What appears to be the least expensive alternative may have hidden costs and consequences. Independent caregivers and/or registries that merely provide the services of non-employees (also called independent contractors), typically charge a lower hourly rate for care than an in-home care agency that employs its caregivers. At the same time, the client who uses an independent caregiver may end up bearing hidden costs and assuming additional risks. Those costs and risks may include lack of background checks on caregivers, lack of training, and employer liability, both in terms of insurance and taxes.
According to an article in the January 2005 issue of Geriatric Nursing, “These referral services have no liability because they consider the caregivers independent contractors. The result is that the client is responsible for liability insurance, taxes and other issues they might be ill equipped to deal with,” said Tina M. Marelli, MSN, MA, RNC and home health care editor. “Many [agencies] are registries that don’t employ the caregivers and do little, if any, investigation into their employment history or past,” said Marelli. By hiring an independent, the client becomes the employer. This means the client bears the responsibility of the employer’s portion of payroll taxes as well as the potential liability of unreported or unpaid taxes by the caregiver. In addition, as an employer, there is the obligation to provide Workers’ Compensation insurance. Be aware that most homeowners’ policies do not include coverage for risks associated with hiring an independent caregiver to provide in-home care.
Questions to Ask
When choosing a home care company, it is important to know what questions to ask before making any decision. Conducting a brief interview allows you or a family member to evaluate the best service for your situation.
• How long has the company been in business and do they operate as a
business?
• Are the caregivers employees, bonded, insured and covered by Workers’
Compensation and unemployment insurance?
• Is there a written plan that explains the services that will be provided? Before
any in-home care begins, you should receive a written plan of care that explains
both the services and the financial arrangements.
• Are there contingencies if the caregiver is unavailable? There are times when a
caregiver may be unable to come to work.
When considering to employ a private caregiver, ask the same questions.
It is easy to be overwhelmed when making a decision about home care for a loved one. Instead of focusing on the per-hour cost, concentrate on the quality of care your loved one will receive. The long-term consequences of hiring an independent and/or agency-referred caregiver may not be worth the risk. By understanding the options available for in-home care, you can feel satisfied and safe about your choice.
Myles McNamara is owner of Comfort Keepers In-home Care, providing assistance to Seniors in the comfort of their own home. Located at 24355 Lyons Avenue, Suite 110 in Newhall, he can be reached at 661-287-4200.