Sacramento, CA
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How Do Home Care Agencies, Home Care Registries and Direct Hire Caregivers Differ?

Caregiver cooking.

Selecting someone to care for your loved one can be an overwhelming task. For many families, understanding the difference between a home care agency, a home care registry, or hiring a caregiver directly 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, a registry, or a direct hire caregiver 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 or directly hire a caregiver, that task falls largely to you.

Home Care Agency

Right at Home Sacramento-Davis is a licensed home care agency and we provide in-home care services based on a written plan of care we create with you and the individual needing care. We perform rigorous background checks in concert with the California Department of Social Services 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 caregivers with continuing education through our Right at Home University system as well as ongoing hands-on training and support both in our training center and in the field. When a caregiver gets sick or needs to take time off, we will provide a suitable replacement caregiver.

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 withholding, and in some cases conducting a background screening. If your caregiver needs time off for any reason, finding a replacement falls to you.

Direct Hire

Hiring a caregiver directly adds to the complexity of managing a caregiver. Like using a registry, many of the legal requirements including worker’s compensation, liability, and unemployment insurance coverage becomes your responsibility as the employer. Just as with a registry, you are responsible for replacing a caregiver any time they cannot be at work.

Below is a breakdown between agencies and registries:

Finding the Right Person


Registry / Direct Hire

Employees of the company?
Verifies employment eligibility?
Provides criminal background check?
Provides caregiver training?
Provides continuing education opportunities?

Liability Issues
Handles Federal and State tax withholding?
Handles FICA and Medicare withholding?
Handles Unemployment Insurance?
Provides workers' compensation insurance (or equivalent)?
Carries professional liability insurance for the caregiver?

Quality Assurance
Conducts random supervisory visits?
Provides qualified replacements if caregiver cannot make the shift?
Creates a written plan of care?
Keeps family members involved in loved one's care?          

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.

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