Understanding Caregiver Qualifications
There are many terms used to describe a caregiver's qualities, qualifications, duties and responsibilities. Understanding them will allow you to make decisions about which caregiver is best for your own care, for aging seniors and elderly parents, for individuals who are disabled or recovering from medical events, and many other unique situations where assistance is required.
Please note that definitions may vary widely from state to state.
In Oregon, Caregiver Registries, such as Caregiver Connection, and In-Home Care Agencies, verify caregiver's qualifications, reference checks and background checks. If you find your caregiver on an Internet-Based Search, be sure to include time and energy to check references in your hiring schedule.
Background Check
A caregiver has access to potentially vulnerable populations such as the elderly, people with disabilities, or convalescents in their homes. A background check can rule out individuals who have been placed on a registry for abuse, neglect, misappropriation or exploitation of a vulnerable adult, or is a registered sex offender.
Records searched in a comprehensive background check for a caregiver may include:
Social Security Number Verification: a possible indicator of identity theft crime
Caregiver Connection performs Social Security Number verification on all caregiver candidates.
Nationwide Criminal Database Search: reviews 7 years of multiple data sources from all 50 states including Departments of Corrections, state courts, law enforcement agencies, traffic courts, county courts, and prison parole and release file
Caregiver Connection performs a Nationwide Criminal Database Search on all caregivers who are active on our registry every 3 years.
County Criminal Record Search: reviews 7 years of data on court cases filed, charges filed, conviction data, and case disposition for each county of residence
Caregiver Connection performs a County Criminal Records Search on all caregivers who are active on our registry every 3 years.
Registered Sex Offender Search: reviews 7 years of records for all applicable states which report and release sex offender data.
Caregiver Connection performs a Registered Sex Offender Search on all caregivers who are active on our registry every 3 years.
Motor Vehicle Records Search: reported information includes infractions, disciplinary actions, issue date, expiration date, status, and restrictions. Driving records may be a good indicator of alcohol or substance abuse, or expose a pattern of ignoring safety rules and procedures.
Caregiver Connection performs a Motor Vehicle Records Search on all caregivers who are active on our registry every 3 years.
Bonded Caregiver
Bonding is type of insurance taken out from a bonding company that covers theft by an employee, typically for amounts from $5,000 to $25,000. Independent caregivers can bond themselves, though this not common. If you hire a caregiver from an agency, it’s likely that the agency has purchased a bond that will compensate you in the case that you are the victim of theft by the agency’s caregiver.
However, the bonding company does not have to reimburse you unless the theft has been validated in a court of law, meaning the caregiver has to be arrested, charged, and convicted in criminal court before the bond is paid. Therefore, only a small percentage of caregiver thefts get this far in the legal system.
Caregiver Connection does not require that caregiver candidates are bonded; however, if this is important to you, we suggest that you require your independent caregiver purchase their own bond.
CNA, or Certified Nursing Assistant
Depending on the state you live in, Certified Nursing Assistants may also be called Personal Care Assistants or Home Health Aids. In Oregon, the terms 'personal care assistant,' 'home health aide' or 'caregiver' are all generic terms for caregivers.
CNA requirements vary from state to state. In Oregon, CNA’s generally have a high school diploma or GED, as well as 150 hours of additional training. Half of this training takes place in a classroom, and the other half is hands-on clinical training, referred to as in-service training, typically in nursing homes. Certified nursing assistant training programs are found in online courses, community colleges, and trade schools. Students must pass an examination in order to be certified as a CNA by the state Board of Nursing.
CNA’s work in a wide variety of settings, including nursing homes, hospitals, adult care or adult foster homes, and private homes. In order to work in an Oregon hospital, CNA's must have about 40 hours of additional training; this level of certification is called CNA-2.
In Oregon, there are no minimum state-mandated requirements for independent caregivers. Despite this, most of the independent caregivers referred by Caregiver Connection have a CNA qualification or other healthcare-related backgrounds, such as nursing or acupuncture studies. We select for caregivers that have at least 3 years of experience that includes a mix of private duty, facility, hospice and home care experience. Additionally, caregivers are required to take at least 3 hours of additional training annually to meet ongoing education requirements.
In order to be included on our Caregiver Connection registry, a caregiver must meet our registry standards for care giving skills and experience, as well as for interpersonal skills.
In-service training is professional training or staff development in which professional caregivers are trained and discuss their work with others in their peer group during the course of employment. In-servicing is a key component of continuing medical education for many types of medical professionals, including CNA’s. and caregivers.
Caregivers on the Caregiver Connection registry are required to take at least 3 hours of additional in-service training annually to meet ongoing education requirements, per Oregon regulations.
In-Service Training
Insurance Considerations for Employers of Independent Caregivers
When hiring an independent caregiver to work in your home as your employee, there are several types of insurance that may be necessary or advisable for your particular situation. Consider reviewing the following:
Automobile Insurance: If you hire an independent caregiver to drive a vehicle to perform errands or transport the care receiver, appropriate automobile insurance is required.
Caregiver Connection verifies caregiver auto insurance every 3 years. You may want to check your caregiver's auto insurance to make sure that it is current, or ask them to use your car.
Home Owner’s Insurance: Some home owner’s insurance policies may exclude coverage if a private-duty caregiver gets hurt on the job. Talk with your agent about what your current policy would cover if there is an accident in your home, and determine whether an umbrella policy is needed for your protection.
Liability Insurance: Liability insurance covers independent employees who accidentally cause property damage or injury to others while working in their employers’ homes.
Caregiver Connection’s independent caregivers are insured for liability for $500,000 through CMF Group; visit their website if you have questions.
Worker’s Compensation: Also known as Workman’s Comp, this type of insurance covers most—but not all—on-the-job injuries including lost wages and rehabilitation for employees of companies, even if the injury is caused by carelessness, and varies by state.
Independent caregivers in Oregon and Washington, such as those referred by Caregiver Connection, are not covered by state Worker’s Compensation insurance.
Insurance to Cover Caregiving Costs
Long-term care insurance: Long-term care insurance (LTC) is an insurance product that may help pay the costs associated with in-home care.
Caregiver Connection’s independent caregiver services are covered by some LTC policies that specifically cover independent caregivers.
Medicare: Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. In general, Medicare covers doctor visits, hospitalizations, rehabilitation, skilled home health care and prescriptions.
Caregiver Connection’s services are not covered by Medicare, as the services our caregivers provide are considered custodial care.
Medicaid: Medicaid is available only to low-income clients that meet specified criteria, such as adults with low income and people with certain disabilities, to pay for long-term medical and custodial care costs.
Because Medicaid is a joint program of the federal government and each state, coverage by state may vary. In Oregon, a Medicaid case worker is assigned to help qualified individuals access approved caregivers.
Caregiver Connection does not service Medicaid clients, since our independent caregivers work as privately paid employees of clients.
Levels of Home Care
Custodial Care: This term usually refers to the Medicare definition for non-medical care that helps individuals with their basic daily care, such as eating, bathing and using the toilet. Though services vary by state, typically Medicare requires that custodial care services must be provided within a nursing facility to qualify for aid. Learn more here.
Caregiver Connection does not service Medicaid clients, since our independent caregivers work as privately paid employees of clients.
In-Home Care or Independent Caregiving Services: At it’s most basic level, In-Home Care care helps individuals with daily care in their own home by performing duties such as:
Personal grooming, like bathing and dressing
Movement assistance, such as transferring from bed to chair, or getting into and out of the shower safely
Medication reminders
Errands like grocery shopping and picking up prescriptions
In addition to non-medical daily care that helps the care receiver to maintain independent living, in-home caregivers often also provide quality-of-life services, from companionship and conversation, to transportation for errands or medical appointments, and much more.
Though home care is typically a private pay situation, some Long Term Care Insurance policies may cover costs.
Caregiver Connection’s qualified, independent caregivers specialize in providing home care, and work with you to decide what duties are appropriate and valuable in your situation.
Skilled Home Healthcare: Skilled home healthcare is skilled nursing care or therapy to help heal or rehabilitate after a hospital stay or medical event. Prescribed by a physician and performed by a licensed professional in the home, these services include:
Skilled nursing
Physical therapy
Pain management
Caring for wounds
Catheter care
Intravenous injections
Prescription management
Caregiver Connection does not provide this service, but our caregivers often work in conjunction with Skilled Home Healthcare teams to provide complete care services.
Palliative Care: Palliative Care services involve a multi-disciplinary approach to quality living for those with chronic, complex or progressing illness.
Caregiver Connection caregivers provide non-medical Palliative caregiving duties and work in conjunction with Palliative Care teams to provide complete care services.
Hospice Care: Hospice care begins after treatment of disease is stopped, incorporating palliative care without curative intent. Hospice care may be provided either in a hospice facility or in one’s own home.
Caregiver Connection caregivers provide non-medical Hospice caregiving duties and work in conjunction with Hospice Care teams to provide complete care services.
Locating Caregivers
There are three popular ways to find a caregiver; understanding how each works will help you find the right caregiver for you or your loved one. Learn more about the differences here.
For more information on hiring the best caregiver for your unique situation, you’ll find tips here.
In-home Care Agencies: Licensing requirements and the types of care provided by In-Home Care Agencies varies from state to state. Agencies send their caregiver employees to cover shifts as needed.
In Oregon, all In-Home Care Agencies are licensed by the state, from companionship to bedside caregiving to skilled nursing services. Check your state’s website to find out what types of licensing are required in your state and ask your In-Home Care Agency if they carry those licenses.
Caregiver Registries or Referral Services: Caregiver Registries are referral services for independent caregivers; licensing rules vary by state, and agency criteria for caregiver qualifications vary by agency. The agency broker matches you with screened caregiver candidates for you to interview and hire directly.
In Oregon, Caregiver Registries such as Caregiver Connection are licensed and regulated. Look for reputation, longevity in the community and the registry’s criteria for caregiver qualifications as you choose among them.
Internet-based Services: Internet-based Services are generally not regulated; caregiver candidates post their own profiles for services, and potential employers sort through them using criteria such as location. It’s the duty of the employer to verify references, credentials and all other aspects of the caregiver’s qualifications.
The Oregon Home Care Commission does provide a website search site for independent caregivers who have had background checks and receive training. Other commercial sites such as care.com and craigslist are not licensed or regulated.
