Cleveland, OH (Change Location)

Caregiver Are Not All The Same

Facts you should know.

Professional caregivers generally can be grouped into three different categories: agency employees, independent contractors with a registry, and independent caregivers. As there may be different business models for each caregiver category in the marketplace, the following information is intended as a general summary of typical differences between these categories. This is not intended as an exhaustive description of every home care model. To confirm whether the descriptions below apply to the caregiver you are considering, please consult with the caregiver and/or the referring agency or registry.

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Agency Employees

  • Most agencies hire caregivers who are screened, trained, bonded and insured.
  • An agency is typically responsible for scheduling, handling any performance issues, and paying applicable payroll-related taxes.
  • Most agencies handle all risk as the employer by obtaining workers' compensation, liability and bond insurance.
  • An agency typically provides additional support between the caregiver, client and the client's family. Agencies are also generally able to provide replacement caregivers should the assigned caregiver become unavailable.
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Independent Contractors with a Registry

  • A registry usually recruits, screens and refers a caregiver to the client.
  • The client may become the "employer" and may then be responsible for hiring, scheduling, handling any performance issues and paying/reporting applicable taxes (depending on the registry's model).
  • The client may assume risk if the independent contractor is not covered by workers' compensation, liability and bond insurance.
  • While the registry caregiver may have had a criminal background check and reference checks, it is possible that he/she is not receiving support, training and continuing education. A replacement caregiver may also be unavailable should the caregiver become unavailable (depending on the registry's model).
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Independent Caregivers

  • Otherwise referred to as "the gray market," independent caregivers are usually responsible for marketing themselves and finding their own clients.
  • They may undergo a criminal background check and reference checks on a case-by-case basis.
  • The client may become the "employer" and may then be responsible for hiring, scheduling, handling any performance issues and paying/reporting applicable taxes.
  • The independent caregiver may not receive support, training and continuing education. A replacement caregiver may also be unavailable should the independent caregiver become unavailable.*

*Adapted from Stages of Senior Care - Your Step- by-Step Guide to Making the Best Decisions, by Paul and Lori Hogan.

  • The client may assume risk as the independent caregiver may not be covered by worker’s compensation, liability and bond insurance.
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