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Hiring Caregivers Privately vs. Home Care Company

Over the years I have addressed the question of what is the benefit of working with a home care company as opposed to hiring caregivers privately many times.  The observations I offer remain the same.  What changes each time is the questioner.  Over the years we have been privileged to support thousands of families in their journeys through aging.  And always we begin again!

In our work at Personal Care we frequently interact with private caregivers.  We find them to be either the “best of the best,” or the worst.  For a family who lives locally, is engaged in the aging process with their family, and has the skills and will to deal with employee taxes and human resource issues, hiring privately is a good choice. The work between caregivers and clients is intimate and the success of the work is predicated on meaningful relationship.  When a family makes the effort to legally employ and support a private caregiver in their work responsibilities it can be a deeply meaningful experience.

Financial Implications for Family and Caregiver

The key to this success is considering the employment needs of the caregiver as equal in importance to the care needed by the family member.  Families who think that paying a caregiver directly so they can make more money, is only helpful if the employee’s taxes are withheld, reported and paid.  We have had many caregivers come to work for us late in their careers because they realize that they have not accrued any credit toward a social security income once they can no longer work.

Treating a caregiver as a 1099 contractor, or paying without any documentation of payroll, essentially focuses on the utility of the transaction and not the best interest of either the client or the caregiver.  The caregiver has no track record of paying taxes, and is therefore not eligible for the lending opportunities that help people make big purchases such as homes or vehicles.   The caregivers subsequently end up paying high interest rates and are limited in what purchases they can make.  The client’s family has the risk of being liable for unpaid social security and other payroll taxes.  If a family is capable of taking on the responsibilities of managing the payroll legally, the outcome can be excellent.

Background Vetting

Companies like Personal Care must comply with the State of Georgia’s requirement for fingerprinting. All of our caregivers are fingerprinted for the Georgia Bureau of Investigation, which then flags anyone who might have a felony conviction. Fingerprinting is not a requirement for private caregivers. Personal Care also provides an additional background check, and is authorized to conduct credit and/or motor vehicle background checks if necessary.

Training and Development

Our license with the state requires that our caregivers conduct annual Continuing Education. We offer both in person and online opportunities for employees. Private caregivers do not have this requirement or access. The state permits proxy care tasks to be trained and completed by CNAs. Examples include diabetes care or tube feeding, and must be taught and supervised for an individual client based on their care plan. This authorization is not available for private caregivers.

Staffing Management

Another key ingredient to hiring privately is making sure enough caregivers are available.  In other words, it is important to have back up. If a family member uses only one span of time a day, such as a morning shift, a day shift, or a night shift, securing enough support is not too difficult.  When a client requires more hours and/or more complex care, finding people who are available and trained is much more challenging and time consuming.  The potential for problems with patient care and home care increase exponentially as the number of caregivers in a home increase.

Most families do not have the time, ability or desire to take on this work.  Additionally, many families do not live close enough to supervise a private caregiver or team of caregivers.  Private Home Care Providers must employ Registered Nurses to provide supervision for our employees. Personal Care employs two full time RNs for this purpose. When families use Personal Care for their home care needs, they are hiring a company with 41 years of history in home care.  Our company is locally owned and managed, and continues to use the mission set forth in its earliest years, which is to complete the circle of care for each client.

We know that each person’s care needs are unique to their lives and families.  Whether it is our office team of intake, staffing, bookkeeping, and administration, or our field staff of RN supervisors and nursing assistants, we work towards the goal of optimizing a client’s quality of life.

Certainly this year of pandemic protocols has stretched us like no other.  Yet it is our intention to maintain our standards of care and ensure that when we are given the opportunity, we endeavor to deliver the best quality of care.  We do this by careful hiring, training, coaching, and retention practices.  Strong human resource support and protocols for our caregiving team generates a substantially higher retention rate than the industry standard.  We understand that our care delivery is only as strong as our caregivers and we work to support our employees through full benefits—health insurance-retirement, vacation—and investment in the quality of their lives.

We strive to be clear and timely communicators and problem solvers.  We hope to make hard life transitions less difficult for a client and their family members.  We understand the high cost of home care, and we want to add value to our clients’ lives, as well as their families and communities.

Martha Clinkscales