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This is for private in-home service.

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Yes, but you need to follow withholding tax rules, find out what home insurance you need, and figure out other legal matters. Will you have a contract? Who is liable if the caregiver drops the patient? You’ll need background checks so you know you’re not hiring a criminal. And so on.
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Caringinhome Jan 2023
Thank you!
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Absolutely to your points. Thank you Fawnby.
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Caringinhome, with a Caregiving Agency, if a caregiver is unable to make his/her shift, the agency would quickly find someone to fill that shift. With private hire, there is no one to fill in at the last moment.
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Yes. We hire ours direct and use a payroll service to pay their checks, social security and workers comp, and unemployment.
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gladimhere Feb 2023
And income taxes?
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I've been stiffed from agencies where one of their persons calls out and they call me and say they have no one to cover.

My direct hire caregivers are more reliable and will pick up shifts.
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The reasons often given for using an agency are vetting of the employee and coverage with insurance and so on. If you know a worker well, or know of their work history through friends, and etc. it may be possible to hire them. When my friend was on hospice recently the agency required that she have 24/7 care in her home. The agency would have been 40.00 and hour and the gals who worked for her, 12 hour shifts daily, and known to her, were 20.00 an hour. Even at that you are looking at 100s of dollars a day and the money goes out the door very very quickly. It certainly is worth thinking about. I sure wish you luck.
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There are advantages to hiring through an agency
There are advantages hiring privately
There are disadvantages to both.
Privately there is paperwork. You do need to do this legally and take out taxes. You should have your employee covered by insurance if they are injured on the job.
You do need to do a full background check.
All this is taken care of when you use an agency.
(I did get the best 2 when I hired privately and found them by contacting my local Community College. They both had just completed their CNA certification and were waiting for the next semester to start when they would begin Nursing School)

But yes you can hire privately.
I suggest that you hire at least 2 people and alternate days if possible that way they can cover for each other and you do not end up with caregivers that get just as burned out as you would working day after day.

Also keep in mind that you do have to follow regulations regarding the number of hours a person can work as well as over time pay.
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I have had a terrible time with agencies. The people they employ are under employed with no qualifications and often in desperate straights. They are usually in some kind of situation where they have limited availability. This has happened in every case I've used an agency. I have a person now, who while a nice person has a very limited time frame of availability and car troubles etc. I've been trying to work with it because the first person they sent I had to say dont come back. She didnt show up on time ever and multiple times never showed up and never contacted me. The care is assigned to my brother through the VA so I cant exactly tell them what agency to use.
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We have ALWAYS used agencies like In-home Supportive Services (IHSS) but a lot of our workers were unreliable so I would think hiring a private caregiver is the way to go!
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Yes it is possible to hire a caregiver directly and not through a staffing agency.

To be legal, one method is where you are the employer and the caregiver is the employee. Therefore, you would need to follow all the federal and state rules to be an employer.

The other method is that the person you employ, would be self employed. In that case, you are trusting them to set up the business where they would be the employee and they would charge you a rate for their services. It would be no different than if one was a plumber, electrician, handyman or a self-employed lawyer.

I don't know how much money you would save. I would expect an agency has a lot of overhead that you might choose not to have, such as malpractice insurance.
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