Private Home Care

The comparison nobody sets out honestly

Plenty of families hire a caregiver directly. A neighbor's aide who has spare hours, someone recommended at church, a person found through a listing. It is common, it is legal, and it is often perfectly fine.

It is also not simply "the same care for less money," and the difference is worth understanding before you choose.

• Hiring directly, you become the employer: Someone who works in your home, on your schedule, doing tasks you direct, is generally a household employee rather than an independent contractor, regardless of what either of you calls the arrangement. That brings payroll tax obligations above certain thresholds, and getting the classification wrong is the kind of mistake that surfaces years later. Worth twenty minutes with an accountant before you start, not after.
• Your homeowner's insurance probably does not cover them: Most policies exclude or sharply limit coverage for domestic employees injured in the home. Caregiving involves lifting, transfers and bathrooms, which is where injuries happen. Check the policy specifically rather than assuming.
• There is no backup: This is the practical one that catches most households. When a directly hired caregiver is ill, has a family emergency, or simply leaves, there is nobody. An agency has a bench; an individual does not.
• Nobody is supervising: No nurse writing a care plan, no one reviewing whether the care is still right as the situation changes, no second opinion when something looks wrong.
• And you do the screening yourself: Florida Level 2 background screening is fingerprint-based and checked against state and federal databases. Agencies run it as a matter of course. A private hire runs whatever you arrange, which in practice is often a conversation and a reference.

When hiring directly is the right call

We would rather say this than pretend otherwise.

If the hours are few and predictable, the tasks are light, the person is already known and trusted by the family, and somebody is around to notice if things go wrong, then hiring directly is reasonable and it will cost less.

Where it stops being reasonable is when the hours grow, when the tasks become hands-on, when the person is alone with a vulnerable adult for long stretches, or when there is nobody to fall back on. That is the point at which the cheaper option starts carrying risk that is not priced into the hourly rate.

What you are actually buying from an agency

Not the caregiver. The caregiver is the part both options give you.

You are buying the employment relationship, so payroll, tax and workers' compensation sit with us. You are buying screening, meaning Level 2 background checks on everyone. You are buying supervision, because a registered nurse writes and reviews the plan of care. You are buying backup, so someone comes when the regular caregiver cannot. And you are buying somebody to complain to who is not the person in your kitchen.

That last one matters more than families expect. Raising a problem with a directly hired caregiver means confronting someone you depend on, in your own home, tomorrow morning. Raising it with a coordinator does not.

Private pay, and what it actually costs

Private home care is billed by the hour. Rates depend on the level of care, the hours, and the time of day, since nights, weekends and holidays are usually charged differently.

We quote in writing before anything starts, and we will tell you if a smaller number of hours or a different mix of services would achieve the same result for less. If a directly hired caregiver would genuinely serve you better, we will say that too.

Three things reduce the cost that people overlook. Long-term care insurance frequently covers private home care, and it is the funding source households forget they bought. Locate the policy and a coordinator will walk you through the terms, free of charge. [Florida Medicaid Long-Term Care](/accepted-insurance-plans/florida-medicaid-long-term-care/) pays for home care for households that meet the eligibility test, which is administered by your county's Area Agency on Aging. And combining services sensibly, with a nurse only for the hours that legally require one and a caregiver for the rest, usually costs considerably less than one person at the higher rate.

Private duty home care and private duty nursing

These sound the same and are not.

Most people who call asking for private duty nursing need private duty home care, and a considerably smaller bill.

• Private duty home care: A caregiver, privately arranged, providing non-medical help: bathing, dressing, meals, mobility, company, supervision.
• Private duty nursing: A licensed RN or LPN providing continuous one-to-one skilled nursing in shifts, for tasks that legally require a nurse.

What we can tell you about staffing

The minimum is four hours per visit. From your first call, the typical time to a first visit is 48 hours.

When your regular caregiver is unavailable, we can arrange a replacement within four hours. That is the difference the comparison above turns on, and it is the reason most households move from a private hire to an agency.

A registered nurse writes and supervises every plan of care. Caregivers are Level 2 background screened, employed, insured and covered.

Where we provide private home care

Private home care across Palm Beach, Broward, Miami-Dade, Martin, St. Lucie, Indian River and Okeechobee counties. See personal care, companion care, home health aides, 24-hour home care, live-in care, respite care and Alzheimer's and dementia care for the individual services.