Those 3 words are the most important words on a home care agencies marketing material and what every consumer should be looking for when shopping for help in the home. There are 2 different types of agencies in “Nonskilled” home care. Both can provide the same services as light housekeeping, help with safe showering, laundry, meal preparation, transportation and companionship. To the consumer the 2 agencies can look the same. The differences between a Nurse Registry and a Home Care Agency are many and some of them are not the safest practices placing clients at unknown risk.
The definition of a nurse registry per ACHA is “An agency that offers health care related contracts for nurses, home health aides, certified nursing assistants, homemakers, and companions in a patient’s home and as temporary staff to health care facilities.” ( Nurse Registries | Florida Agency for Health Care Administration (myflorida.com).
Nurse registries are essentially staffing agencies. They use independent contractors to send into your home to assist you. They are held by AHCA to perform level II background checks, but they do not know the people they are sending to you. Per AHCA they are also not permitted to supervise, train, or monitor the contractor in your home including not being able to confirm they came for the shift. The homeowner is the employer and at the end of the year a 1099 statement is given to the contractor for tax purposes. This document will tell the IRS who the person was contracted with and if they choose not to pay their taxes, the homeowner will be responsible for paying the social security and unemployment taxes. They have no liability or workers compensation insurance and no accountability for the behavior or actions of the contractor in your home. Nurse registries also provide many of the staff at inpatient nursing facilities and the same rules apply. You have no idea who is taking care of you in some of these places!
Home care agencies, both skilled (paid by health insurance) and non-skilled are defined by AHCA as “An agency that provides skilled services (by nurses, therapists, social workers) and/or unskilled services (by home health aides, certified nursing assistants, homemaker, companions) to patients in their homes. A home health agency may also provide staffing to health care facilities on a temporary basis (Home Health Agencies | Florida Agency for Health Care Administration (myflorida.com).” These agencies have liability and workers compensation insurances to protect the clients and staff. They are W2 employees who are vetted and can be trained by an RN at the agency to perform specific duties. Home care agencies typically send a nurse out first to meet with you and discuss your needs. Then she creates a plan of care for the nurse’s or home health aides to follow. The agency can monitor, supervise, and train their staff within the scope of practice for the agency. Skilled agencies come after a hospital stay, fall, or new diagnosis and require a doctor’s order. Non skilled agencies can help with almost everything around the home and often function like a personal assistant to the client. Just because you need help at home doesn’t mean you should subject yourself to unnecessary risks, play it safe and look for those 3 words; “licensed, bonded, and insured” because it definitely matters!
