A service may introduce you to a caregiver without becoming the caregiver's employer or managing the work after the introduction. An agency may take on a different set of responsibilities. The label used in the phone call does not settle the question. The written agreement does. The Federal Trade Commission advises families hiring in-home help to determine whether they are dealing with an agency or hiring the worker directly and to examine who handles screening, supervision, taxes, insurance, and complaints. See the FTC material listed on the Sources page.
Use this sheet when a company says it can find, refer, place, match, or provide a caregiver. Your job is to discover whether you are buying an introduction or an ongoing service.
1. Ask the first dividing question
Say: “After this caregiver starts, who is the caregiver's employer?”
Write the answer exactly as given: ______________________________
Then ask: “Where is that stated in the agreement?”
Listen for one of two clear answers: the company employs the caregiver, or the family hires the caregiver directly. If the representative says the caregiver is independent, self-employed, part of a registry, or simply matched with families, ask who decides the schedule, directs the work, pays the worker, and handles required tax paperwork. The IRS explains that a worker's classification depends on the actual working relationship, not merely the name used in an agreement. See the IRS household-worker and worker-classification material listed on the Sources page.
Walk away from the call without committing if the representative will not identify the employer or will not show you the agreement language that supports the answer.
2. Divide the work that happens before the first shift
Ask who completes each item below. Put “family” or the company's name beside every line.
Finding candidates: ____________________
Interviewing candidates: ____________________
Confirming identity: ____________________
Checking references: ____________________
Searching applicable public registries: ____________________
Reviewing any criminal-history information offered by the service: ____________________
Confirming the caregiver may perform the agreed tasks: ____________________
Getting the final choice approved: ____________________
For a Missouri registry check, ask which registries are searched, what identifying information is used, and whether you receive the result. Missouri's Family Care Safety Registry describes the background-screening information available through that program and the people or organizations eligible to request it. See the Missouri Department of Health and Senior Services material listed on the Sources page.
Do not accept “fully screened” as the complete answer. Ask for the name of each search, who ran it, and what happens if the result needs clarification.
3. Find out what the fee actually finishes
Ask: “When your fee is paid, which of these results have I purchased?”
A list of names: ____________________
One introduction: ____________________
Interviews arranged for me: ____________________
A caregiver who has accepted the schedule: ____________________
An ongoing employment relationship managed by the company: ____________________
Another result stated in the agreement: ____________________
Then ask what happens if you interview the referred person and decline to hire, the person declines the schedule, or the person accepts and never begins. These are agreement questions. Record the answer, then circle the paragraph in the agreement that says the same thing.
A useful answer identifies the exact deliverable and the point at which the company's work is complete. A weak answer describes access to candidates but never says whether any candidate must accept your schedule.
4. Assign the work that continues after the introduction
Ask who will handle each recurring task if you hire the person presented to you.
Collecting time records: ____________________
Calculating and issuing pay: ____________________
Handling required payroll filings: ____________________
Keeping employment records: ____________________
Receiving performance complaints: ____________________
Changing the schedule: ____________________
Ending the working relationship: ____________________
Recruiting another caregiver if this one leaves: ____________________
The IRS publishes separate guidance for household employers, including information about wages, withholding, and employment-tax responsibilities. Do not assume a referral company's involvement transfers those duties. Ask what it performs, what it does not perform, and which documents show the division. See the IRS household-employer material listed on the Sources page.
5. Test the word “replacement”
Say: “If this person does not work out, what exactly will you do?”
Write down:
Who decides that another candidate is needed: ____________________
Whether another search is included: ____________________
How many introductions are included: ____________________
What conditions limit another introduction: ____________________
What the family must do to request it: ____________________
Where those terms appear in the agreement: ____________________
Listen for the difference between finding another candidate and supplying someone for an uncovered shift. Those are different promises. Make the representative identify which promise, if either, appears in writing.
6. Compare the two lanes on one page
If you do the hiring yourself, write the name of the person who will own each unfinished task. If you hire the work out, write the agreement paragraph that assigns it to the company.
Candidate search, person or paragraph: ______________________________
Screening, person or paragraph: ______________________________
Employment paperwork, person or paragraph: ______________________________
Payroll administration, person or paragraph: ______________________________
Schedule administration, person or paragraph: ______________________________
Performance problems, person or paragraph: ______________________________
Finding the next caregiver, person or paragraph: ______________________________
A blank line means the work has not disappeared. It means no one has accepted it yet.
7. Make the decision from the unfinished-work list
Choose direct hiring only after naming the person who will complete every family-owned task. Choose a referral or placement service only after identifying what its fee completes and what returns to you. Choose an employer agency only after the agreement confirms that the company actually holds the responsibilities you expect it to hold.
For the broader distinction between agency care and direct hiring, use Hire a Caregiver in St. Louis: Agency or Direct. For the full hiring sequence, use Start Here: Five Steps to Hiring.
Final note for the file: “We are hiring through ____________________. The caregiver's employer is ____________________. The company completes ____________________. The family completes ____________________. The agreement paragraphs are ____________________.”