St Louis - Aging in Place: In Home Care Services are not created equally

St Louis Home Care OptionsHome Care Services - Important Issues to Consider

Many people don't know everything that is involved in arranging for and choosing in home care services or aging in place services until they are actually faced with the need. Often the need for senior care arises unexpectedly and without notice. There are many different avenues you may take when choosing home care, each having its differences. You can obtain services from an agency, be introduced to an attendant through a registry, or hire a caregiver privately. Since most people in need of senior home care are new to the process and often don't have the resources or the time to investigate the merits of each option, we offer you the following descriptions and urge you to make an "informed decision" when choosing in home care in St. Louis, St. Charles, Lincoln or Warren County.  Don't become an "Accidental Employer"!  Make sure that you understand the difference.

Home Care Agencies

Home Care Agencies are full service companies responsible for the hiring, training, supervision, and scheduling of caregivers. Caregivers who work for Agencies go through rigorous federal, state and county background checks and are employees of the agency, not independent contractors. As the employer, Agencies are required by law to carry Workers' Compensation insurance, and most agencies will also carry General Liability insurance, Professional Liability insurance, and a Surety Bond. Agencies are required to withhold Federal and State income taxes, and to withhold and match Social Security and Medicare taxes for their employees. Agencies also contribute to State and Federal Unemployment Insurance funds. As employers, Agencies also have been assigned Federal Tax Identification Numbers and State Employer Account Numbers. Employees are issued W-2 forms annually from Agencies.

Agencies are usually involved with the home care process throughout the entire course of service. Agency administration monitors and maintains schedules of caregivers, satisfaction of clients, and personnel changes as necessary. Agencies invoice for services rather than asking a client to pay caregivers directly. Any changes that may need to be made are done through the Agency. Many Agencies are available 24 hours per day, and can take care of emergency situations as they occur.

Home Care Placement Agencies

Home Care Placement Agencies (also know as registries) act as liaisons or introductory entities between caregivers and clients. However, registries do not employ their caregivers, and therefore caregivers are not covered for Workers' Compensation, Liability Insurance, and are not Bonded. Some Registries attempt to get around these issues by carrying these insurance policies for their administrative personnel only, and can then say that they have them, but since the caregivers are independent contractors, they will not be covered in case of an accident. Registries are required to train, screen, and interview prospective caregivers. Registries do not withhold any taxes from their caregivers’ paychecks. The caregivers are responsible for paying their own taxes and are issued 1099 forms annually to reconcile their income with State and Federal authorities.

Registries typically introduce a client to a caregiver for a fee, but do not supervise and manage the ongoing care or scheduling between the client and the caregiver. Clients pay caregivers directly for their senior care services, and the caregiver usually pays a percentage back to the Registry. Registries have no responsibility or liability for anything that may occur to a client or caregiver during the course of services.

Hiring a Caregiver Privately

Hiring a caregiver privately represents a third option for hiring a caregiver. Clients themselves are solely responsible for finding and screening prospective caregivers. Individual clients often do not have the knowledge or the resources to go through this process effectively. When a caregiver is found, clients arrange for the terms of employment, and negotiate payment for services. In most private hire situations, clients become Household Employers and are required to register with the Internal Revenue Service as such. Clients must withhold Federal and State income taxes, withhold and match Social Security and Medicare taxes, and contribute to Federal and State Unemployment Insurance funds. It is advisable to consult a tax attorney or an accountant before undertaking a private hire situation.

Unforeseen problematic issues may arise in a private hire situation. For instance, if the caregiver is ill or needs time off unexpectedly, a client may be faced with a potentially dangerous situation being alone. Family members may be called upon quickly to assist. If personality or performance issues arise, clients may need to start the entire hiring process over again. Furthermore, if a caregiver is injured while at a client's residence, the caregiver could sue the client for damages and medical treatment. Some Homeowners Insurance policies will cover a certain portion of these expenses, however separate coverage must often be obtained specifically for this purpose. Appallingly, if a caregiver should steal from a client, the only recourse is to pursue legal action against the caregiver directly.

Assistance Home Care is a full service Home Care Agency in the State of Missouri. We conform to all applicable State and Federal employment and tax laws, and carry all required insurance policies.

Assistance Home Care provides senior care services in St. Louis, St. Charles, Lincoln and Warren Counties in the State of Missouri. Contact us today if you have questions about choosing home care or would like to schedule a complimentary assessment.

ASSISTANCE HOME CARE IN ST. LOUIS: CONTACT US TODAY - To get answers to your specific questions please feel free to call us:

Mid County           314-631-1989

South County       636-724-4357

West County         636-200-2909 

St. Charles             636-724-4357

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