to work, you will be on the hook for a solution.  Someone from the family might need to miss work to tend to your loved one.  There have been cases where frequent problems of this sort have cost family members their job.

With a fully licensed home care agency, clients and their families need not worry for the simple fact agencies can assign another qualified caregiver to provide care.


Abuse and Exploitation

Most who enter the home care industry are caring, giving people. Unfortunately, there are those who know it is very easy to take advantage of frail, functionally limited, often impaired clients. With this in mind, who does the criminal background checks on independent caregivers? Unfortunately, the answer is no one. This responsibility falls upon the client and/or their family and this process takes time and money to complete. If these checks are not completed, risk of physical, psychological or financial abuse is quite possible.

Agencies require criminal background checks. This is at no cost to the client.