Home Care Agency vs. Registry: Is Saving Money Worth the Risk?
Imagine your loved one is in the hospital, a rehabilitation center, or a skilled nursing facility. The discharge team informs you that he or she cannot return home without 24-hour care in place. You’re handed a list of home care providers—or perhaps a few brochures—and asked to choose someone to assist with essential daily needs like bathing, grooming, and toileting.
Naturally, your first concern is your loved one’s safety and well-being. But right behind that comes another pressing issue: the cost of in-home care.
Why Agency Rates Are Higher
Rates can vary significantly. Home care agencies typically charge between $35 and $45+ per hour. Why the higher cost? One major reason is legal compliance. Agencies are required to follow employment laws, including those mandated by the California Domestic Worker Bill of Rights (A.B. 241), which ensures caregivers receive overtime pay for work exceeding 9 hours per day or 45 hours per week. Agencies also provide workers’ compensation, withhold payroll taxes, and handle other employment obligations—costs that are inevitably passed along to clients.
Why Registries Appear Cheaper
In contrast, registries operate as referral services rather than employers. They connect families with independent caregivers—contractors who are not employees of the registry. This model allows them to offer much lower rates, often around $25 per hour, or as little as $250 per day for live-in care (an effective hourly rate of just $10.41). For context, California’s minimum wage is $16.50 and will rise to $17.00 by 2026.
But the lower cost comes with important trade-offs—and risks.
What You Might Be Giving Up
❌ Lack of Supervision and Oversight
Registries do not supervise caregivers. If a caregiver is incompetent, negligent, or abusive—physically, emotionally, or financially—there is typically no system in place to monitor or address these issues. Agencies, however, offer ongoing supervision to ensure caregivers provide safe, appropriate, and consistent care.
❌ No Backup Caregiver
If your caregiver from a registry calls out sick or doesn’t show up, you're left scrambling. Agencies maintain a roster of trained staff and can quickly send a replacement when emergencies arise.
❌ No Payroll or Tax Handling
Registries do not process payroll, withhold taxes, or pay overtime. This means those responsibilities—including legal liabilities—may fall on you. Agencies handle all employment compliance, reducing your risk.
❌ No Workers’ Compensation Insurance
Caregiving is physically demanding. In 2023, more than 563,000 healthcare workers reported musculoskeletal injuries related to lifting or moving patients (CDC). If your independent caregiver is injured on the job and you hired them through a registry, you could be liable for medical and disability costs. Agencies are legally required to carry workers’ compensation insurance for every employee.
❌ No Liability Insurance
If an incident occurs—property damage, theft, or harm to your loved one—many registries don’t offer liability coverage. Agencies, on the other hand, carry liability insurance that helps protect both their clients and their caregivers.
The Hidden Risk: Misclassification
One of the most overlooked dangers of using a registry is worker misclassification. According to the California Department of Industrial Relations, if you control a caregiver’s schedule, duties, and how they perform their work, you may be considered their employer. That means you could be held responsible for paying wages, overtime, payroll taxes, and providing workers’ compensation insurance.
Why Choose Caring Companions At Home?
At Caring Companions At Home, we are a licensed, bonded, and insured non-medical home care agency serving Southern California for over 26 years. We directly employ every caregiver we place, ensuring:
- Rigorous Screening: Social Security verification, work authorization, national and state criminal background checks (including sex offender registries), and at least three professional reference checks.
- Initial and Ongoing Training: All caregivers complete orientation, receive at least five hours of training, and benefit from ongoing education.
- Professional Oversight: Our care management team includes a Gerontologist, Registered Nurse, and Social Worker to ensure your loved one receives the best possible care.
When it comes to the safety and dignity of someone you love, the lower price offered by registries may not be worth the risk.
For more information, visit www.caringcompanionsathome.com or call us at 888-950-0750.
