How Do Home Care Agencies and Home Care Registries Differ?

Selecting someone to care for your loved one can be an overwhelming task. For many families, understanding the difference between a home care agency and a home care registry adds an additional layer of complexity.

We believe the process of selecting someone to care for your loved one should be simple and transparent. We believe the process of starting home care should be a comfortable transition for the person receiving care and for your family. We believe you should be part of your loved one's care, but not have to actively manage all aspects of their care.

Understanding the Differences

The main difference between an agency and a registry comes down to managing the caregiver. When you select a home care agency, we manage the caregiver assigned to providing your loved one's care. When you select a home care registry, that task falls largely to you. To see the difference, see the chart below for comparison.

Home Care Agency

We provide in-home care services based on a written plan of care we create with you and the person needing care. We perform rigorous background checks as part of our hiring process, and we professionally supervise our caregivers to ensure your loved one is receiving the best care possible. We provide our home health aides, CNAs, homemakers and companion caregivers with continuing education as well as ongoing training and support.

Home Care Registry

A home care registry acts as an employment services for skilled and unskilled caregivers. Requesting an employee referral from a registry is very similar to hiring a person on your own. When you use a registry, you are responsible for managing the caregiver, handling payroll tax withholdings, and in some cases conducting a background screening.

Below is a breakdown between agencies and registries:

	Right at Home	Registry/Direct Hire
FINDING THE RIGHT PERSON
Are caregivers employees of the company you pay for care?	YES	Maybe*
Does the company verify that caregivers can legally work in the United States?	YES	Maybe*
Have all caregivers undergone rigorous criminal, abuse registry and reference background checks?	YES	Maybe*
Are caregivers company-trained before they are assigned to homes, and do they receive ongoing training?	YES	No
LIABILITY
Are Social Security, federal and state taxes, and unemployment insurance paid so the family is not legally responsible?	YES	No
Is workers’ compensation insurance (or the equivalent) paid so the family is not Legally Responsible?	YES	No
Is professional liability insurance for the caregiver paid so the family is protected?	YES	No
Are the caregivers bonded/insured?	YES	No
QUALITY OF CARE
Does the company conduct supervisory home visits to verify quality care is being provided?	YES	No
Does the company provide qualified replacement care if the scheduled caregiver cannot make it?	YES	No
Does the company develop a written care plan?	YES	No

*Currently, there are no federal laws requiring background checks prior to hiring a person. Each state has its own requirements as to whether background checks are mandatory, and if mandatory, what a background check consists of. Federal laws do require all employers to verify an employee’s eligibility for legal employment in the United States. However, whether or not any caregiver will be considered by the registry to be an employee or independent contractor depends on that registry. It is recommended that you investigate any registry you are considering.

We know you have options when it comes to home care services and we believe you should understand the differences between home care agencies and home care registries. Knowing the differences will help you make an informed decision that best meets the needs of your family and the person needing care.

Better Home Care Through a trusted Agency in:

Oak Harbor, Anacortes, Coupeville, Greenbank, Freeland, Langley, Clinton, San Juan Island, Orcas, Shaw, Lopez

What it means to be a licensed Home Care Agency in Washington State

Healthcare in Washington State is one of the most regulated industries in the country. A benefit of regulation is that there are laws to protect the elderly and the consumer from fraud and abuse.

In Washington State there is also a very high degree of state supervision of licensed home care agencies backed up by random, unannounced inspections and field audits. The state also sets high standards for minimum levels of professional and liability insurance and criminal background checks that must be proven and reviewed every two years.

The goods news about Washington State’s high levels regulation, supervision and oversight is that there are very high standards of care. The bad news is that it costs more to deliver. While some consumers may be tempted by the lower costs of ‘independent’ caregivers, this is not a true apples-to-apples comparison.

Independent Caregivers, while licensed by the state, are not subject to the high degree of state supervision and oversight that is directed towards licensed Home Care Agencies. In addition, independent caregivers are not required to carry liability insurance so consumers are at risk should there be a mishap.

When using an independent caregiver, state and federal employment laws apply to the family that hires the caregiver. What that means is that you, in essence, become their employer and must therefore comply with federal and state employment laws and collect and pay employment taxes.

Just as there are cost-conscious consumers that are willing to cut financial and legal corners, there are independent caregivers that are willing to cut corners, too! Self-employed caregivers are not audited by the state to see whether they have been for paying workman’s compensation insurance. In many cases, earning go unreported or under reported and the required taxes goes unpaid as well.

A prudent consumer should bear all of these costs and risks in mind when choosing a reliable source of quality care. When choosing a licensed Home Care Agency in Washington State, you can be assured of quality, value, and protection from accidents and mishaps.

If you decide on in-home care, there are several questions you should ask to ensure that your loved one will stay safe, healthy and happy:

What happens if you or your caregiver becomes ill or are otherwise unavailable? What are the alternate arrangements?
Is there always someone to answer the phone - 24hrs a day, 7 days a week?
Is there a minimum service commitment required or may I use as little as one-hour of service?
Do you pay your federal and state taxes, Social Security (FICA) and unemployment insurance, so that our family is not legally responsible?
Can you verify that you and your caregivers are legally able to work in the United States?
If you or your caregiver are injured at a client's residence, who is responsible? (Many homeowner's insurance policies exclude injuries to "domestic employees.")
Do you perform criminal background checks and state abuse registry checks? Do you check caregivers' references from prior work history?
Are you bonded or insured in case one of your clients is injured or there's a theft?
How do you document that your services were indeed completed?
How do you monitor in real-time that care is being delivered?

Personal health caregivers are often the only people with whom we may come in contact with extended period of time. Often our ailment or afflictions keep us isolated from friends and family we might otherwise see more often. And so in a way, it magnifies the effect these people and agencies they represent; have upon our well being; the very way we feel while they are here to assis us. Right at home workers are both highly professional and caring. I feel lucky to have them as part of my personal care team.

Richard