Minimize the Risks of Bringing a Caregiver Into Your Home

July 01, 2011

Recently there have been mutiple stories and headlines in the news about privately hired caregivers stealing from seniors in their own homes. Overall, there has been an increase and frequency to this issue of seniors being taken advantage of, as well as an alarming decay in the quality of service  provided by direct hired caregivers (or even "agency" supplied careegivers) in the recent past.

As a client explained, "Bad times bring out bad people".  In either case, whether the caregiver was hired privately, or provided by an "agency" - there are certainly risk for the person doing the hiring.

There are certainly methods to minimize the risks if you are that person seeking a caregiver.

The biggest risks are in a direct hire by the client (sometimes called "off the books" or payment "under the table"). The person doing the hiring is responsible for all employment requirements. Things such as caregiver training, background checks, proof of eligibility to work in the United States, general and professional liability insurance, bonding for theft, workmen's comprehensive insurance, state and federal payroll taxes and caregiver supervision are the responsibility of the person hiring the caregiver directly.

In instances of private hire, any hopes of recovery of monies stolen offer little or no hope of recovery of the loss/theft.

Hiring through an agency, while less risky, also has its risks. Not all agencies do all they should do to protect clients.

Many agencies are quickly formatted and created, with no background and effective management in senior care. Many of these agencies have zero supervision of caregivers, and often do not even do simple background checks of their hired staff.

In California, other than a simple city business license, primarily for tax purposes, there are neither state nor local regulations that apply nor is there routine inspection of the operation of home care agencies.

State wage orders and payroll tax payments are circumvented by not hiring the caregivers, but instead using them as independent contractors.

Some agencies do not provide any caregiver training, background checks, proof of eligibility to work in the United States, general and professional liability insurance, bonding for theft, wokmen's comprehensive insurance and field supervision.

With no random checks or inspections, there is little risk to the agency doing business this way of being caught. Any problems usually are discovered only after a negative incident has occurred.

If that happens, this type of agency simply closes its doors and leaves the client "holding the bag". Following any negative incidents many agencies simply change its name - move into a new location (or simply change a PO Box address) and begin calling on senior clients for new business.

The best protection for a person seeking to hire a caregiver and to protect oneself when considering hiring a caregiver for work in you or your loved ones home is to look for a qualified agency that has been in business for a while, has a local address and phone number and most importantly is a member of one of the home care associations that verify their quality business practices.

Associations in home care such as the California Association for Health Services at Home (www.CAHSAH.org) or the National Private Duty Assocation (NPDA), do their best to verify that member agencies do business in such a way to protect the senior clients in every way possible. As an example, some associations verify each year that member agencies hire and pay payroll taxes for their caregivers, does background checks on caregivers, covers general/professional liability insurance, bonding, and workman's compensation insurance covering the caregivers.

Before hiring a caregiver, a person may also want references (from past clients), or even check with the Better Business Bureau (BBB) as to their business practices. Personally visiting the caregiver agency's office may also be prudent and beneficial.

The lessons to be learned from the tragedies of elder abuse or senior being taken advantage of is to do your homework and checkout an agency beforehand.

If you do decide to hire directly, understand that you are responsible for having an employee and are liable for payroll taxes, bonding and workman's comprehensive coverage, or the potential fees and fines after an incident may occur.

Liabilities and risks are less likely to occur by doing diligence and asking appropriate questions of the agency before hiring a caregiver. Be certain that all caregivers are being monitored and supervised by the hired agency, and be certain to remain in communication with that agency in regard to supervised visits or caregiver management.