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Risks of Hiring Non-Agency, Private Caregivers

We talk with family caregivers, guardians and elder professionals every day.  I’m frequently asked why it is better to hire a professional Full Service Home Care Agency in Albuquerque, when it might cost less per hour to hire a friend or a private individual to help a parent or loved one.

Essentially, there are three choices for home care services; private hire, domestic referral agencies and Full Service Home Care Agencies.  Although there are compassionate and caring private caregivers in our industry, there are two issues that families need to understand before undertaking private hire solutions to their home care. The first is the personal liability families will assume with a private caregiver and the second is that they are now entering into a worker / employer relationship in the eyes of the law.  Private hire caregivers do not pay for liability and bonding or workman’s compensation insurance which protects the family in case of theft, property damage, exploitation or caregiver personal injury.

When they privately hire caregivers, the family now becomes responsible for employee taxes and any personal injury that occurs on their premises. Let’s remember that caregivers are highly susceptible to physical injuries that, without the Workers Compensation Coverage, will fall directly onto the family to financially provide for in the case of an injury in their home. Workman’s compensation injuries often result in disability payments for 500 weeks or longer to the employee.  Often we receive the phone call after a senior has been financially exploited by a privately hired caregiver or when the family has suffered financially after paying for a privately hired caregivers disability claims.

The most important distinction is the background screening that is conducted. At Home Care Assistance of Albuquerque our caregivers must pass a certified nurse’s aide exam, the state criminal registry and then a far more thorough national private investigative background search to ensure our employees are not hiding any inappropriate behavior that may place one of our senior clients at risk.

Our vetting process eliminates candidates who do not pass a 10 panel pre-employment (and random ongoing) drug screens. In fact, only 19% of caregiver applicants pass the pre-employment drug screen and CNA test. You simply cannot trust an unknown individual with the care of your loved ones by using only reference checks. You need to know the history of who you are hiring. With the private hire caregiver, even though on a rare occasion you might get a committed family member to watch closely, you’ll not receive the consistent oversight of a professional care manager who can recognize employee performance shortfalls or the need to update the plan of care based on the clients changing health status.

Be sure to vet your agency of choice to ensure they carry the necessary insurance that protects your family’s assets. Some companies may present  themselves as ‘agencies’ but in fact only have independent contractors working in the field so they are actually registry model home care businesses like Craigslist Scheduling Companies. This arrangement creates an employer-employee relationship between the worker and the consumer.  Always request a copy of the agency’s current certificate of liability insurance, workman’s compensation insurance coverage and automobile coverage.  Always make certain the workers they are assigning to you are their employees.

The IRS rules that agencies using independent contractors cannot provide work supervision or training to workers in home care without becoming employers.   Supervision, scheduling and worker training are important benefits to consumers and are provided only by agencies that hire their workers as employees.  So the family that uses a registry company really receives a much lower trained employee and assumes the liability for this unsupervised worker in their home.

In these cases the family was responsible for the workers injuries (remember, they hired the caregiver as an independent contractor- so workman’s compensation and professional liability insurance was never paid) and instead the caregiver’s attorney pursued the family as they are now the responsible party by law.  In a professional full service agency, the employee injury is the financial responsibility of the agency- their employer.

For the family, hiring a professional home care agency should provide assurance that someone with experience and accountability is reviewing the changing care needs of the client.  A professional agency will provide routine assessments to make certain the care plan keeps pace with the client’s needs.   And they will weekly supervise their employees by reviewing what was accomplished.