A private duty home care registry connects families with independent home care aides who provide nonmedical support at home, such as help with activities of daily living (ADLs). Unlike home care agencies, private registries don’t employ caregivers directly. Instead, they refer caregivers to families, who often explore registries when they’re deciding whether to manage care on their own or bring in outside help. Understanding how registries work, including what they do and don’t handle, can help you and your loved one choose the right approach.
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A private home care registry is a referral service that connects families with caregivers who work as independent contractors to provide home care services for people in their homes. Unlike a home care agency, a registry doesn’t employ caregivers directly and it doesn’t manage the care they provide.
Instead, the registry’s role is to:
Once a caregiver is selected, the family typically hires them directly and works with them on an ongoing basis.
This arrangement gives families more control over who provides care, but it also means that the family is responsible for managing the care.
You may also encounter another type of registry during your search, known as a state registry. Private registries and state registries support different aspects of hiring a home care professional. Families use private registries to find appropriate caregivers for their loved ones, while employers like home care agencies use state registries to verify their caregiver’s credentials and background checks.
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When you’re exploring in-home care, one of the biggest decisions is whether to work through a home care registry or work with a home care agency. Both can connect you with caregivers, but they differ in how care is set up, who handles the details, and how involved you’ll need to be.
Registry: You hire the caregiver yourself and pay them directly. The registry helps you find someone but doesn’t employ them. The caregiver is typically considered your household employee for tax purposes, and you’re responsible for withholding and paying Social Security and Medicare taxes, completing and filing the correct tax forms, and more.[01]
Agency: The agency hires the caregiver and handles payment and taxes, so you pay the agency instead of the individual caregiver.
Registry: You work directly with the caregiver to set schedules, responsibilities, and make any changes.
Agency: The agency coordinates schedules, manages care, and helps handle any issues that come up.
Registry: Hourly rates may be lower, but you may pay a referral fee and take on more responsibilities that can affect overall cost.
Agency: Rates are often higher, but they usually include caregiver management, scheduling support, and backup coverage.
Registry: You’re generally responsible for checking in on how things are going and addressing any concerns.
Agency: The agency typically supervises caregivers, provides training, and can step in if there are problems.
Registry: You may have more say in choosing your caregiver and building a direct working relationship.
Agency: Care is more structured, but agencies can often provide a replacement if your caregiver is unavailable.
Rules for private home care registries vary by state, but they generally focus on how the registry operates as a business rather than how care is delivered.
In some states, registries may be required to:
Because registries act as referral services rather than employers, regulations often focus on transparency and business practices rather than direct oversight of care.
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Caregivers who are referred through registries are generally expected to meet any applicable state requirements, which may include background checks, training, and/or registration depending on where your loved one lives. Beyond those minimum standards, the level of screening can vary.
Some registries may:
Others may take a lighter approach. Registries that use more thorough screening or offer additional support services may charge higher fees, although costs vary widely depending on how the registry works and the services it offers.
A home care registry may be a good option if you’ve decided to bring in outside help and want more control over who cares for your loved one and how they work.
It may be a better fit if:
If you’re still deciding whether it’s time to bring in additional support, learning more about the signs that an aging parent may need help can clarify your next step.
If you’re ready to compare options, understanding the difference between hiring privately and using an agency can help you choose the right approach.
And if you plan to move forward on your own, reviewing the steps to hire an in-home caregiver can help you prepare for what’s involved.
If you’d like to have help finding care, or if you’d rather not manage the details of employing a home care aide directly, A Place for Mom can connect you with home care agencies in your area and help you compare options, at no cost to your family.
Employers are the most common users of state registries, which are designed to verify professional caregivers’ credentials. Private registries connect families with caregivers for hire. They serve different purposes.
Yes. Many registries will offer another referral if the initial match doesn’t work out, though policies vary.
It can be, but not always. Lower hourly rates may mean additional responsibilities for families, which can affect overall cost and convenience.
Not always. Some operate with one-time referral fees, while others may have ongoing terms. It’s important to review the agreement before proceeding.
Internal Revenue Service. (2026, February 20). Topic no. 756, employment taxes for household employees.
Florida Legislature. (2023). Section 400.506: Licensure of nurse registries; requirements; penalties. The Florida Senate.
Florida Administrative Code. (2024). Rule 59A-18.0081: Certified nursing assistant and home health aide. Florida Department of State.
Florida Administrative Code. (2015). Rule 59A-18.005: Registration policies. Florida Department of State.
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