HomeSun City InsiderReferral VS Employee-based Caregiver Options

Referral VS Employee-based Caregiver Options

Written by Eileen Lynch, Director of Operations of Parkinsons Resource Organization
At some point in the journey with Parkinson’s, a family will more than likely need to hire in-home caregivers to assist with anything from bathing and grooming to medication compliance, transportation, meal prep, companionship, or simply to give the family a break. While it might seem tempting to find a home caregiver on your own, consider time, taxes, insurance and personal safety when making your decision. Otherwise you could fall into a dangerous and potentially expensive situation. To protect yourself legally and financially while pursuing the highest quality of care, consider the following:

Referral Agencies vs. Employee-based Home Care Agencies

“Referral” agencies operate like a clearing house – they help find, for YOU to employ, the right in-home care provider, for which the agency receives a finder’s fee.
Think of it like a matchmaker. An “employee-based” in-home care agency directly employs in-home care providers. They handle payroll, taxes, bonding, and licensure of the caregiver. You pay for access to their employees.

Hiring Practices

Who is responsible for running a background check? How extensive is that background check? Is the caregiver licensed? Is the caregiver insured? If you hire independent contractors, that responsibility falls on you. If you go through an agency, make sure you ask about their
hiring practices.

Taxes, Workers’ Compensation and Insurance

Employee-based home care agencies carry workers’ compensation and handle taxes and insurance for their employees. The company you want to work with must have extensive insurance, including Professional and General Liability, Non-Owned Auto, a Dishonesty Bond and Workers’ Compensation policies. If you hire an independent contractor, you may need to also hire an accountant, elder law attorney, or others to help with payroll and other human resources issues.

Training, Supervision and Replacement

Training and supervision are crucial to maintain high quality care. A good agency will have transparency about their training program. They will also handle personnel issues – if a caregiver starts showing up late, slacking on duties, etc. Sometimes a caregiver gets sick, or goes on vacation. At that point, you want to know your agency’s replacement policy – will they be able to quickly supply a replacement caregiver of similar caliber?

Overtime Pay

If you hire your caregiver as an independent contractor, understand the legal meaning of an Independent Contractor. It’s your responsibility to ensure that the caregiver is compensated properly for hours worked, including overtime pay. Incorrectly calculating overtime pay could make you vulnerable to lawsuits and other risks down the road.

The decision about who to allow into your home to care for yourself or your loved one is huge – but you don’t have to do it alone. At Parkinson’s Resource Organization, we help people with Parkinson’s and their non-professional caregivers through emotional support, education and practical resources. Our support groups provide solidarity and community to people facing the fight of their lives. Our Wellness Village Resource Directory is a digital portfolio of pooled resources to ease the research burden and maximize quality of life.

Are you or someone you love living with Parkinson’s? Get in touch! Call us at (760) 773-5628 or visit our website at



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