Hiring a Caregiver Privately vs Using an Agency in Nevada

Hiring a caregiver directly is legal, common, and considerably cheaper on the hourly line. It also moves a set of obligations onto you that people usually do not price until something goes wrong. Here is the whole trade, without a thumb on the scale — we are a referral service and we refer to agencies, so weigh that.

The hourly gap is real

A privately hired caregiver typically lands somewhere between those numbers — above what an agency pays, below what an agency bills. That gap is the entire appeal, and it is genuinely substantial over a year.

What the agency rate is actually buying

Employer obligations

A caregiver you hire, schedule and direct in your home is generally your employee, not a contractor. That means payroll taxes, unemployment insurance, and — importantly — workers' compensation. If an uninsured caregiver hurts their back transferring your father, the exposure is the household's. Some homeowner policies exclude domestic employees entirely. Check yours before, not after.

Background screening

Nevada requires licensed agencies to fingerprint every attendant and run them through the Central Repository to the FBI within ten days of hire, and to re-investigate at least every five years. A private hire is screened as thoroughly as you screen them.

Backup coverage

This is the one that ends most private arrangements. Your caregiver gets flu, has a family emergency, or quits. An agency sends someone else — imperfectly, but that day. A private arrangement leaves you covering the shift yourself, indefinitely, at the worst possible moment.

Bonding and liability insurance

Nevada requires a licensed agency to carry a surety bond scaled to headcount, running to the Aging and Disability Services Division and indemnifying an older client for property damage, plus proof of adequate liability coverage. A private caregiver carries what they carry, which is usually nothing.

Training and supervision

Nevada requires a defined training curriculum before an attendant works independently, eight hours of continuing training a year, documented competency evaluation, and documented supervisory visits or calls. Nobody supervises a private hire but you.

Insurance and program acceptance

Many long-term care policies reimburse only licensed agency care. Medicaid personal care services run through enrolled providers, or through an Intermediary Service Organization under the self-directed model. If you intend to claim, check before you hire.

When hiring privately genuinely makes sense

• You already know and trust the person — a former aide, a neighbor, a family friend
• The hours are modest and predictable
• Someone in the family will handle payroll, taxes and insurance properly, and will actually do it
• You have confirmed workers' compensation coverage
• You have a real answer for what happens when that person is unavailable

When it usually does not

• Around-the-clock or overnight coverage — the backup problem becomes constant
• Dementia with behavioral complexity, where training and supervision matter most
• Two-person transfers
• Anyone intending to claim on a long-term care policy that requires an agency
• Where no family member is nearby to manage the arrangement

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Common questions