Types of Home Care Providers

Just like there are different types of home care services available, there are also different types of home care providers to consider. As a consumer it's important for you to fully understand the advantages and disadvantages of each type of home care provider before making a decision.

Home Care Agency - A home care agency is an organization that provides home care services, like skilled nursing care, physical therapy, occupational therapy, speech therapy, and personal care by home health aides.

The home care agency employs the qualified individuals to provide these services. The agency is responsible for its employees’ taxes, insurance, bonding and worker's compensation (as required by law). Employment is the key word. It carries with it an array of protections. If an employee is sick or goes on vacation, the agency provides another employee to perform the needed services. Employees receive training specific to the kind of care they provide. A licensed home care agency provides ongoing supervision for their employees. This helps the agency monitor and respond to the changing needs of clients, assuring that the appropriate level/skill of caregiver is assigned and mediating any other issues. The agency conducts background checks according to state law. In many instances the agency is licensed to provide all levels of home care (skilled nursing, therapy and non-medical services for example) so the individual does not need to work with more than one company and can access formal payor sources such as Medicare or insurance for those needs.

Registries or placement agencies differ from home care agencies in that the nurses, therapists, or home care aides they provide are contractors, not employees. Using a placement agency may seem a less expensive alternative; however, placement agencies provide less supervision and oversight of their workers. In some cases, the registry offers only referral and screening services, with the client taking the responsibility to pay the worker directly. In that case, you act as the employer and may be responsible for paying workers compensation and payroll taxes for the worker.

An independent worker is a person who is individually hired by either a family member or the person needing help. Employing a health care professional is an important decision, and one in which most people have little training or practice. While this may appear less expensive, there are many "hidden" costs and some significant risks.

Anyone who hires an independent worker must pay all appropriate payroll taxes - they are the employer. If the independent worker is injured on the job, the person who hires the individual is responsible for medical bills and any other expenses. Also, if the independent worker is sick or goes on vacation, he or she is not obligated to find a replacement. There is no supervision or training program. Unfortunately, there is always the potential for both physical abuse and financial exploitation when work is being done on behalf of a frail and sometimes functionally limited individual. While most individuals who provide care do so out of a desire to help others, there will always be those who see this type of work as an opportunity to take advantage of someone. This becomes especially easy in a private home setting with little or no supervision. Perhaps lower in hourly costs, choosing an independent contractor does not provide the security, trust and assurance most people want for themselves or their loved ones.