By Shannon Martin, EasyLiving, Inc. Home Health Agency
When families are searching for help for their elders in the home, it can be confusing for them to navigate the different options available, from seeking someone privately to hire to the various agency types. Here is a breakdown of some important information for family caregivers and professionals who are trying to help, specifically regarding the options in the state of Florida.
The state of Florida regulates home care and healthcare-related businesses, and there are essentially three types of agencies specifically related to in-home senior care. The first type is the fully licensed home health care agency (if you see a company’s full license number, you will see the initials HHA before the number). Such agencies go through a licensing and inspection process and meet stringent standards for providing home care, including personal, hands-on care (hygiene assistance, help with bathing, dressing and toileting) and medication management assistance. Most home health agencies also provide supplemental services such as meal preparation, companionship, and housekeeping. Some of the home health agencies are also licensed under Medicare, which means they can provide skilled services and bill the individual’s Medicare insurance. The home health agency designation covers both skilled agencies (those providing nursing and therapy services) and non-medical agencies that provide “custodial care” or personal care only.
Another type of agency which is registered with the state is a Homemaker Companion Service (HCS). These senior care agencies are forbidden from providing hands-on care (personal assistance with activities of daily living or lifting a patient for example), but can provide services such as transportation, meal preparation and housekeeping. A nurse registry (NR) is also a registered entity with the state of Florida, but serves as a matching service, rather than an employer of the home caregivers. The client may be responsible for liability and supervision. To better understand what is required of these various agencies, you may want to read The Florida Agency for Healthcare Administration chart that outlines the requirements of different types of in home care providers.
Many families seek help through classified ads or by hiring someone who is recommended from a friend. While some families find a wonderful home caregiver this way, it is vital to understand the responsibility and liability being taken on by the individual and family in this situation. Consult your attorney and C.P.A. regarding the potential legal and tax implications, as you are typically considered the employer in such cases. Many clients are caught unaware when the home care worker is injured on the job and has no worker’s compensation insurance or disability coverage. We often talk with families who assume that their homeowner’s insurance will cover such situations, but typically find this is not true when they inquire of their insurance agency. It is also important to understand that you will be taking on the role of supervising and managing the situation. If your caregiver gets sick or has personal issues, you may be stuck without someone to help.
A licensed home health agency (HHA) in the state of Florida employs the caregivers and purchases worker’s compensation insurance, liability insurance and handles payroll taxes, in addition to training and supervising the caregivers. If you have a concern or a home caregiver becomes ill or cannot complete their duties, the management staff of the agency is there to assist you. When interviewing a home health agency, find out about the experience and background of the management team as well as how they handle and respond to any concerns. Ask about the training and supervision they provide to staff and their hiring process.
Each state regulates its healthcare providers differently, so find out about the requirements in your state and inquire with any potential provider about the issues and coverage mentioned above. As a professional working with families in the senior care industry, it is incumbent upon us to have a basic understanding of the different models of care so that we can be knowledgeable in referring and assisting families.

