--- title: "Home Care Agency vs Private Caregiver: Key Differences" description: "Home care agency vs private caregiver vs registry: who employs the caregiver, who pays payroll taxes, who covers call-outs, and a checklist for any provider." url: https://homecare.preview.multisites.ai/guides/agency-vs-registry-vs-private-caregiver/ publisher: HomeCare.com phone: 800-974-3458 start: https://care.homecare.com/?source=homecare.com --- Guide: Choosing care # Home Care Agency, Registry or Private Caregiver: Who Employs Whom and Who Is Liable The three models differ mainly in who employs the caregiver. With an agency, the caregiver usually works for the agency. With a registry, you usually hire the caregiver yourself. With a private caregiver, you find and hire directly. When you hire directly, you are generally the household employer, with tax and legal duties. Updated October 15, 20269 min readBy HomeCare.com 01 ## Employer role decides most things Who employs the caregiver decides who pays taxes, who carries insurance and who finds a replacement. 02 ## Direct hire makes you an employer The IRS lists health aides and caretakers as household workers. You may owe payroll taxes and need to file forms. 03 ## Cheaper on paper is not always cheaper A lower hourly wage can grow once you add taxes, insurance, backup care and your own time. 04 ## Backup coverage is a real difference Ask who covers a sick call, a vacation or a caregiver who quits. Do not assume it exists. 05 ## Ask every provider the same questions Use the checklist in this guide with any provider, including HomeCare.com. On this page 1. What are the three ways to hire in-home help? 2. What is a home care agency? 3. What is a home care registry? 4. What is a private caregiver? 5. What taxes and paperwork does a household employer owe? 6. Is it cheaper to hire a private caregiver? 7. What about background checks? 8. Who is liable if a caregiver is hurt or something goes wrong? 9. What does HomeCare.com say about how it works? 10. What should I ask any provider before I hire? 11. How do I choose? 12. Next step Questions about care for your family? [800-974-3458](tel:+18009743458) ## What are the three ways to hire in-home help? You can hire through an agency, through a registry or directly from a private caregiver. The difference is who employs the caregiver and who handles the work around the care. Terms vary by state and by company, so treat this as a general map. Question Agency Registry Private caregiver Who usually employs the caregiver? The agency Often the family, or the caregiver is independent The family, as household employer Who finds the caregiver? The agency The registry matches or refers You Who usually pays payroll taxes? The agency, as employer Often the family The family Who screens the caregiver? The agency Varies You, or a service you pay Who covers a sick call? The agency, if it has staff Varies You Who manages day-to-day work? The agency, with the family’s input Often the family The family These are common patterns, not rules. Always ask each provider to explain its own setup in writing. A good provider will not mind. Our glossary entries on [home care agency](https://homecare.preview.multisites.ai/glossary/home-care-agency/), [caregiver registry](https://homecare.preview.multisites.ai/glossary/caregiver-registry/) and private duty caregiver give short definitions. ## What is a home care agency? A home care agency is a business that employs caregivers and sends them to client homes. In the usual model, the agency hires, schedules, pays and supervises the caregiver. Why it matters: - **Employment.** The caregiver is generally the agency’s employee. The IRS says that if an agency provides the worker and controls what work is done and how it is done, the worker is not your employee. - **Wage rules.** The Department of Labor says third-party employers, such as home care agencies, must pay at least the federal minimum wage and overtime to their domestic service workers. That includes live-in workers. The agency, not the family, is responsible for that compliance. - **Backup.** An agency with enough staff can often send a replacement. - **Cost.** The hourly rate usually covers the worker’s pay plus the agency’s costs. The family pays one bill. Some states license agencies. Rules differ. Ask whether your state requires a license and ask for the license number. ## What is a home care registry? A registry is a referral service that connects families with caregivers. In the common model, the registry matches you with a caregiver and steps back. The caregiver is often independent, and the family may become the employer. Registries vary, so ask. The important question is not the label. It is what happens after the match. - Does the registry employ the caregiver, or do you? - Who pays and files payroll taxes? - Does the registry check backgrounds? How far back, and what does it cover? - If the caregiver quits, does the registry find a new one at no charge? - Does the registry stay involved after the first visit? ## What is a private caregiver? A private caregiver is an individual you find and hire yourself. You might hear them called a private duty caregiver or an independent caregiver. There is no company in the middle. That gives you control over who you hire and what you pay. It also gives you the employer role. The IRS lists household workers in Publication 926. The examples include caretakers, health aides and private nurses. If you pay someone for household work in or around your home, and you control how the work is done, that person is generally your employee. The IRS says a worker who controls how the work is done, supplies their own tools and offers services to the public is usually self-employed. A caregiver working set hours in your parent’s home usually does not fit that description. Our glossary compares a W-2 employee versus a 1099 contractor. Misclassification is a real risk. If you are unsure, ask a tax professional. ## What taxes and paperwork does a household employer owe? If you hire a private caregiver as an employee, you may owe federal payroll taxes and need to file forms. The IRS sets these rules in Publication 926 for 2026. Item What the IRS says (2026) Social security and Medicare Apply when you pay one household employee $3,000 or more in cash wages in 2026. Total rate is 15.3%, with 7.65% from you and 7.65% from the worker. Paying the worker’s share You can choose to pay it yourself instead of withholding it. Federal unemployment (FUTA) Applies when you pay $1,000 or more in cash wages in any calendar quarter. Tax is 6% of the first $7,000 per employee. State unemployment You may also owe it. Ask your state agency. Federal income tax withholding Not required. Withhold only if the worker asks and you agree (Form W-4). Work eligibility You and the worker each complete Form I-9. Year-end Give the worker a W-2 and file Schedule H with your tax return. You may also need an employer identification number. Family exceptions Wages paid to your spouse, your child under 21, or your parent generally do not count for social security and Medicare tax, with limited exceptions. Here is an example. It is our estimate, using the IRS rates. - You pay a caregiver $800 a week in cash wages. - Your 7.65% share is $800 x 0.0765 = $61.20 a week. - If you also pay the worker’s 7.65%, your weekly tax cost is about $122.40. Our glossary entry on [household employer and nanny tax](https://homecare.preview.multisites.ai/glossary/household-employer-and-nanny-tax/) covers the basics. A tax professional or a payroll service can handle the filings. Some families hire one. Overtime and live-in care need extra care. The Department of Labor says a live-in domestic worker employed by a family is exempt from overtime but must still be paid at least the federal minimum wage for all hours worked. Employees on 24-hour shifts who do not live in the home generally must be paid minimum wage and overtime for all hours worked. State law can be stricter. Talk to an employment or elder law attorney before you set a schedule. See also [live-in care](https://homecare.preview.multisites.ai/live-in-care/). ## Is it cheaper to hire a private caregiver? Not always. A lower hourly wage can look like a saving. But the real cost includes payroll taxes, insurance, backup care and your time. CareScout’s 2025 Cost of Care Survey reports a national median of $35 an hour for a non-medical caregiver. The survey does not report agency and private rates separately, so we cannot tell you which is cheaper. See [home care costs by state](https://homecare.preview.multisites.ai/cost-of-home-care/) for local medians. When you compare, price the whole package. Cost to compare Agency Private hire Hourly rate Billed rate Wage you agree on Employer taxes Usually included in the rate You pay (see table above) Insurance and workers’ compensation Ask the agency Ask your insurance agent Screening Ask what is included You arrange and pay Backup when the caregiver is out Ask what is included You find it, possibly at short notice Your time Lower Higher: payroll, schedules, replacements ## What about background checks? Every model should screen caregivers. The question is who does it, how far it goes and what you can see. Our guide on [hiring in home care](https://homecare.preview.multisites.ai/home-care-resources/hiring-in-home-care/) explains screening in more depth, and the glossary entries on [background check](https://homecare.preview.multisites.ai/glossary/background-check/) and bonded and insured caregiver define the terms. Ask these questions. - What does the check include? Criminal records, sex offender registry, identity verification? - How far back does it go? - Does it cover every state where the caregiver has lived? - Is driving history checked if the caregiver will drive your parent? - Are licenses verified for anyone who claims a nursing or aide credential? - How often is the check repeated? If you hire privately, you or a screening service you pay must do this work. Ask the service what its report covers. ## Who is liable if a caregiver is hurt or something goes wrong? Liability depends on who the employer is, your state’s rules and your insurance. There is no single answer. Ask every provider for specifics. An agency that employs caregivers may carry workers’ compensation and liability insurance. Ask for proof. Our glossary entry on workers’ compensation for caregivers explains the idea. If you are the employer, ask your insurance agent how a worker’s injury or a worker’s mistake would be handled under your policies. Do this before the first shift. An elder law attorney can also advise. See our guide on [elder law attorneys](https://homecare.preview.multisites.ai/paying-for-care/elder-law-attorney/). ## What does HomeCare.com say about how it works? HomeCare.com says it is not just a registry. Its contact page says: “HomeCare.com isn’t just a registry; it’s a powerhouse transforming home care through innovation and technology.” This guide does not put HomeCare.com into one of the three boxes. We ask you to use the checklist below with HomeCare.com too. Here is what the company publishes about its approach. - Its credentialing page says every Professional Caregiver it refers must pass a thorough background check. - Screening covers at least the past seven years. It includes a Social Security number trace and verification, federal and state criminal records, the national sex offender registry, a motor vehicle check in the current state if requested, license or credential verification, and a FACIS search for trained medical professionals. Our guide to the [credentialing process](https://homecare.preview.multisites.ai/family-resources/our-credentialing-process/) has the details. - Families can choose the number of visits and the hours per visit, with no minimums and no contracts. - The company says it can provide a caregiver on short notice and back-up care. - A mobile app confirms the caregiver is at the house on time and that billed hours are accurate. - Support teams are available seven days a week. These are the company’s own statements. HomeCare.com provides non-medical care. Ask a care advisor who employs the caregiver, who handles payroll taxes and who carries insurance for your situation. ## What should I ask any provider before I hire? Ask the same questions of every agency, registry or private caregiver, including us. Write down the answers and compare them side by side. The 9 questions for home care providers is a good companion list. Question Why it matters Answer from provider Who employs the caregiver? Decides taxes, insurance and legal duties Who pays and files payroll taxes? You may owe them if you are the employer Is there workers’ compensation and liability coverage? Can I see proof? Covers injuries and damage What does the background check cover, and how far back? Safety of your parent What happens if the caregiver calls out? How fast is backup? Gaps in care are risky What if we do not like the caregiver? Replacement process and cost How are hours verified and billed? Protects you from billing errors Are there minimum hours or contract terms? Flexibility and exit costs How is dementia or mobility experience checked? Match to your parent’s needs Who do I call when something goes wrong, and when are they available? Weekends and nights matter Does your state require a license for this type of provider, and what is the license number? Confirms oversight A provider that answers clearly and in writing is a good sign. Vague answers are a warning. ## How do I choose? Choose the model that fits your capacity as much as your budget. Ask yourself three questions. 1. **Can you be an employer?** If you have time for payroll, taxes, schedules and backup, a direct hire can work. 2. **How much risk can you carry?** An agency or other provider that handles employment can reduce your workload. It does not remove your need to ask questions. 3. **How reliable must coverage be?** If your parent cannot be alone, backup care matters more than a small hourly saving. Whatever you choose, get the terms in writing. ## Next step Print the checklist above and take it to every call. If you want to ask HomeCare.com, call a care advisor at 800-974-3458 or [request a call](https://homecare.preview.multisites.ai/contact/). Ask who employs the caregiver, who handles payroll taxes and who carries insurance. ## Frequently asked questions ### Is it cheaper to hire a private caregiver than an agency? Not always. A private caregiver may charge a lower hourly rate. But as the household employer you may owe payroll taxes, and you cover backup care, screening and paperwork yourself. CareScout's 2025 survey does not split agency and private rates, so compare total costs, not hourly rates alone. ### Who pays payroll taxes for a private caregiver? If the caregiver is your household employee, you do. The IRS says that in 2026 social security and Medicare taxes apply when you pay one household employee $3,000 or more in cash wages. The rate is 15.3%, split 7.65% each between you and the worker, though you can choose to pay the worker's share. ### What is a home care registry? A home care registry is a referral service. It lists caregivers and matches them with families. Registries differ, but in the usual model the caregiver is not the registry's employee, and the family hires and manages the caregiver. Ask any registry who the employer is before you sign. ### What happens if my caregiver calls out? It depends on the model. An agency usually sends a replacement if it has one available. A privately hired caregiver who calls out leaves you to find coverage. A registry may or may not help. Ask each provider how fast backup arrives and what it costs. ### Who is liable if a caregiver is hurt in the home? It depends on who the employer is and your state's rules. An employer may need workers' compensation coverage. If you hire directly, ask your insurance agent how a worker injury would be handled. For specific legal questions, talk to an elder law attorney. ## Sources 1. [IRS: Publication 926, Household Employer's Tax Guide (2026)](https://www.irs.gov/publications/p926) 2. [U.S. Department of Labor: Domestic Service Final Rule FAQs](https://www.dol.gov/agencies/whd/direct-care/faq) 3. [U.S. Department of Labor: Fact Sheet #79B, Live-in Domestic Service Workers Under the FLSA](https://www.dol.gov/agencies/whd/fact-sheets/79b-flsa-live-in-domestic-workers) 4. [CareScout: 2025 Cost of Care Survey](https://www.carescout.com/cost-of-care) ## Terms in this guide - [Healthcare Fraud and Abuse Control Information System (FACIS)](https://homecare.preview.multisites.ai/glossary/healthcare-fraud-and-abuse-control-information-system/) - [Workers' compensation for caregivers](https://homecare.preview.multisites.ai/glossary/workers-compensation-for-caregivers/) - [Household employer and nanny tax](https://homecare.preview.multisites.ai/glossary/household-employer-and-nanny-tax/) - [Bonded and insured caregiver](https://homecare.preview.multisites.ai/glossary/bonded-and-insured-caregiver/) - [Private duty caregiver](https://homecare.preview.multisites.ai/glossary/private-duty-caregiver/) - [Caregiver registry](https://homecare.preview.multisites.ai/glossary/caregiver-registry/) - [Elder law attorney](https://homecare.preview.multisites.ai/glossary/elder-law-attorney/) - [Background check](https://homecare.preview.multisites.ai/glossary/background-check/) - [Home care agency](https://homecare.preview.multisites.ai/glossary/home-care-agency/) - [Care advisor](https://homecare.preview.multisites.ai/glossary/care-advisor/) ## Keep reading - [**HomeCare.com’s Credentialing Process**All about HomeCare.com’s credentialing process and how we screen 100% of caregivers. Background checks and reference checks for caregivers.](https://homecare.preview.multisites.ai/family-resources/our-credentialing-process/) - [**How to Get Started with Hiring In-Home Care**Learn how to hire a caregiver by finding a home care provider, preparing for a home care assessment, and knowing the right questions to ask when interviewing.](https://homecare.preview.multisites.ai/home-care-resources/hiring-in-home-care/) - [**What is Elder Law and Do You Need an Elder Care Attorney?**Learn what services an elder care attorney provides and how to hire one. They can help you with your long-term care questions and needs.](https://homecare.preview.multisites.ai/paying-for-care/elder-law-attorney/) - [**How Many Hours of Home Care Does Your Parent Need? A Simple Needs Checklist**Count what your parent cannot do alone, and when. A few tasks a week may need two to four hours of visits. Help with bathing, meals and mobility every day...](https://homecare.preview.multisites.ai/guides/how-many-hours-of-home-care-do-i-need/) - [**Overnight Care for Seniors: Awake or Asleep Caregivers, Cost and When It Is Time**Overnight care puts a caregiver in your parent's home at night. An awake caregiver stays up and watches. A sleep-in caregiver rests nearby and wakes when...](https://homecare.preview.multisites.ai/guides/overnight-care-for-seniors/) - [**Respite Care at Home: How Family Caregivers Get a Break**Respite care is short-term care that gives a family caregiver a break while their loved one stays safe. At home, a paid caregiver, volunteer, or relative...](https://homecare.preview.multisites.ai/guides/respite-care-at-home/) ## Talk to a care advisor today. Free consultation. No minimums, no contracts. 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