Question of the Day: "What are my responsibilities when hiring a home health aide? I’m confused about payroll tax, Social Security tax and other benefits."

Answer:  I do not mean to sound facetious when I say that your first responsibility when hiring a Home Care Aide is to avoid being the employer.  I will come back to that.

First, let’s differentiate between a Home Health Aide and a Home Care Aide.  The former is actually someone who works as part of a Home Health team, comprising Nurses, Physical Therapists, Speech Therapists, Occupational Therapists and Home Health Aides.  Home Health is a prescribed set of short term services, under a doctor’s order, to assist a patient who is return home from hospitalization or skilled nursing facility rehabilitation.  Such services may last 4-8 weeks.  In this assignment, Home Health Aides are responsible primarily for bathing services.

In non-medical home care, a Home Care Aide provides support for Activities of Daily Living (ADLs and Instrumental ADLs).  When a client or family hires a Home Care Aide, they should actually be hiring an agency, with the agency serving as the employer of record for the caregiver.  That agency should be providing the client and family with protection that includes liability insurance, a large dishonesty bond (we recommend $50,000), Workers Compensation insurance, Unemployment Insurance, all the payroll taxes, including Social Security, etc. being the responsibility of the employer agency.  There are many other reasons for ensuring that you hire an agency, rather than becoming the caregiver’s employer.  For example, what happens when the caregiver is sick?  The agency is responsible for covering.  If the client does not get along with the Home Care Aide, you want that to be the agency’s problem, not a matter of you firing the caregiver and then having to deal with an unemployment claim.

If you do hiring a caregiver directly – or through a so-called “referral agency” – you are going to be considered the employer of record.  You have enough on your hands without that added responsibility.

Bert Cave, President
Support For Home
Sacramento, California  95825
Member of the national ElderCare Matters Alliance, California chapter 

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