When a family in Philadelphia or Bucks County decides that a parent or spouse needs help at home, one of the first questions is always the same: do we hire through an agency, or do we find someone on our own? Both paths can put a caring, capable person in the house. The real difference between an agency caregiver and a private hire is not personality or kindness. It is screening, supervision, backup coverage, and what happens if something goes wrong. This guide walks through the real differences so you can make the choice that protects your loved one, and your family, with your eyes open.
Comparing Two Paths to In-Home Care
“Private hire” usually means finding a caregiver through a personal referral, a classified ad, or an online caregiver marketplace, then paying that person directly, often in cash or with a simple personal check. “Agency caregiver” means the caregiver is employed by a licensed home care company that handles hiring, screening, payroll, scheduling, and supervision. On the surface, both arrangements can look similar: someone comes to the home and helps with bathing, meals, medication reminders, or simply keeping a person company so they are not alone. Underneath, the two models operate on very different foundations, and those foundations are exactly what determine how safe the arrangement is when something unexpected happens.
Agency Caregiver Versus Private Hire at a Glance
| What matters for safety | Agency caregiver | Private hire |
|---|---|---|
| Criminal background check | Required by Pennsylvania law before the agency hires | Family runs it, or it is skipped |
| Reference and identity verification | Agency verifies prior employers and work authorization | Family verifies, usually informally |
| Supervision | Named supervisor reviews the care and takes concerns | None |
| Backup when the caregiver cannot come | Agency sends a replacement | Family finds coverage the same day |
| Workers’ compensation | Carried by the agency | Family may be liable for injury costs |
| Payroll taxes | Handled by the agency as employer | Family is the employer and files them |
| If something goes wrong | Documented employer, supervisor, complaint process | Usually no recourse beyond ending the arrangement |
What an Agency Caregiver Brings to a Family’s Home
An agency caregiver arrives already screened, trained, and supervised by the company that employs them. Before that person ever sets foot in a client’s home, a licensed agency has typically run a criminal background check, verified identity, checked references from prior employers, and confirmed the caregiver is legally authorized to work. Many agencies, including A-Team Home Care, also put candidates through structured interviews and skills evaluations before the agency matches them with a client. You can see the kind of screening standard we hold caregivers to on our caregiver prescreening process page, and the day-to-day help those caregivers provide on our Philadelphia home care and Bucks County home care pages.
Beyond the initial hire, agency caregivers report to a supervisor. If a family has a concern, whether it is a missed visit, a change in the caregiver’s behavior, or a question about how a task was handled, there is a chain of accountability that does not exist when a caregiver works entirely on their own. The agency also carries workers’ compensation and liability coverage, which matters more than most families realize until they need it.
What Private Hire Really Means for a Family
Private hire can work out fine for some families, especially when the caregiver is a known relative, a longtime neighbor, or someone with a strong personal reference. But without an agency behind the arrangement, the family becomes the employer. That means the family has to handle running background checks (if they run them at all), verifying references, handling payroll taxes correctly, and figuring out coverage when the caregiver is sick, on vacation, or simply does not show up.
A family hiring privately has to arrange any background check on its own, and nothing requires one, so it is easy to rely on a personal connection or a good first impression instead. That is where the safety gap starts to widen, and it is worth being honest about before making a decision.
Background Screening: The Single Biggest Safety Gap
Background screening is the single biggest safety difference between the two options. Pennsylvania law sets the rule for licensed agencies: under 28 Pa. Code § 611.52, a home care agency must require every direct care worker applicant to submit a Pennsylvania State Police criminal history record, or, for anyone who has lived in the state for less than two years, a federal criminal history record plus a determination from the Pennsylvania Department of Aging. The agency may not hire or keep anyone whose record shows a prohibited conviction. A family hiring privately is not covered by that rule, so a check happens only if the family arranges it and reads the results themselves.
The Pennsylvania Department of Aging explains how these checks work on its criminal history background check page.
With private hire, the burden of verifying a caregiver’s history, checking references thoroughly, and confirming there is nothing concerning in their background falls entirely on the family, often at the exact moment they are already stretched thin managing a loved one’s care needs.
Supervision, Backup Coverage, and Accountability
An agency caregiver works under a named supervisor who checks the care and answers to the family. That supervisor checks in, reviews how care is going, and is available if the family needs to raise a concern or request a change. If a caregiver calls out sick, the agency is typically able to send a replacement so the client is not left without care. This backup coverage is one of the most underappreciated safety features of agency care: it means a family is not left on its own to find last-minute help.
Private hire caregivers, on the other hand, usually have no backup. If they are sick, on vacation, or leave the job without notice, the family has to scramble to find coverage, sometimes with very little lead time. For a person who depends on daily help with medication, mobility, or meals, an unexpected gap in care is more than an inconvenience. It is a real safety risk.
Some families choose a hybrid approach, using a family member as the primary caregiver and supplementing with agency support. If that describes your situation, our family caregiver program and family caregiver program details pages explain how that kind of arrangement can work, including how it fits alongside agency-provided care.
Liability, Insurance, and Who Answers When Something Goes Wrong
If a privately hired caregiver is injured while working in a family’s home, the family may be personally liable for medical costs, since Pennsylvania makes workers’ compensation optional for domestic workers hired directly by a household. For employers such as home care agencies, the Pennsylvania Department of Labor and Industry makes workers’ compensation coverage mandatory, which protects both the caregiver and the family if an accident occurs.
There is also the question of what happens if something goes wrong with the care itself: a missed medication, an injury during a transfer, or a disagreement about what was or was not done. With an agency, there is a documented employment relationship, a supervisor to escalate to, and a company with a reputation and a process for addressing complaints. With private hire, families often find themselves with no clear recourse beyond ending the arrangement and starting the search over.
Our Experience Screening and Supervising Caregivers
A-Team Home Care has been serving families in Philadelphia, Bucks County, and the surrounding Pennsylvania counties since 2016. Over that time, we have worked with families navigating exactly this decision: whether to hire privately or bring in an agency caregiver. We have seen firsthand what a difference proper screening, supervision, and backup coverage make when a family is trusting someone with a parent’s or spouse’s daily safety and dignity. That experience is reflected in local recognition, including the Philadelphia Inquirer Philly Favorites, a spot on the Philadelphia100, and inclusion on the Happening List. We built our screening and matching process around what families actually need: a caregiver they can trust, and a company standing behind that caregiver every day.
If you are a veteran or the family of a veteran evaluating care options, it is also worth knowing that we help families secure VA Aid and Attendance benefits to help cover the cost of care, something worth asking about regardless of which path you are leaning toward.
Weighing the True Cost of Each Option
Private hire is often chosen because the hourly rate looks lower on paper. But that comparison rarely accounts for the full picture: the time a family spends screening candidates, the risk of an uncovered gap in care, the potential liability if something goes wrong, and the payroll taxes a family can owe as a household employer when it pays someone directly (see IRS Publication 926). Agencies build screening, supervision, insurance, and backup coverage into their rates, which is part of why the two numbers are not really comparable once you account for what each one includes.
Families who are also weighing pay for a relative providing care, rather than an outside caregiver, may find our family caregiver pay path guide and family caregiver program checklist useful for understanding what programs are available and how to think through the decision step by step. Families comparing agency rates across the region can also review what home care costs in Philadelphia, and the interview script in our guide to choosing a home care agency in Pennsylvania.
Making the Decision With Confidence
There is no single right answer for every family. Some families have a trusted relative or longtime family friend who is a natural fit for private care. Others need the structure, screening, and backup that only a licensed agency can provide. The important thing is going into the decision with a clear understanding of what each path actually includes, not just the hourly rate on the surface. Ask about background checks. Ask what happens if the caregiver cannot show up. Ask who is liable if there is an accident. The answers to those three questions will tell you almost everything you need to know about how safe the arrangement really is.
Frequently Asked Questions
Is an agency caregiver always safer than a privately hired caregiver?
In most cases, yes, because agencies run structured background checks, provide ongoing supervision, and carry insurance coverage that most private arrangements do not have. That said, a well vetted, trusted private caregiver, such as a longtime family friend, can also work out well for some families. The key is making sure whoever you choose has been properly screened.
What happens if a private caregiver cannot come to work?
With private hire, the family usually has to find coverage on short notice, since there is no backup system in place. With an agency like A-Team Home Care, the agency typically sends a replacement caregiver so the client is not left without care.
Who is liable if a privately hired caregiver gets injured in the home?
Without workers’ compensation coverage in place, the family may have to pay medical costs personally if a privately hired caregiver is injured while working in their home. Licensed agencies carry this coverage as a standard part of employing their caregivers.
Can a family member be paid to provide care instead of hiring an outside caregiver?
Yes, in many cases. Programs exist to help pay family members who provide care for a loved one. Our family caregiver pay path page and family caregiver program checklist walk through how these programs work and what to check before applying.
How does A-Team Home Care screen its caregivers?
Every caregiver goes through a structured prescreening process, including background checks, reference verification, and skills evaluation, before we match them with a family. You can read more about our process on the caregiver prescreening page.
If you are weighing agency care against a private hire for a loved one, we are happy to walk you through what to look for and answer any questions about screening, coverage, or cost. Reach out to A-Team Home Care today to talk through your family’s situation and find the safest, most reliable option for the care your loved one needs.
