When an elderly loved one needs help at home, there are several options for Florida home health. Medicare covers intermittent, skilled care at home but most seniors (and others facing disability or chronic illness) will need some additional home care support at some point. It can be difficult to wade through the Florida home health options, so our experts are here to help!

What are my options for Florida home health care?

Privately Hiring an Individual Caregiver

We generally don’t recommend this option for several reasons. Read “The Unasked Questions When Hiring a Home Caregiver” for more detail. One of our favorite celebs, Betty White, is being sued by her caregiver, a cautionary tale about the problems that can arise when you are acting as the employer. Taxes are another important issue, as the state of Florida notes: “If you employ an independent health care professional, you should ask them who will be responsible to pay household employment taxes, income withholding taxes, and unemployment taxes. If he or she does not pay these taxes, you may be required to pay them.”

Additionally, we’ve talked to a number of families over the years who had a caregiver get injured on the job. Without worker’s compensation insurance, this can be a costly problem. Other concerns include caregiver oversight and management, handling backup care, what happens in disaster situations (e.g. Florida hurricanes) and when additional care is needed.

Agencies Regulated by Florida (see this chart for a side-by-side comparison):

• Home Health Agency (HHA): Florida home health agencies, both Medicare-certified and non-medical, are regulated by strict guidelines by the state. Agencies must take steps such as developing care plans, documenting client’s advance directives, providing detailed disaster plans approved by the state, quality assurance and handling the normal duties of an employer (taxes, managing hours worked and insurance). Staff is required to have training in Alzheimer’s/dementia and agencies must carry liability and malpractice insurance.
• Nursing Registry (NR): A registry matches health care professionals like home health aides, CNAs and nurses with clients. The healthcare professionals are independent contractors, not employees of the registry. If you choose to use a nurse registry, make sure to ask about/consider insurance coverage, backup care and supervision. Different agencies may offer more extensive services than others, or you may need to create a plan for handling these issues.
• Homemaker/Companion (HCS): This is another type of agency for Florida home health services, which is only permitted to provide non “hands on” care such as errands, transportation, and household help. These services are also often provided by the 1st two types of agencies.

How can we decide which Florida home health choice is best for us?

• Think about the client’s current and future needs. For example, a homemaker/companion agency might seem fine for now, but almost all clients needing these services require some hands-on assistance at some point (even if temporarily after a hospitalization of when ill). Do you want to have to go through the hiring process over again or bring in two agencies to get the job done?
• Do family members live locally? What kind of help can they (or others) offer? If family members live nearby and can assist with oversight and employment, some of the less formal options may be feasible. If all family members are long-distance or no one has the time to handle all the tasks involved (or fly down at a moment’s notice), you would benefit from a home health agency with great HR management or hiring a care manager to manage the situation. Don’t underestimate what is involved in managing eldercare needs.
• Assess true costs. Is saving money on the per hour cost going to save money overall? Consider employment taxes, insurance needs, and opportunity costs (i.e. if a family member will handle oversight and employer duties, what time, and therefore opportunities–including quality time with your loved one, does this cost?).
• Weigh risks in light of the client’s situation.  It is important that all parties understand the potential risks to a client’s assets (for example, if facing a lawsuit like Betty White, or costs from an on-the-job injury or fraud/theft with little recourse) and how different scenarios may play out.
• Work out a budget and assessment of options. Our care managers can provide a personalized assessment, advising of pitfalls you might not have considered. You may decide to run some risks or deal with an occasional problem for a significant cost savings, or the care manager may be able to help you save in other ways or tap into benefits programs. There are often unique ways to set up a plan to better meet your loved one’s needs while not compromising quality.
• Consider all available resources. We’ve had clients in the past who owned a company or made other arrangements to manage employees. There may also be family members who are willing to take on certain roles. You may have professional advisers or a care manager who can assist with specific needs. Tap into programs or resources to stretch your budget or reduce the level of care needed.
• Beyond just which type of Florida home health provider you choose, it is important to research and feel comfortable with who you’re hiring. Ask for references and/or QA survey results, find out more about their process and policies, understand fees in detail, and make sure you are comfortable with the management and direct care providers.

Want the best experts to guide you in this process? Contact our team today (727-447-5845) to find out how we can help make your eldercare journey easier.

You might also be interested in “Concerns about Hired Caregivers“. If you run into trouble with a caregiver, this guide will help you know your options and where to turn for help.