The Core Difference Is Employees vs. Contractors
Both a home health agency and a nurse registry are licensed through Florida’s Agency for Health Care Administration, and both can arrange for a caregiver to come to your home. The difference is in how that caregiver is employed, and it affects supervision, insurance, and cost.
| Comparison | Home health agency | Nurse registry |
|---|---|---|
| What it is | A state-licensed agency that provides care directly — housekeeping, personal support, meal preparation, personal care, Alzheimer’s and dementia care, and mobility support. | A state-licensed referral service that matches clients with trained, qualified caregivers. Care can be provided at home, in assisted living, a nursing home, or a hospital. |
| Caregiver status | Caregivers are employees of the agency. | A Florida nurse registry is mandated to only refer independent contractors. |
| Supervision | Caregivers are supervised by an RN, with ongoing training provided. | A registry cannot train, monitor, or supervise a caregiver. Care is supervised by a family member, friend, guardian, or POA. |
| Insurance | Caregivers are insured through A Lending Hand Home Health Agency, and workers’ compensation is included for all employees. | We strongly recommend independent contractors carry their own malpractice insurance — minimum $500,000 per incident and $1,000,000 aggregate. Policies are available on request. |
| Rates | Typically slightly higher, because the agency handles payroll taxes, insurance, and other HR responsibilities. | Lower, since there are no payroll taxes, insurance, or HR tasks carried by the registry. |
Why A Lending Hand Holds Both Licenses
Some families prefer the supervision and insurance coverage built into a home health agency model. Others prefer the lower cost of a nurse registry and have a family member available to oversee day-to-day care. Holding both licenses allows A Lending Hand to offer either option, depending on what fits a family’s situation.
Regardless of which model applies, the caregiver screening process is the same: a Level 2 FBI background check, a local records check through the county sheriff’s office, a professional reference check, verification of work history, and a valid driver’s license with proof of auto insurance.
Both a home health agency and a nurse registry can generally accept long-term care insurance. A Lending Hand works with a wide range of insurance companies and can help with initiating and managing a policy.
Have more questions? See our frequently asked questions page, or schedule a free in-home assessment to talk through which option fits your family.