Registry Fact Sheet

·         REGISTRIES ARE LICENSED

Home Care Registries are required to be licensed by the PA Department of Health the same as Home Care Agencies. Home Care Agencies and Home Care Registries are both under the same license.

·         REGISTRIES DO CHECK CAREGIVER REFERENCES

Registries are required to check references the same as agencies, directed by the Department of Health regulations.

·         REGISTRIES DO PERFORM CRIMINAL BACKGROUND CHECKS

Registries are required to check criminal backgrounds the same as agencies, directed by the Department of Health regulations

·         REGISTRIES ARE ALLOWED TO DO UPDATED/ONGOING CRIMINAL BACKGROUND CHECKS ON CAREGIVERS

·         REGISTRIES DO INTERVIEW EACH CAREGIVER PERSONALLY

Registries, the same as agencies, are required to conduct one-on-one interviews, directed by the Department of Health regulations.

·         REGISTRIES DO KNOW THEIR  CAREGIVERS

Like any other business, you get to know the people you do business with. The longer you do business with them the better you know them. Referring a caregiver to a consumer and getting the consumer’s feedback is essential to an agency and a registry in getting to know a caregiver.

·         REGISTRIES ARE LEGAL ENTITIES

        Registries are required to be a legal entity or legal sole proprietor. 

A registry's legal operational status is reviewed by the PA Department of Health as part of the licensing process. 

·         REGISTRIES DO  HEALTH SCREENING OF CAREGIVERS

Registries are required to perform health screening of caregivers in the same manner as agencies directed by the Department of Health regulations.

·         CONSUMERS WHO HIRE REGISTRIES DO NOT HAVE TO OBTAIN AN EIN

Consumers who obtain a caregiver though a registry are not required to obtain an Employer Identification Number.

Please see the instructions for IRS Form 1099 or speak to your tax advisor.  This does not constitute tax or legal advice. 

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·         REGISTRY REFERRED CAREGIVERS DO PAY TAXES 

        Everyone who earns taxable income is required to pay taxes, self employed individuals included. 

Caregivers registered with a registry usually sign a statement acknowledging they are responsible for paying their own taxes.

·         REGISTRIES  DO FOLLOW-UP ON THE REFERRAL SERVICES PROVIDED

Like any business, registries want to make sure that their clients are pleased with the caregiver referrals they are receiving.

In addition, the Department of Health regulations require that Home Care Registries and Home Care Agencies follow up to ensure the consumer is satisfied with the care they receive A registry will want to make sure the client is happy with the referral made and the service the office has provided. 

·         WHY CONSUMERS PAY A LOWER PRICE FOR CAREGIVERS OBTAINED THROUGH A REGISTRY

Home care is less expensive when obtained through a registry because a registry is a more efficient home-care delivery model. For consumers who seek to self-manage their home care, a registry provides just-in-time access to pre-background screened, pre-credential verified caregivers at very affordable rates. The rate consists of the fee a caregiver charges and a modest additional fee to the registry.

·         REGISTRIES AND PAYROLL TAXES

Neither registries nor consumers are responsible to pay payroll taxes for self employed caregivers. Self-employed caregivers are responsible for all taxes related to their work. The caregiver generally signs a statement acknowledging their responsibility to pay their work related taxes.

·         THE STATE OR PA. DEPARTMENT OF HEALTH DOES NOT DEEM THE CLIENT AND OR FAMILY RESPONSIBLE TO PAY THE CAREGIVERS’ EMPLOYMENT TAXES WHEN REFERRED BY A REGISTRY.

A client is not responsible to pay state or federal taxes with respect to independent contractors. Self-employed caregivers are responsible to pay their own employment taxes as acknowledged in the statement they generally sign.

·         THE CLIENT IS NOT RESPONSIBLE TO PAY WORKERS’ COMPENSATION  ON THE CAREGIVER WHEN REFERRED BY A REGISTRY

A self-employed caregiver referred by a registry is not the client’s employee, and is not entitled to WC benefits.  The caregiver generally signs a document stating they agree and understand they are not entitled to this insurance as a self employed individual.

·         WORKERS COMPENSATION INSURANCE  PROTECTS THE AGENCY NOT THE CONSUMER

W.C. insurance that an employee-based agency maintains is designed to protect the agency that purchases the insurance; not the client, unless the client qualifies as a “special employer,” which is determined on a facts and circumstances basis. The client can still be sued by the caregiver and or by the W.C. Company seeking to be reimbursed for damages if the injury was the fault of the client. 

·         A CAREGIVER REFERRED BY A REGISTRY IS NOT GOING TO SUE THE CLIENT FOR UNEMPLOYMENT COMPENSATION IF THEY FEEL THEY ARE NOT GETTING ENOUGH HOURS.

Self employed caregivers referred by a registry are not entitled to UC. Section 402 (h) of the Pa. unemployment law clearly states a self employed claimant is ineligible for Unemployment Compensation Benefits. Also the Pennsylvania unemployment statute does not provide caregivers with a private of action to sue a client claiming entitlement to unemployment benefits.  A caregiver’s sole recourse is to apply for unemployment benefits through the State.

Caregivers generally sign a statement agreeing to and with the understanding that they are not entitled to any employee benefits like UC, WC or health care benefits. As a self employed individual they also understand and generally agree, in writing, that they are not guaranteed any minimum number of hours to work.

·         REGISTRIES AND LIABILITY INSURANCE

Registries carry liability insurance. Some registries’ insurance covers the caregiver, some do not. Some Registries require caregivers to carry their own liability insurance The Department of Health requires all home care companies to disclose coverage to consumers before service beings. 

·         REGISTRIES MAY BE  BONDED

Bonding in this industry generally is for theft only. The bonding company generally does not pay out unless the person who stole is convicted. It is rare to get a conviction especially if there are a number of people in and out of the home, as is usually the case when someone requires home care .Bonds can be purchased with various limits. Even if a person is convicted of the theft that does not mean the bonding company will pay out the total amount of the loss. If the bond limit is not as high as the amount of loss it will only pay the bond limit.  Bonding generally is for the protection of the employer against employee theft. A self employed person with no employees would not bond themselves against stealing. They are not going to do a dishonest act against themselves.  When a bonding company does pay out, it goes after the person convicted of the theft for reimbursement hence, the person who purchased the bond if a self employed individual.  It would make no sense for a self employed person to be bonded.

Bonding rarely pays out and does not stop a caregiver from stealing. Bonding is not an assurance of quality or honesty.  It is better to rely on thorough criminal, personal and employment background checks and screening and competency tests than to rely on bonding that may never pay off. It is more important to be properly insured and have a thorough selection, screening and competency process.

·         REGISTRY REFERRED CAREGIVERS ARE TRAINED AND MEET COMPETENCY REQUIREMENTS 

The PA Department of Health has specific training and competency requirements for all caregivers who are referred by home care registries or employed by agencies.  All caregivers must be trained and pass all required competencies.

All caregivers must meet these requirements before being rostered with the registry. Self-employed caregivers understand, the more training and skills they have, the more marketable they are and the more referrals they will receive. Their income depends on these factors.

·         REGISTRY’S RELATIONSHIP WITH CAREGIVERS REGARDING CONTROL OF THE CAREGIVER

Since caregivers obtained through a registry are not registry employees, a client can take direct and immediate action against a caregiver who under performs. A client does not need to beg and implore a registry to replace a caregiver, and hope the registry will respond; rather, the client takes immediate action and informs the registry. Self-employed individuals are more likely to work harder for a client since their jobs are not guaranteed. They are also more likely not to raise their rates in a poor economy because they depend on referrals, not on a guaranteed 40 hours a week. Their work ethic and skills are their guarantee of income.

 REGISTRY REFERRED CAREGIVERS ARE INDEPENDENT CONTRACTORS NOT SUB-CONTRACTORS

Independent Contractors are self employed individuals. A self employed individual does the work they are contracted to do. A sub-contractor does the work that another individual or another business has contracted to do. In the case of a registry, a caregiver is not a subcontractor to the registry; the caregiver is a direct contractor to the client whom the caregiver obtains through a registry referral.

·         REGISTRIES DO INTERVIEW THE CAREGIVER FOR YOU

A registry is responsible to conduct a face-to-face interview with the caregiver, as well as obtain all the background checks, training and competencies and do all appropriate screening, meeting all of the requirements as set forth by the Department of Health regulations. The consumer may also interview the caregiver if they choose to.

·         REGISTRIES ARE ACCOUNTABLE

If a consumer is not happy with the caregiver referred and wants a replacement, the consumer need only request a new referral and a new referral will be made immediately. The consumer does not have to put up with lateness, call outs or any other inappropriate behavior. The consumer may request a replacement for any reason including personality conflict. In the case of a caregiver call out the consumer may request a new referral for that day or they may choose to do the care themselves or make other arrangements. There is no penalty for not wanting a replacement. Most registries, like agencies, have an after hours system to get in touch with the company for emergencies such as these.

·         CAREGIVERS REFERRED BY A REGISTRY ARE ACCOUNTABLE

Caregivers that are self employed Independent Contractors must be extremely accountable for their actions. They know their hours are not guaranteed and if they are not the best at what they do, they will not be referred another case. Unlike employees, who have their job until someone fires them, an independent contractor needs to be affirmatively re-hired each day. They are aware that the client wants someone they can count on to be there as scheduled every time. They know they must keep up on their skills and the newer technology. They must be flexible, honest, patient, and compassionate and treat the client with dignity or they take the chance of losing the client and not getting another one.

·         CAREGIVERS REFERRED BY A REGISRTY ARE HIGH QUALITY  PROFESSIONALS

Caregivers referred by a registry must pass the same stringent qualifications, competencies, and screening as agency caregivers. All in-home caregivers must be in compliance with the Department of Health licensing regulations. Competencies must be renewed yearly according to the licensing regulations. Registries and Agencies are surveyed equally by the Department of Health on a yearly basis.

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*The information contained in this document is based on usual business practices. There may be exceptions as each business has its own policies and procedures. It is best to interview the company regarding licensing and compliance practices before starting service. The Department of Health Regulations referred to are based on the Pennsylvania Home Care License Regulations and can be found on the Pa.Department of Health Website.

One model of home care is not better than the other. The different models offer different options to the consumer. The key is to make sure the Home Care company you are working with is Licensed, Insured, knowledgeable and honest  in the information they give out,  so you can make an informed decision on the company that is right for you. One point to remember is, all home care companies, registries and agencies alike, are required to be licensed by the state of Pa.

If you have any doubts as to the registry or agency’s credentials or requirements call the Department of Health for clarification and to verify the Home Care Company is properly licensed.

The number is 1-717-783-1379.

To verify any information regarding Workers Compensation Insurance, or Bonding, please call your individual insurance broker. They will be able to confirm the information given in the fact sheet. Or call the Department of Labor and Industry State Workers’ Insurance Fund at 570-963-4635.

To verify Pa. UC Law contact your local office of Unemployment Compensation benefits.

To verify that a Registry or Agency maintains liability insurance and does criminal background checks on the caregivers ask to see the documents.