Hiring a private caregiver vs a home care agency: what families don't think about
Thinking about hiring a caregiver on your own? A nurse explains the hidden responsibilities and risks, and why an agency is often the safer choice.
Published
By Teresa Sajkowski, RN, BSN, Founder of Always Responsive Home Care
Since founding Always Responsive Home Care in 2010, I have talked with many families who first tried hiring someone privately. Most of them did it for a very understandable reason, to save money. What they didn't expect was everything that came with it. Here is what to think about before you decide.
Why families consider hiring privately
Caring for a loved one is a big investment, and it makes sense to look for ways to keep costs down. Sometimes a friend recommends someone, or a family finds a caregiver online. The hourly rate may look lower than an agency's, and that can feel like the right decision at the time.
The difference is what that rate includes. With an agency, the rate covers the caregiver plus everything happening behind the scenes. When you hire on your own, those behind the scenes responsibilities usually become yours.
What you take on when you hire privately
Screening and background checks
You are trusting this person with your loved one and your home. When you hire privately, it is up to you to check references, run background checks and verify any training or certifications. Many families don't have an easy way to do this well.
Payroll, taxes and paperwork
If you pay a caregiver above a certain amount set by the IRS each year, you may be considered a household employer. That can mean withholding and paying payroll taxes, filing extra tax forms and following state wage and overtime rules. Mistakes can lead to penalties down the road.
Insurance and liability
What happens if a caregiver gets hurt while helping your loved one in your home? Or if something is damaged or goes missing? Without the right insurance in place, your family could be responsible. Some states may also require workers' compensation coverage for household employees.
Backup when the caregiver can't come
Everyone gets sick, has a family emergency or needs a vacation. When a private caregiver calls out, there is usually no one to step in, and the family has to scramble to cover the shift, often at the last minute.
Supervision and training
Who makes sure the care is being done safely and the right way? Who notices when your loved one's needs change and updates the plan? When you hire privately, that responsibility falls on you, even if you live far away or work full time.
Following state rules
Many states have rules about what caregivers can and cannot do and what training they need. Staying on top of those rules is hard for families to manage on their own.
Private caregiver vs home care agency at a glance
| What's involved | Hiring privately | Always Responsive Home Care |
|---|---|---|
| Background checks and screening | Your family handles it | We screen, background check and train every caregiver |
| Payroll and taxes | Your family may be the employer | Caregivers are our employees, and we handle payroll and taxes |
| Insurance | Your family may be responsible | We carry insurance that protects your family and our caregivers |
| Backup coverage | Your family finds a replacement | We find, send and orient a replacement caregiver |
| Supervision | Your family oversees the care | Our care team supervises and updates the care plan |
| State requirements | Your family keeps up with them | We meet or exceed state regulations |
| Support when you need it | Depends on one person | Our team is available 24/7 |
Is an agency really more expensive?
An agency's hourly rate may be higher than a private caregiver's, but it includes the screening, insurance, payroll, backup coverage and supervision you would otherwise have to handle or risk going without. When families add up the time, stress and risk of doing it all themselves, many find that an agency is the better value. It also means you get to simply be the daughter, son or spouse again, instead of the employer.
Questions to ask any home care agency
- Are your caregivers employees or independent contractors?
- How do you screen and train your caregivers?
- What happens if a caregiver calls out?
- Who supervises the care, and how often do you check in?
- Are you available 24/7?
- Do you require long term contracts or large deposits?
At Always Responsive Home Care, we are happy to answer every one of these questions, and we think you will love the answers. Our guide on how to choose a home care agency goes deeper.
Why families choose Always Responsive Home Care
- Caregivers who are our employees. We never use independent contractors. Every caregiver is screened, background checked and trained. In New Jersey, all of our caregivers are Certified Home Health Aides (CHHAs).
- Caregivers who stay. We pay our caregivers well and treat them like family, which means very low turnover and steady care for your loved one.
- A care team that stays involved. We supervise our caregivers, check in with your family and update the care plan whenever needs change.
- Backup when life happens. If a caregiver is sick or calls out, we take care of finding the replacement.
- Every level of care. Hourly care, overnight care, 24/7 care, live-in care in select locations, and 24/7 Virtual Care.
- Simple and upfront. No long term contracts, no large deposits and nothing billed in advance. We work with all long term care insurance policies and take care of the administrative work for you. Our payment options page explains how billing works.
- We make it right. We treat every client like family, and if something isn't perfect, we will make it right.
Let us take care of the details
You should be able to focus on your loved one, not on payroll, paperwork and finding last minute coverage. Call Always Responsive Home Care today or fill out the form below for a free in home assessment. We will listen, answer your questions and build a plan that gives your loved one great care and gives your family real peace of mind.
About the author
Teresa Sajkowski, RN, BSN, is the founder of Always Responsive Home Care. She started the company in 2010 in New Jersey and has grown it into a home care franchise serving families in multiple states.
This article is for general information and is not tax or legal advice. Rules for household employers vary by state, so check with a tax professional about your own situation.
Common questions
Click or tap a question to see the answer.
Is it cheaper to hire a caregiver privately?
The hourly rate may be lower, but you usually take on the screening, payroll, taxes, insurance, backup coverage and supervision yourself. When you add those up, an agency is often the better value and far less stressful.
Do I have to pay taxes if I hire a caregiver directly?
You may. If you pay a caregiver above a certain amount set by the IRS each year, you may be considered a household employer with tax and paperwork responsibilities. A tax professional can tell you what applies to your situation.
What happens if a private caregiver gets hurt in my home?
Without the right insurance in place, your family could be responsible. When you work with Always Responsive Home Care, our caregivers are our employees and we carry the insurance that protects your family and our team.
What happens if an agency caregiver calls out?
With us, we find and send a replacement caregiver and orient them to your loved one's care plan, so you are not left scrambling.
Can we switch from a private caregiver to an agency?
Yes. Many families come to us after trying to hire on their own. We can often start care quickly, sometimes the very same day.
