Options for Hiring an In-Home Caregiver

Yesterday we mentioned some of the risks of hiring an in-home caregiver, particularly if you opt to privately hire from public sources without doing a proper background check. Today we’re following up that post with one outlining options for the main types of caregivers. As with the last entry, the information is from a Health Care Reform Expo held last week in La Jolla and sponsored by local members of CAHSAH. This information comes from a presentation titled “A Pivotal Year for Health Care” given by Brittnei Salerno, president and CEO of La Jolla Nurses Homecare.


Option 1: Hiring a Caregiver Directly

This includes finding someone using online or newspaper ads or church and community bulletins. The cost to hire is low but risk is high.

• You are responsible for checking references and doing a complete background check. (By law in California, you can request one from the Department of Justice.)

• The patient, as the employer, is responsible for deducting payroll taxes and obtaining Workers’ Compensation Insurance.

• The patient does the hiring and the firing, which can be both awkward and difficult depending on circumstances.

• Be sure to tell the caregiver exactly what you expect of them and how they should be carried out.

Option 2: Hiring Through a Direct Referral Agency

The cost for using an agency is moderate and the risk is high.

• There typically is a fee to help the patient hire a caregiver

• The patient is the employer and responsible for supervision, payroll taxes and Workers’ Compensation Insurance

• If it doesn’t work out, the patient does the firing and must start the process to find a replacement

Option 3: Hiring Through a Full-Service Agency

The cost is moderate to high and the risk is low.

• The agency is the employer and takes care of the screening, hiring, firing and payroll

• The agency is liable for the caregivers’ actions while employed with them

• The agency finds a replacement if needed

• Caregivers may be eligible for employee benefits, such as health insurance and 401(k) retirement accounts