Is it a scam when an in-home caregiver from an agency tries to have the client quit the agency and hire them personally?

Wow is all I can say. While it may not be illegal to the law, I'm sure that this woman has a contract with the agency to guard against something like this. If she is being sneaky with her employer, then I might have to wonder what she would be like caring for my loved one. Once a sneak always a sneak. It would absolutely bother me for someone to do this while working for someone elses company. I think I would have to inform the agency because I, for one, could not trust her with my loved one. Good luck

It is a conflict of interest and YES i would be very skeptical.

If it sounds too good to be true it probably is. Also. the agency has insurance to cover problems if they occur, she doesn't. You could complain to the agency if there is a problem, no one to complain to if she is hired. Do you really want someone who sounds like she has a problem with loyalty to work for you? I would go to the agency and tell them what she said.

Unethical at the very least. Against her contract for sure. I think Mom should call the agency and ask for a different caregiver to be assigned.

The worker is scamming the agency. She is only trying to use it to obtain private clients. If she wants private clients she can post her name on local bulletin boards and advertise in local papers. If she doesn't want to work for an agency she shouldn't get herself into people's homes on false pretenses.

I work for a non-profit community service organization that, among many other sevices to seniors, operates a home health agency...and I am also a client, as they provide aides for my mother.
As part of the hiring process of each home health worker, they thoroughly check out the person's background (both employment and criminal); evaluate the candidate's suitability for in-home work; train and orient the new employee on-job with supervisors and experienced workers; and then continually assess performance of the employee. In addition, they handle all the responsibility of finding and scheduling clients and assuring payment for services is made; they mak proper payroll deductions for taxes and other required fees, liability insurance, and handle all the other legal requirements of an employer (which the client in this case would be responsible for). So they take care of many expensive and time-consuming tasks for the client, in addition to provision of care...it's not all profit.
This worker is almost certainly violating terms of her employment contract, and exhibiting a character trait that I would not want in anyone caring for my family...she is dangerous.
Inform the agency of her proposal, and demand that she not return.

Well my 2 cents. I lost care of my mom to a non-profit. They did not screen the care of a young lady they put in her house to care for her. I am in another state. They told me over the phone the lady never leaves my mom alone. I got pictures of the aide down the street talking on her phone and walking with a man. The agency said my mom was not with any man like she old me she went to Fort Lauredale with other ladies and a man. The man was there. I was told other things that are or were not true. The aides would tell me one thing then the case worker would tell me something else. Now the aides don't tell me a thing since they don't match. The aide is now out of the house and a new one is in. It would not say to go thru a non-profit since it is all about money. For me to keep a daughter who lovers her mom and wants to be with her take her away from blood it is all about her money. I lose time every day not having her near and and being able to see and spend time I could have because she is forgetting more and more each day and one day I know when I call she will not know who I am. I call every day. She sleeps a lot but I will keep calling it is all I get. Everyone take care of your family appreciate them, spend time that you have. SMILE

YES, it is a SCAM. Unfortunately, a very popular one and it is happening with increasing frequency. My mother was solicited by a nursing home employee who then, upon my mother's return to home, got my long-term Durable POA revoked (it can be done easily, by an attorney who believes whatever the client says, in this case, the scammer). I am a contract therapist of 26 years, and work for home health agencies and nursing homes at time. Recently, it seems like every home health aide works these scams on the side. Many want tp be paid cash. MOST COMPANIES can NOT prevent it, as they cannot legally prohibit "moonlighting." I feel that it is solicitation, conflict of interest, and of course unethical, but there are no laws to stop it. As a therapist, I would risk losing my license and being fined, but many Home Health Aides have nothing to lose. It won't show up on a Criminal Background check, because ir's not actionable at this point. This needs to change! Eventually, as they rip off more and more elderly, they will hopefully require higher standards, licensure, etc. But for now, best you can do is switch to another agency and of course tell them why. ASAP!!! Good luck. For me, it meant never seeing my mother again

Most bonded and insured agency caregivers sign a contract that will not permit this.Many are not allowed to jump to another agency and then work for the same client either (unfortunately).I had many ups and downs with four agencies and wish I had been able to cherry pick my favorites from each agency, unfortunately when there are call offs this becomes a nightmare.Best to find one agency that has the highest percentage of 'good' caregivers and stick with them.Make sure they are licensed by your state and are fully insured and bonded.Nevertheless keep a watchful eye on all caregivers in your house at all times and never let your guard down.Just like nursing homes stop in unannounced a few times every week and let the caregivers know this is SOP or they can work elsewhere.If you have good neighbors get feedback from them.It is your home and loved one.The agency management doesn't have the time to check up on all their people often enough.Never judge a book by its cover because I had good and bad from a rainbow of backgrounds and age groups.My best ones did it as a career after caring for a loved one from their own family previously.Beware of the braggarts because they were the ones I caught up in the most lies.

In response to Cautious (who took the time to make a thoughtful response) and not meaning to argue, I just want to add that those "agreements" are meant to dissuade the employee, and at least in Indiana, do not hold up in court. Nor does the non-compete agreement (mentioned as the second thing), and in our state, those are not even used anymore. since they have no record of successful enforcement in court. Being bonded and insured is essential for issues like theft, and similar criminal activity (assuming it can be proven), but does NOT prohibit unethical solicitation. This is a huge problem, and is growing, and we need to be proactive and vigilant. There are soooo many scams against the elderly anyway, and it's stunning that those of us entrusted with their care would even consider taking advantage, but it happens regularly. I can not (and would not) even accept gifts, unless they have minimal value (i.e. a thank-you card, or candy, etc.). Yet, I have seen aides accept large amounts of cash, jewelry, etc., and there is no way to prosecute them if the elder says they want them to have it. Even when you know that the senior was manipulated and coerced, it's so hard to prove. I certainly don't mean to imply there are no good Aides (I worked as one for a couple years while getting my therapy degree), but there aren't enough. I still feel that some type of formal education and licensing would help. Let's face it, when a company pays minimal wages for such a demanding job (also inexcusable), and often treats these folks with disrespect (as do nurses and therapists, not to mention the patients and their families), the employee will naturally look at other options, where they can provide the same services and earn more money with less restrictions. However, as I have told them (including the one who solicited my mother), if they feel that they want to offer those services as moonlighting, at the very least they should approach the family BEFORE the senior in their charge. If they are honest, why should that be a problem??? Many times, when Medicare no longer covers the presence of an Aide and the family would like it to continue, it could work out well for both parties. If an Aide has nothing to hide, and no ulterior motive, they should be able to approach the situation in this honest way. After all, there are "sitter" services where thet could list themselves (i.e. "SitterCity.com") and do the same thing (those sites do background checks also, for what that's worth). I hate to say it, but the things I am seeing constantly lately are escalating, because there is NO real enforcment with teeth, and nothing to stop it. Only licensing (and the violation fines and suspension that come with negative reports) will put a stop to this. Naturally, the big companies who employee these people won't see it that way - they would have to pay them more (and they deserve it - that work is brutal), and then those companies wouldn't make as much huge profit. When things get bad enough, the law will finally catch up - our society just never shuts the barn door until the horse is long gone...Climbing off my soap box now. Again, I encourage you to put a stop to it, report the person, and change agencies. Plus everything that Cautious said!!! Nothing like stopping by unannounced (I've done that for my patients) to find things out and be able to report them.

I understand why many aides do this, doesn't make it right... they are paid poorly, but should not use the agency to 'network'..... I simply put an ad in the paper, I have excellent references and because I live in small community, everyone knows everyone, so rarely are the references checked... and yes I make more money... but I am also responsible for my own taxes, ect...
But I do agree with all that said to call the agencey asap, and report her, this is blantan disrepect of the client if nothing else.....
No disresecpt intended to the person that posted about his/her agency, but it's like many nursing homes... some are wonderful, some are not...
It is just one more way our elders are falling thru the cracks, no legislation to protect the aide or the agency, or the client....
Hope you find someone trustworthy and compassionate to help, and sorry you are far away , that makes it even harder....

I should of mentioned in my response that under the terms of my guardinship I had to go with a licensed,bonded,and insured agency.I worked full time so I did second shift and partial third shift myself to save money.I always had total respect for the 'good' ones because most were single moms working for pretty much a minimum wage rate, yet worked their tails off.I wish there was a means where these people could work as free agents and get paid a decent wage under a strict guardinship.I agree it is a real mess and at $16 -25 dollars a hours to the agency the money goes fast.I guess that is why clients can become so demanding at times.At those rates the last thing I wanted to see was a caregiver on their cell/smart phone everytime I walked in unannounced.Yes,cell/smart phones are the worst device ever created in regards to elder neglect with the 'bad' ones.Just my opinion.As bad as things could get at home the rehabs and nursing homes were worse and I had to retain the private caregivers when my mom was in those facilities too.Everyone is cutting costs and leaving a elder with severe dementia alone in those places is truly sad.Even with 24/7 coverage I could write a book about the total gross neglect for the sake of profit taking place in the so called eldercare care system.I could of not done it without the 'good' private hire caregivers I had working with me to protect my mom.

I don't know what states most of the responders are from but some of you might be surprised to find that the agency that provides aides deem them independent agents and thus, they are not insured nor do they get any benefits. My mother gets aides thru a state funded nursing home waiver program and it all depends on what agency they are from and no, just bc it is a state contract with the agency, doesn't mean they are insured, contracted, etc. For example, when one of the aides had to switch to another agency to keep working for her, the agency makes the aide pay for her background check and medical certification to prove that they are healthy and have required vaccinations. She told me they sent her to a specific doctor and he did NOT GIVE HER ANY EXAM, just basically signed the paper. after asking a few questions. This cost around $75. These aides do not get vacation or sick time, they pay their own gas and mileage. Also, they are told they have to buy their own gloves. Yet these agencies keep a large portion of the hourly rate. Yes, some provide required continuing education classes but they have to be attended on the aides own time.
So back to the question. Out of 4 agencies that we had aides from only one provided a paper for the client to acknowledge that for a period of time (6 months) she could not leave the agency to work for that client unless the client paid a fee. But after 6 months no fee. you mentioned a contract - so if the contract has similar language then she could pay the fee or wait the time. Regarding ethics, I don't know what this aides personal situation is but how ethicial is it for an agency to take 40% of hoursy wage just for placing the aide and not paying for the background check, the medicial certification, insurance, vacation and sick leave, etc? That being said, if the mother has signed a contract saying she would not hire an aide privately she should check to see if she faces a penalty for doing so and she would not be able to use that agency again if discovered. And if the aide doesn't show up or she is not doing her job, the mother has no agency to call for a backup replacement aide. That's why there should be laws requiring agencies to hire aides as regular employees with all benefits to protect the employee and the clients, like our elderly familiy members. If benefits were provided, I doubt these aides would be trying to make these deals on the side in order to make a living and support their own families

Everything 2much said is true... this is why I am an independant caregiver... I refuse to let an agecny get more money as I work my butt off for min. wage... and to say again, there are very good ones out there, don't know if you could call the Better Business Bureu to see if they have had complaints first, then check into them... unfortuntley our elders are paying for this 'lack of care' and it is so difficult when a family really needs this extra care for a loved one.... seems much of our medical services now a days is a business as compared to acutal care... I walked off the floor and quit in the middle of a shift in a NH simply because of the treatment a resident was getting by an LVN, because she wanted a drink of water... and I turned them in..... it's a sad and frightening situation for our elders...

I wanted to add that an employee of the agency can contract outside the agency for additional work with a client. For example, if a care assistant gives baths a couple of times a week for the agency, he is free to provide additional baths for private pay. It is between the assistant and the client. Many assistants stay on as private assistants after the contract with the company has been completed. Companies do not mind this at all IME. We have even received recommendations from the company to do this if we need additional services.

I work on contract, not in the healthcare field. I have done this both independently and through a consulting firm. Both are perfectly honorable ways to earn a living. The firm takes more than 40% of what they charge the client for my work. I am OK with that. I know what my expenses were when I worked independently.

But I would never, under any circumstances, be placed through a consulting firm and then immediately approach the client to cut a private deal. That is unethical. If you want to work independently, more power to you. But don't use an agency to find you a position and then turn on them.

To address the original question, such a person is demonstrating a lack of integrity. Is that someone you want in your loved one's home?

Please notice that I am not saying not to hire an independent. There are plenty of good independents out there. I'm saying don't hire someone who demonstrates a willingness to go back on their word and to behave unethically.

In an ideal world you can talk "ethics" but the reality in the home heath care business, the agency has the advantage. There are more aides out there wanting work then there is work. So they get low pay, no beneftis, endure wear and tear on their cars, pay high gas which in not covered when the agency sends them from one end of town to the other for 3-4 hour jobs. And the client is losing also, untrained or poorly trained aides, some with no experience just sent out to fill a spot (and this is from my personal experience) aides working more hours than they should to make ends meet which results in your mother getting tired worn out aides who when they can do take advantage to make their phones calls, relax, etc. In my opinion, unless an agency is going to pay a decent wage, offer benefits and pay for background and health checks, then maybe they should only be acting as a placement agency where the client pays a fee and then after satisfied with an aide sent by the agency, from then on all hourly pay goes to the aide not the agency. If it does work out then for that fee paid by the client, they can find them another aide and start the process over again. I'd love to hear the other side from any home health agency out there. But based on my observations, this is what is happening. I suggest everyone call their aide's agency and find out whether the aide is considerent an independent worker, whether if injured or if they cause injury or theft, is the agency insured to reimburse the client, ask them who pays for background checks and medical certs and how often. Ask if agency pay mileage, vacations, sick leave. You might not want to hear the answers.

2much, you summed it up perfectly... I have worked with what I call " warm bodies", just someone in the room, I got one of the aides for M fired.... told the daughter she was 'stealing' from them, that got her attention, then I went on to explain she was 'stealing' in the form of getting a paycheck for doing NOTHING... M never did like this woman, and would tell me things like she had to call her many many times to get her awake to come and tend to them... we had monitors set up, and come to find out, when the person interviewed for the job, she even told the family she hoped M could wake her up, she was a sound sleeper... so in this case, I hold the family accountable,,, they hired her anyway.... !!!
And like you, i would like to hear from agencies, and how they treat the aides.... it is a business, like all others, they are in it for profit.... not all, but many....
The agency the family uses for S is amazing... I have no complaints whatsoever.... they have a great name in our community and go above and beyond to make sure things are good for S... the offer was made for one of the RN's to come out when they found out M had died... they were concerned about S, and how he was handling things.... so I have nothing but great things to say about this agency... but have dealt with some that need to be shut down....All I can ever think about is families that have to do this long distance, and don't know what they are getting.... maybe there should be skype interviews so the the family could get a 'feel' for what they are getting into...something to think about.....

LindahernerOT, I appreciate your input re home health aides since it serves as a good warning, but I have to say I've experienced issues with in home independent physical therapists. Like staying for about 15 minutes but charging medicare for a whole hour (and not b/c the client couldn't take any more) doing the same routine in bed exercises instead of making an effort to get the client out of the bed, cancelling appointments at the last minute (some excuses: I had to go to the other end of town to do an assessment on a new client) . Billing for visits that did not take place. Dropping clients when their scheduled vacations come up or it becomes too inconvenient to travel to that location based on their other client's locations. And if they do these things while I am around checking, what do they do when the elderly client is alone? It is very depressing to learn all this about the elder care business. Maybe this should have been a separate post but my point is, no one is watching over these agencies and people we entrust the care of our elders to and unless aides are treated fairly their problems will affect the care our elders receive.

Many eldercare agencies,most nursing homes,numerous hospitals & rehabs,most attorneys,and all of big pharma,etc,etc all know the dire situation elders,loving families,and 'good' caregivers are in and are running the whole thing as one big profit center at the expense of what is moral and just.Nobody in the last election had any answers and I'm sure things are going to get a lot worse.I was lucky because I lived with my mom every day and learned a good lesson on how this whole system works up to the last day of her life on this earth.It is a profoundly corrupt system.The week after my mom passed nine months ago I made a list and am now going after every one of these sleazy operations that made life a living hell for my mom,myself and my good caregivers.Round one against the nursing home went well (this one has only started) and no I'm not in it for one red cent of profit.I also found out my guardinship attorney worked part time on cases for the nursing home! Wrong - conflict of interest.So going back to the original post - 50% of the people I worked with were trustworthy and the other 50% were in for only the money.Do not hesitate to expose the bad guys otherwise they move on and just do more damage to someone else.Beware.That is why I call myself "Cautious".

Cautious, Thank you for continuing to try to correct the system. i agree that's why i am joining groups that say they are working toward reforms, like National Consumer Voice for Quality Long-Term Care and the Family Caregiver Alliance. Because it is going to be worse when we start needing care. The problem with most caregivers is that we are usually too worn out during caregiving to fight the system. We need groups and elected officials to support us and the only way they will do that is if we group together.
Info about the groups i mentioned:
Founded in 1977, Family Caregiver Alliance was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. Long recognized as a pioneer in health services, FCA now offers programs at national, state and local levels to support and sustain caregivers.

The National Consumer Voice for Quality Long-Term Care was formed as NCCNHR (National Citizens' Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice is the outgrowth of work first achieved by advocates working for Ralph Nader and later for the National Gray Panthers.

2much2cover, your screen name is perfect! There are so many things to say in the world of poor senior care, how sad. You are quite right that the problem is not limited to Aides. I rarely have agreed to work in Home Health because of the therapists and nurses, and their abuse of the system, and my fear of having to report them. I can say that the regulations are much tighter now, and client signature captures are required by the feds to prove that someone actually was IN the home. But they do cut visits way too short, and the other things you mentioned. From the therapist and nurse (and Aide side), I can say that, on a day when one has six patients scheduled and 40 minutes of unpaid drive time, plus extra and excessive required charting requirements between each one, it leaves very little time for actual patient care. The professionals are often painfully aware of their substandard services, and the only option is to see the patient longer times, then make up the difference on their own time (I spend two hours unpaid for every paid hour of patient care, but I do give each person a full hour). It is again the large corporations that own and run Home Health (a matter of business news, if you follow it, ugh) that create the need for unethical and substandard behavior while maximizing their profits. No wonder they have the worst turn-over rates in the health industry. It's not an excuse for doing ANY of the things you mentioned, though, and those should be reported also. I am always thrilled when a family member is able to show up, or even call me or return my call to discuss how treatment went. I can always be held accountable and discuss goals and progress. Clients should expect NO LESS. Being an independent contractor (along with jobs as therapy diretor, running my own therapy business, teaching, etc, over 26 years), I have set a high standard to assure that myself and others stayed busy and in demand. But I've witnessed some other things that gave therapy a bad name. Report those things, please, always. If you actually saw a situation where a visit was billed and did NOT occur, that is Medicare fraud and as bad as it gets. Therapist will get fined and suspended (which is why licensure helps, easy to punish and mean it). The only way to fix this mess, and all the bad apples involved, is to police it! Thanks for your input - therapists are no angels either!

Please tell the agency what is going on immediately! They sign agreements not to do this, which states clearly that this person in the home with your loved one is NOT OF GOOD CHARACTER!
Even if they aren't making good money, no reason to be deceitful. Next thing you know we'll be reading that an elder signed their house over to this person without family knowing. Good Luck to you. Would you let someone steal their food and stay in the home?

For those of you who think going thru an agency means the aide is insured for liability, here is a sample contract terms from an agency between the aide and the agency:

The HOME HEALTH AIDE shall be an independent contractor and not an
employee of the AGENCY. It is highly recommended that the HOME HEALTH
AIDE maintain a policy of Liability Insurance to cover any claim arising out of the
performance of his/her services under this Agreement. The HOME HEALTH
AIDE shall indemnify, save harmless and defend the AGENCY for any such claims
arising from an act or omission of the HOME HEALTH AIDE or his agents. The
HOME HEALTH AIDE assumes the liability in the event of a Worker's
Compensation or malpractice liability claim. The HOME HEALTH AIDE shall
maintain automobile insurance in the amounts of $10,000 / $20,000 liability for
personal injury and $5,000 liability for property damage arising out of his
ownership, maintenance or use of the automobile. Evidence of insurance coverage
shall be furnished to the AGENCY.
G. The HOME HEALTH AIDE is not entitled to coverage under the AGENCY'S
Worker's Compensation policy, and waives all benefits under the terms of this
policy. The HOME HEALTH AIDE will not be responsible for the failure to render
the agreed service for the AGENCY if such failure is due to (a) illness, (b) absence
due to normal vacation, (c) absence because of attendance at a special training or
professional meetings, provided that adequate notice is given to the AGENCY.
H. The HOME HEALTH AIDE understands and agrees that the (i) AGENCY will not
withhold on behalf of the HOME HEALTH AIDE any sums for income tax, social
security, or any other withholding pursuant to any law or requirement of any
governmental body relating to the HOME HEALTH AIDE, (ii) In the event that the
Internal Revenue Service should question or challenge the independent contract
status of the HOME HEALTH AIDE, the parties hereto mutually agree that both
HOME HEALTH AIDE and AGENCY shall have the right to participate in any
Page 4 of 6
discussion or negotiation occurring with the Internal Revenue Service irrespective
of.

Did anyone of you wonder, if what this woman is doing is so bad and she is trouble, how come this agency hired her to go out and work for your family members? Again, I suggest they read the contract to see what it says about hiring agency aides under private agreement. And they call the agency and ask exactly what background checks they do, are their workers with workers comp insurance, do they cover the aide for insurance if they cause harm in your home or they are harmed. Maybe this family should be firing the agency for sending someone some here have labeled deceitful, not of good character, etc. Did this agency do any background checks for references or did they hire her off the street? I would think if she is a "scam artist" this agency would have know by now.

Many of my agency caregivers would tell me the whole background check thing is a joke and training was pretty much just watching a couple DVDs.Most are quickly 'processed' and rapidly sent out on assignments.To make matters worse they form cliques and work as teams to cover up mistakes or abuse.Many of my best caregivers were the outsiders who would not play the games.One of my best caregivers was a 70 year old woman who always told me "she came from the old school" and she was truly a jewel.The other was a young woman of 23 when she started with us and she was Godsent because my mom was rapidly going downhill. She was like a loving grandchild with mom and easily brought her a few more good years at home due to her uplifting spirit and great care.They were both from the same agency that I had my best luck with.The owner of that agency used a lot of gut feel when she hired and tried hard to match caregivers with the needs of the client and family.I deeply respected many of them because I knew what they were being paid per hour yet would drive across town in a roaring blizzard to be at the house on time.Plus they had to tolerate me ,a very demanding guardian!I wish I had a simple answer for this one but it really comes down to being very involved every day and interacting with all the caregivers who walk through the door.Anyone who thinks they can hire a agency and run it all remote control is fooling themselves and putting their loved one in great jeopardy.

Cautious, I think we need government intervention in having minium standards and requirenments for home health agencies. This is something everyone should be concerned about, whether they are caring for someone now or will be under the care of strangers in the future. That's why I am starting to get involved in groups like The National Consumer Voice for Quality Long-Term Care who are working for national legislation. I don't want to regret in the future that I did nothing to change the system when I could for the older me down the road.

Some agencies, maybe it depends on the state, do carry insurance and their workers are bonded. I asked these questions when I consider hiring a caregiver from a agency.

The non profit who has gaurdainship of my mother hired a young aide to watch her. She was leaving my mother alone in the house and doing down the street for who know how long. I wrote them they said she was not leaving my mother alone and that I was to stop. I had security in the neighborhood get pictures of the aide leaving my mother and now the aid had resigned. A young women named Jullian ? in Fort Lauderale FL was the aide. I hope she dosesn't get a caretaker job again. Be aware South Florida and of South Florida Gaurdainship program. I have copies of bills they said they paid and I already paid by cashier checks. Also the bills of the house have doubles and tripples since they have had ETG of my mother and her money. They do not keep track of itemized bills only hundreds of dollars a week for what I might ask. Where are the receitps? They spend money on what and leave her with no teeth or hearing aides for months. She picks up her dog poop and they have to clean her hand while I am on the phone. Why if she has dementia is she picking up the dog poop? If they want her to do something take her out of the house to the senior center or focal point for interaction with others like the phys doctor suggested not let her sleep in her room all the time. SFGP checks every week on her for an hour takes her money and does not really know what is going on day to day. I wish they were regulated but their not. This is elder neglect and they are getting away with it every day. When will it end.

No it is not a scam. For the work my caregiver was doing at the price I was paying the agency; $25 hr vs. $11 hr I asked her if she would be interested in receiving $14.50 per hr (California)? And she agreed. It has been working for my family (mother) and caregiver for 5 years.