Home Care Agency, Registry or Private Caregiver: Who Employs Whom and Who Is Liable

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.

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, 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.

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 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.

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 for local medians.

When you compare, price the whole package.

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 explains screening in more depth, and the glossary entries on 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.

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 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.

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. Ask who employs the caregiver, who handles payroll taxes and who carries insurance.