Archive for August, 2013

Should You Hire a Caregiver Yourself? Or Go Through A Home Care Agency?

August 27, 2013

You could hire a caregiver by running a newspaper or online advertisement, asking friends and neighbors for recommendations, or posting a “help wanted” notice on your church or synagogue bulletin board.  At least in the short run, it will probably be less expensive than going through a licensed home care agency.  But should you do so?

Advantages of hiring directly: 1. Lower per hour cost.

Disadvantages of hiring directly: 1. You are the employer and the caregiver is your employee.  This means that you are responsible for withholding, reporting and submitting federal, state and local taxes (Don’t forget those pesky “head taxes”.).  You are also financially responsible in the event your caregiver/employee is injured .  Most states, including Colorado, require that you buy workers compensation insurance to cover your one employee.  2.  You become the supervisor.  3. Training, both initial and on-going:  Are you competent (and do you have the time) to teach the caregiver the proper way to lift a patient, how to feed someone so they do not choke…and what to do if they do start choking, CPR, when to call 911 for help and when not to, etc., etc., etc.  4. Vetting of the caregiver: Do you know how to conduct a comprehensive background check?  5. Back-up: Who will be your back-up when your caregiver/employee’s car inevitably will not start, or the babysitter does not show up, or… 

Advantages of engaging a licensed home care agency: 1. The agency, not yourself, is the employer.  2. If you do not like who the agency sends, you can insist on a different person.  If the agency cannot or will not satisfy your requirements, you can easily replace the agency.  3. Supervision is provided by the agency.   4. Training is provided by the agency.  5. Background checks are performed by the agency.  6. Home care agencies have back-up caregivers on call.

My bias is clearly in favor of having a licensed home care agency provide your caregiver.  I used a home care agency when my mom needed 24/7 care and am glad that I did.  An important caution: Not all licensed home care agencies perform all of the above functions, nor do they all perform them well.  You need to ask a lot of questions and check references before engaging the services of an agency.  Ask about the agency’s insurance and bonding.  Get details about how the agency finds and screens caregivers.  Ask about specifics of the agency caregiver training program.

Another caution: Make sure you are dealing with a home care agency and not a registry.  An agency is the formal employer of its employee caregivers.  A registry gives you a list of caregivers who are not employees of the registry.  That means that you are the employer and the caregiver is your employee. 

The last time I looked, Metro-Denver had 235 licensed home care agencies.  Some are better than others.  Contact me offline & I will be happy to share my opinion of which agencies are best.  For care outside of Metro-Denver, There are some home care agency franchises that I would be comfortable recommending.

Hiring a caregiver directly is a roll of the dice.  You may find a wonderfully compassionate person who is well-trained and does not need supervision.  Who never sues or files a complaint against you.  You may even be successful in any IRS audit you experience.  Or not.

Disclaimer:  This eNewsletter and all links to other sources should not be construed as tax or legal advice because they are neither.   Raymond Smith, The Long Term Care Specialist, does not give legal or tax advice.  Consult your tax advisor or attorney for these matters.


© Raymond Smith, The Long Term Care Specialist, 2013