Licensed Home Care Agencies vs Independent Caregivers

Having owned and operated a large licensed (NC) and highly decorated (both regionally and nationally) home care company for over 8 years, I often get the question about what is the difference (other than money!) for hiring a licensed Home Care Company versus hiring Independent Caregivers. Although there are differences in every state in the USA, here are some reasons why, whenever possible, families should go the route of a professional licensed Home Care Agency in their state:

1. State Licensed - First of all, the company is licensed by that individual state. Meaning an application was submitted, reviewed, and accepted by a state accredited licensing office. Most often, that same state agency/office, then will conduct audits of agencies on an annual or semi-annual basis. In many cases, such as in NC, these same licensed agencies are also licensed by other state departments to provide service and to accept reimbursement such as Medicaid, Long Term Care Insurance Companies, Veteran Affairs, local Council on Aging etc. Thus, other companies, like individual states, will do their own approval/acceptance process of the agency and will audit them on a regular basis.

2. Employees - All employees of licensed home care companies should be direct employees of said companies. This includes full background checks done on all individuals before being hired by the agency. It also means drug testing, client supervision, and nurse training and review. Most licensed home care agencies do initial training and on-going training for all, or at least most, caregivers in their employment.

3. Insurance - Again, agencies will have Worker's Comp, General/Professional Liability, and even Theft Insurance (or Bond) on all caregivers. With a professional agency caregiver, there is less likely a chance for an incident in most cases but if there is an incident, the company has the necessary insurance to cover any issues. This is very important! For example, if an independent caregiver does not have their own Worker's Comp Insurance in place, and they slip and fall in the family's/clients home, it is possible that the independent caregiver can (and have!) sued the family for funds to reimburse medical costs etc.

4. Background Support of the Licensed Agency - I think this is a major oversight of families choosing independent caregivers versus agencies. Often times, no matter how much a family supervises and tries their best to schedule caregivers for their family members ................ things come up! Caregivers get sick, they have vacation, their children or loved ones get sick, or they simply move away. With the support of a large licensed Home Care Agency, it is their responsibility to immediately staff a replacement (Short-Term and Long-Term) a caregiver in the person's stead. The family does not need to be involved other than screening the new caregiver if they wish.

5. Taxes & Liabilities of Employee - Again, as stated in #2 above, when dealing with an Agency it is their responsibility (since caregivers are direct employees) to takeout and pay social security, state and federal taxes, Medicare etc. If a family goes the route of hiring their own caregiver, they are financially and legally liable in submitting, and in some cases, paying taxes on the employees behalf. Please check with your own state attorney and/or CPA to verify what this all entails. The main point I am trying to make is most people don't realize this is an issue. And obviously, no one wants any issues with the IRS when hiring a caregiver. By going with a licensed Home Care Agency, the caregivers are direct employees and the agency does this for the client/family's behalf.

6. Payment Sources - Independent Caregivers get paid Privately (Cash or Check) as the only means of payment. Whereas Home Care Agencies (Licensed) can be provide services and get paid by numerous payment sources including Long Term Care Insurance companies, Worker's & Accidental Insurance Plans, VA Plans, Medicaid, County Grant Blocks, etc. Let me be clear, Licensed Non-Medical Home Care Agencies cannot accept Medicare nor Third Party Insurance companies but many can and do accept the above payment sources which simply an Independent Caregiver cannot.

I hope this all helps explains some of the reasons why a large licensed Non-Medical Home Care Agency is the best route to go for In-Home Care. For additional questions, please don't hesitate to check out our websites www.comforcare.com or www.homecarecharlottenc.com (local) or call us at NC: 704-543-0630 or SC: 803-431-7447 or e-mail at [email protected] My company, ComForcare Home Care (Charlotte) handles the Greater Charlotte Metro Market and some of the Upstate SC market.