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A plain guide for families in Connecticut, New Jersey and New York

Private Home Care Agencies: How to Choose One

You're comparing agencies, and each one says something a little different. Here is what the name means, how to check any agency yourself, and the twelve questions worth asking before you say yes.

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What is a private home care agency?

A private home care agency employs caregivers and sends them to your home for the hours you choose, and you pay the agency directly. It is different from Medicare home health, which needs a skilled-care order and homebound status. Check any agency on the state's official lookup before you start.

Medicare home health needs two thingsPart-time or intermittent skilled services, and being homebound.Medicare.gov, home health services
Medicare and long-term careMedicare and most health insurance "don't pay for long-term care services" in the community.Medicare.gov, long-term care
Agency or registry (Connecticut DCP)"Agencies place their employees in homes." Registries match independent or consumer-paid companions.CT Department of Consumer Protection consumer guide
Connecticut registrations renew every yearAll registrations expire annually on October 31st, so check the date on the lookup.CT Department of Consumer Protection

The basics

What a private home care agency is

A private home care agency is a business that hires caregivers, schedules them, and sends them to your home for the hours you choose. You pay the agency, usually by the hour or by the shift, and the agency pays the caregiver. That's the whole idea behind "private pay": for companion care, no insurer has to approve it before it starts, and you decide how many hours you want and when.

It is a different thing from Medicare home health. Medicare covers home health only when you need part-time or intermittent skilled services and you are homebound, and a Medicare-certified home health agency must provide it. Medicare does not pay for 24-hour care at home, or for custodial or personal care that helps with daily living when that is the only care you need. Medicare also says that it and most health insurance don't pay for long-term care.

So the two are built for different jobs. Home health follows an illness or an injury and comes with a doctor's order. A private home care agency covers the everyday help that keeps someone safe and comfortable at home: company, meals, housekeeping, errands, rides and reminders, with more hours or an overnight caregiver when that is what the family needs.

Some families have a long-term care insurance policy. These policies usually reimburse a daily amount up to a set limit for help with things like bathing, dressing or eating, and what a policy pays for depends on the policy itself. Some Medicare Advantage plans may offer limited in-home support, so it's worth asking your plan. Our guides on paying for care walk through each source.

Three ways to get a caregiver

Agency, registry or hiring privately

There are three common routes to a caregiver, and they differ mostly in who the caregiver works for. With an agency, the caregiver is the agency's employee. With a registry, you are matched with a caregiver who is paid at least partly by you or who is treated as an independent contractor. When you hire privately, you find the person yourself.

Connecticut puts this in its law. A registry is anyone in the business of supplying, referring or placing an individual with a consumer who is directly paid by the consumer, or who is treated as an independent contractor. Registries must register with the state like agencies do. They must also give the consumer a signed notice that the consumer may be considered an employer and may be responsible for "federal and state taxes, Social Security, overtime and minimum wage, unemployment, workers' compensation insurance payments" and other payments the law requires.

The Connecticut Department of Consumer Protection puts it this way: if you consider a registry rather than an agency, you or your loved one may be responsible for filing paperwork with the IRS and may also be responsible for paying employment taxes. New Jersey's Division of Consumer Affairs says much the same about hiring someone privately: you are required by law to pay withholding taxes, Social Security and disability payments, and that person will not have had a criminal history background check unless you arrange one.

Backup is the part families forget to ask about. If a caregiver is sick or the car won't start, who finds a replacement, and how fast? With an agency, the answer should be a plan the agency can describe. With a registry or a private hire, it is usually you. Ask before the first shift, and ask for the answer in writing.

Three states, three rulebooks

How each state regulates agencies

The rules for a home care agency depend on the state the care happens in, and they are not the same from one state to the next. A word like "personal care" can mean one thing in Connecticut and something stricter in New Jersey, so read the page for your state.

  • Connecticut

    The Department of Consumer Protection registers homemaker-companion agencies, and the Department of Public Health licenses home health care agencies and home health aide agencies. Each may do different things. See the Connecticut page for what each can provide and how to look one up.

  • New Jersey

    A firm that employs, places or refers someone to provide companion, health care or personal care services in the home of a person with a disability or age 60 or older must register as a Health Care Service Firm with the Division of Consumer Affairs, regardless of the title the provider goes by. Hands-on personal care is done by licensed or certified personnel.

  • New York

    An agency that provides nursing, home health aide or personal care services must hold a license from the State Department of Health. A company that provides companion care only is a different kind of business, and it may not appear on the Department of Health's agency search, because that scope does not require the license.

Five minutes, before you sign anything

How to check an agency

Every agency can say it is registered or licensed. You can look it up yourself, and it takes a few minutes. Use the state's own site, not a directory, and compare the name and the number to what the agency gave you.

A registration or license shows that an agency is on the state's books. It is not a rating. Connecticut's law says a registration may not be described as an endorsement by the commissioner of the quality of services, so use the lookup as your first check and the questions below as your second.

  • Connecticut: eLicense

    The Department of Consumer Protection tells consumers to verify an agency or registry registration at CT eLicense (elicense.ct.gov). Registered agencies must say that they are registered and show their registration number in their advertising. Complaints can be filed with the Department at dcp.complaints@ct.gov.

  • New Jersey: Division of Consumer Affairs

    Health care service firms must be registered with the Division of Consumer Affairs. Ask the firm for its registration number and confirm it with the Division before you start. The Division's consumer guide on home health aides explains who is certified to do what.

  • New York: Department of Health agency search

    Licensed home care services agencies are listed on the Department of Health's home care profiles site. If an agency says it provides nursing, home health aide or personal care services and you can't find it there, ask why.

Twelve questions

Questions to ask an agency

Print this list or keep it open on your phone while you call. Expect plain answers. If an answer is vague, ask again, and if it stays vague, take note.

  • 1. Who visits first?

    Ask who comes to your home before care begins, what they ask about, and who writes the care plan. You want a person, not a form, and you want to meet them before the first shift.

  • 2. How are caregivers screened?

    Ask about background checks, reference checks and how qualifications are verified before hire. In Connecticut the law requires a background check before an offer, including the sex offender registry.

  • 3. How are caregivers trained?

    Ask what training happens before the first shift and what continues after. Connecticut's consumer guide says agencies must train staff as mandated reporters, so you can ask about that too.

  • 4. How will you choose the caregiver for us?

    Ask how the match is made, whether you meet the caregiver before the first visit, and what happens if it isn't working. You should be able to ask for someone else.

  • 5. Who do I call after hours?

    Ask for the number a real person answers at night, on a weekend and on a holiday, and who that person is.

  • 6. How does backup work?

    Ask what happens when a caregiver is sick or running late, who finds the replacement, and whether the plan is written into your care plan.

  • 7. How can the schedule change?

    Ask how much notice you need to add hours, cut them back or cancel a shift, and whether there is a minimum number of hours per visit.

  • 8. How does billing work?

    Ask what the rate is for each schedule, how often you are billed, what is charged for holidays or short notice, and when a rate can change. Connecticut agencies must give at least sixty days' advance written notice of a rate change for the same level or type of services.

  • 9. What will the agency not do?

    Ask for a plain list. In Connecticut, for example, the Department of Consumer Protection says registered agencies may not provide medical services, administer medications or shots, or do nursing tasks like blood pressure checks or wound care.

  • 10. What do I get in writing?

    Ask for the service plan or contract before care starts. Connecticut requires a written contract or service plan no later than seven calendar days after services begin, and says a client can cancel at any time if the contract has no fixed duration.

  • 11. Who supervises the care?

    Ask who checks on the caregiver and on how your family is doing, how often, and how you reach that person. Ask how changes in your parent's needs are noticed and acted on.

  • 12. Can I see your registration or license?

    Ask for the number and look it up yourself on the state's site. Then ask what the registration covers and what it doesn't.

Close to home

Finding a private home care agency near you

Care is local, so start with where your parent lives. Endurance arranges care across Connecticut, New Jersey and New York, from our offices at 60 Long Ridge Rd, Suite 214, Stamford, and 788 Morris Turnpike, Suite 201, Short Hills. The pages below cover each town: what's nearby, how care is arranged and what to ask.

In Connecticut, start with the town pages for Greenwich, Stamford, New Canaan, Darien and Westport, or the Fairfield County page. In Westchester County, New York, see Scarsdale, Rye and Rye Brook. In New Jersey, see Short Hills and the Bergen County page.

Side by side

Three ways to get a caregiver, side by side

Three ways to get a caregiver, side by side
QuestionHome care agencyRegistryHiring privately
Who employs the caregiverThe agency employs the caregiver.The family may be the employer under the law. Confirm the arrangement and your responsibilities in writing.You do.
Who handles payroll, taxes and insuranceThe agency. You pay the agency, not the caregiver.You may be treated as the employer and be responsible for taxes and workers' compensation.You do. New Jersey's guide says you must pay withholding taxes, Social Security and disability payments.
Who finds a replacement when someone is sickThe agency. Ask to see the backup plan in writing.Usually you or the caregiver. Ask the registry before you start.You do.
Who supervises the careThe agency's own staff. Ask who, and how often.You direct the work. Ask whether the registry checks in.You do.
What you check before you startThe agency's registration or license on the state's lookup, plus the written service plan.The registry's state registration (Connecticut requires one) and the signed employer notice.References and a background check, which you arrange yourself.

Questions families ask

What is a private home care agency?

A private home care agency hires caregivers, schedules them and sends them to your home for the hours you choose. You pay the agency directly, not through insurance. The agency handles payroll and a replacement when someone is out, and it should be able to show you its registration or license on the state's lookup.

Is a private home care agency covered by Medicare?

Generally no. Medicare covers home health only when you need part-time or intermittent skilled care and you are homebound, and it does not pay for 24-hour care or for personal care that is the only care you need. Medicare says it and most health insurance don't pay for long-term care. Some Medicare Advantage plans offer limited in-home support, so ask your plan.

How do I find private home care agencies near me?

Start with the state's own lookup: CT eLicense in Connecticut, the Division of Consumer Affairs in New Jersey, and the Department of Health agency search in New York. Then call two or three agencies with the same dozen questions, and ask each to put its answers and its service plan in writing.

What is the difference between a home care agency and a home health agency?

A home care agency provides everyday help at home, such as company, meals, housekeeping and rides, and is paid privately. A Medicare-certified home health agency provides skilled care, such as nursing or therapy, ordered by a doctor for someone who is homebound. The two are licensed or registered separately, and each state sets its own rules.

Is Endurance a private home care agency?

Yes. Endurance Home Care is a private-pay home care agency. It does not accept insurance directly, though families with a long-term care policy can use it and we help with the paperwork. It is registered in Connecticut (HCA.0002450) and New Jersey (HP0435100). In New York it provides companion care only.

What is the difference between a home care agency and a registry?

An agency employs its caregivers and places them in homes. A registry matches you with a caregiver who is paid at least partly by you or is treated as an independent contractor. In Connecticut a registry must tell you in writing that you may be treated as the employer and owe taxes and workers' compensation.

Is it cheaper to hire a caregiver privately?

The hourly pay may be lower, but you take on the rest. You may owe withholding taxes, Social Security and workers' compensation, you arrange the background check, and you find the replacement when someone is out. New Jersey's consumer guide warns that a privately hired person will not have had a criminal history background check.

How do I check that a home care agency is registered?

Ask the agency for its registration or license number, then look it up on the state's site. In Connecticut that is CT eLicense. In New Jersey it is the Division of Consumer Affairs. In New York it is the Department of Health's home care agency profiles. Registration shows an agency is on record, not that its care is good.

Can I stop using an agency if it isn't working?

Usually, yes, but check your contract. In Connecticut, a client can cancel a contract or service plan at any time if it has no fixed duration, and an agency must give sixty days' written notice before a rate change for the same level or type of services. Ask any agency how much notice it needs for a schedule change or a caregiver change.

Does a private home care agency provide nursing?

Usually no. A home care agency that provides company, meals and housekeeping is a different kind of business from a licensed home health agency that provides skilled nursing. Each state has its own registration or licensing rules for them. If your parent needs wound care, injections or medication administration, ask a licensed home health agency, and ask your doctor.

Do agencies charge by the hour?

Many agencies charge by the hour for visits and by the shift or the day for overnight and live-in care, and rates differ with the schedule. Ask any agency for its rates in writing. As a market reference, CareScout's 2025 national median for in-home caregiver services is $35 an hour. Endurance does not publish prices.

What should I ask an agency first?

Ask who visits first, how caregivers are screened and trained, who you call after hours, and what happens when a caregiver is out. Then ask to see the registration number and the service plan. Those four come before everything else.

Where we arrange care

Endurance Home Care service area across Connecticut, New York and New JerseyCompanion care and personal care in every county of Connecticut and New Jersey (29 counties). In Connecticut, hourly, overnight and 24-hour care are available in Fairfield and New Haven counties, and live-in care is available in every county. Companion care only in every county of New York (62 counties). In New York, companion care by the hour, overnight or around the clock is available in Westchester County and Manhattan, and live-in companion care is available in every county. The same counties are listed as links beside this map.
  • Companion and personal care
  • Companion care, any schedule
  • Not served

Companion and personal care

In Connecticut, hourly, overnight and 24-hour care are available in Fairfield and New Haven counties, and live-in care is available in every county.

Companion care, any schedule

In New York we provide companion care only: company, meals, errands, appointments and someone watching out for your parent. In New York, companion care by the hour, overnight or around the clock is available in Westchester County and Manhattan, and live-in companion care is available in every county.

We serve every town in every county shown. Find your town or tell us the address when you call.

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