Confused About Home Care

Are you confused about Home Care?

What’s the Difference between Home Care and Home Health?

  • Home Care Agencies provide services that do not require a physician’s order and are not paid by Medicare or medical insurance. Typically, non-medical home care agencies provide assistance with activities of daily living and independent activities of daily living.
  • Home Health Agencies provide services from licensed medical personnel such as nursing, physical therapy, occupational therapy, etc. These services usually require a physician’s order and are usually paid by Medicare or other medical insurance.

Staff Caregivers vs. Independent Contractors

The National Private Duty Association published a position paper outlining its concerns about consumer and worker risks associated with the use of Independent Contractors for home care services. The use of private pay home care services is soaring and many consumers do not understand the risks to which they or their loved one can be exposed by companies that place care workers who are classified as independent contractors.

The Problem

Consumers often turn to companies that offer the cheapest price for care without understanding the implications of their choice. Many consumers are hiring workers from registries and companies that do not employ or supervise their workers, but merely “place” them in home care settings. This has resulted in unfortunate situations for seniors and their families. Below is an examination of the risks to which seniors, families and home care workers could be exposed.

Risks Associated with Use of Registries and Independent Contractor Companies

One major issue is that there IS an employer-employee relationship that is created in most of the care situations—it is between the worker and the consumer. Unfortunately consumers in most cases are not aware of this. Referring registries and independent contractor agencies often don’t communicate to the worker and consumer that this arrangement could result in the creation of an employer-employee relationship. Because of this, both the worker and consumer can suffer significant financial liabilities.

Liabilities and abuses

Payroll taxes

Anyone who receives a paycheck must pay the government any taxes due. This includes social security, Medicare, federal and state unemployment, and state and federal payroll taxes.


When the consumer is the employer and responsible for compliance, and none of these taxes are being paid, the government may sue the consumer or their estate for back taxes, interest and penalties. In a situation where many days of care, or many hours each week of care over a long period of time have been delivered, this tax responsibility can be a substantial amount. Other remedies that authorities may seek can include civil fines and criminal penalties.


There are also many problems for workers. No payment into social security leaves them vulnerable in their old age, and no protection is afforded for their periods of unemployment.

Worker Related Injuries

If no workers’ compensation protection is provided (as mandated by law for employees), and the worker sustains an on-the-job accident, the liabilities can be substantial. Medical costs and disability payments for workers could cause financial hardship for even a very wealthy client. For clients who could not afford to pay, the worker could be left with no help for a devastating injury. Many consumers incorrectly assume that homeowner’s insurance will cover this type of loss, when, in fact, homeowner’s insurance usually specifically excludes employees in the home.

Abuse and Exploitation

Most workers who enter the home care industry are caring, giving people. Unfortunately, there are also those who know that it is very easy to take advantage of frail, functionally limited, often cognitively impaired clients. Independent contractor agencies, because they have little on-going liability and want to avoid being considered as the employer of the worker, may provide inadequate or no background investigations on their caregivers. This could subject clients to physical, psychological, or financial abuse.

Supervision of the Worker

Because of the Internal Revenue Service regulations, registries and independent contractor agencies cannot provide any substantive work supervision, scheduling or training to workers in home care without becoming employees. If they do, the company, by law, becomes the employer of the worker. Supervision, scheduling, and worker training are important benefits to consumers and workers and are provided only by agencies that hire their workers.

 

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Our Contact Information:

A Way to Stay
1596 Quarry Road,
Yardley, PA 19067
(215) 321-5100

Better Business Bureau Accredited Business CQA Certified Bucks County Long Term Care Consortium One of the Best, 2016! Bucks County, Courier Times