Private caregiver vs. agency in Florida

Three ways to hire help in Florida, not two

When families say “private caregiver vs. agency,” they are usually comparing three different arrangements, and Florida law treats each one differently:

• Direct hire: you find, hire, pay and manage the caregiver yourself. Under s. 400.464, an individual acting alone, not affiliated with an agency or registry, is exempt from home health agency licensure.

• Nurse registry: a licensed registry refers a caregiver to you. Under s. 400.506, that caregiver is an independent contractor, not the registry’s employee, and the registry must tell you it cannot monitor, supervise, manage or train them.

• Agency or registered companion provider: the provider employs the caregiver, schedules, supervises and replaces them. Home health agencies are licensed by AHCA; companion/homemaker providers register with AHCA under s. 400.509.

Side-by-side: private caregiver vs. agency in Florida

Taxes: what Florida families need to know

If you control what the caregiver does and how they do it, the IRS generally treats them as your household employee, not a contractor. According to IRS Topic 756 and Publication 926:

• If you pay one household employee $3,000 or more in cash wages in 2026, you generally must withhold 7.65% (6.2% Social Security plus 1.45% Medicare) and pay a matching 7.65% yourself.

• If you pay household wages of $1,000 or more in any calendar quarter of this year or last, federal unemployment tax (FUTA) applies to the first $7,000 per employee.

• You report these on Schedule H with your Form 1040, and you need an employer identification number to issue a Form W-2.

• If an agency provides the worker and controls what work is done and how, the worker is not your employee.

• Wages paid to your spouse, your child under 21, or (in most cases) your parent don’t count for these taxes.

Florida adds its own layer. The Florida Department of Revenue says a household employer who pays $1,000 or more in a calendar quarter is liable for state reemployment tax. Talk with a tax professional before you start paying anyone directly; back taxes and penalties are a common, avoidable surprise.

If you hire directly, do these five things

1. Check references and run a background check before the first shift.

2. Write down duties, hours, pay, and what the caregiver must never do (for example, sign checks or give medications).

3. Set up payroll or a household payroll service, and register for Florida reemployment tax if you’ll cross the threshold.

4. Call your homeowner’s insurer about injury coverage for a household worker.

5. Line up a backup, whether a relative or an agency, before you need one.

Who each option is for

Private caregiver vs agency: our pick by scenario

• You live out of state: agency. A direct hire with no backup is risky when you can’t drive over on a sick day. See help for long-distance families.

• A trusted family friend wants to help 15 hours a week: direct hire can work. Set up payroll properly, put duties in writing, and line up an agency for backup days.

• A nurse registry offered a caregiver: ask in writing who the employer is for tax purposes and who supervises. Under Florida law the registry cannot supervise the caregiver.

• Your loved one has moderate dementia with wandering: agency or registered provider. Missed shifts are a safety issue, not an inconvenience.

Warning signs the current arrangement isn’t working

• Missed or late shifts with no replacement.

• Unexplained spending, missing items or new “friends” around your loved one; our financial exploitation guide explains what to watch for.

• You can’t get a clear answer about what happened during the day.

• Your loved one seems afraid of or withdrawn around the caregiver.

• Care needs have grown beyond companion tasks (lifting, wound care, overnight safety).

How families combine them

A common Florida setup is one privately hired caregiver for the main weekday hours plus an agency for weekends, vacations and sick days. Another is an agency companion for a few months while the family learns what good dementia care looks like, then a direct hire once they know what to ask for. Our guide to choosing a dementia caregiver in Florida has interview questions for either route.

Where Dementia Companions fits, and where it doesn’t

We are a provider, so the screening, payroll and backup sit with us. Every companion is screened for dementia care experience, we send 3-5 matched video profiles within 48 hours so you can watch their interviews before you decide, and if the fit is wrong we rematch at no cost. The rate is $35 an hour for 40+ hours a week, no contract; call us about shorter schedules. We are not the cheapest option per hour, and we don’t provide nursing. We do arrange live-in companion care from $375 a day. Learn more on how it works.

Our companions don’t provide hands-on personal care such as bathing or toileting. If your loved one needs it, add a licensed home health agency or aide, and our companion can work alongside them.