The True Cost of Hiring a Private Caregiver: Why “$24/Hour Cash” Really Costs $35-40/Hour (Or More)

The True Cost of Hiring a Private Caregiver: Why “$24/Hour Cash” Really Costs $35-40/Hour (Or More)

You find a caregiver on Care.com who seems perfect.

She’s warm, experienced, and willing to work for $24/hour — significantly less than agencies charge $37-45/hour.

“We’ll save $2,000+ per month!” you think.

Eighteen months later:

  • The IRS sends a bill for $18,000 in unpaid payroll taxes, plus $18,000 in penalties
  • Your caregiver files a wage claim for $12,000 in unpaid overtime
  • She also files for unemployment after you terminate her — $14,000 more
  • Total damage: $62,000

And that’s before the lawsuit.

This happens to California families every single day.

Most people don’t realize: When you hire a private caregiver, you become an employer under state and federal law — with all the legal obligations, tax requirements, and liability exposure that comes with it.

There’s no such thing as hiring an “independent contractor” for ongoing caregiving. It doesn’t exist legally.

This article breaks down the REAL costs of hiring a private caregiver in California — every expense, every legal requirement, every hidden liability — so you can make an informed decision about how to care for your loved one.

Because what looks like savings on the surface could be financial devastation beneath the surface.


The First Question: Who Is the Employer?

This is the most critical question — and the one most families get wrong.

There are only TWO legal options:

Option 1: YOU (or your family) is the employer

This means:

  • You hire, fire, supervise, and pay the caregiver directly
  • You are responsible for ALL employer obligations (taxes, insurance, labor law compliance)
  • The caregiver is YOUR employee, not an independent contractor
  • All liability for injuries, wage claims, and lawsuits falls on YOU

Option 2: A licensed home care AGENCY is the employer

This means:

  • The agency hires, fires, supervises, and pays the caregiver
  • The agency handles all employer obligations
  • You pay the agency, which pays the caregiver
  • All liability stays with the agency, not you

There is NO third option.

What about “independent contractors”?

In California, ongoing caregivers CANNOT be classified as independent contractors. AB5 (California’s gig worker law) and IRS rules make this crystal clear:

A worker is an employee (not a contractor) if:

  • You control when, where, and how they work ✓
  • They work regularly scheduled hours ✓
  • You provide tools and supplies ✓
  • They work exclusively or primarily for you ✓
  • The work is integral to your household ✓

Ongoing caregiving meets ALL of these criteria. The caregiver is your employee. Period.

What about referral agencies or registries?

Some organizations call themselves “agencies” but are actually just referral services. They match you with caregivers but don’t employ them — leaving YOU as the employer.

Red flags that you’re the employer (not them):

  • You pay the caregiver directly (not the agency)
  • You sign a contract with the caregiver (not the agency)
  • The agency describes itself as a “registry,” “referral,” or “placement” service
  • The agency disclaims being the employer in the fine print

With referral services, you get all the liability of hiring directly, with none of the benefits of using an actual employer-based agency.


Critical Questions to Ask BEFORE Hiring Anyone

1. How Do I Verify the Caregiver Has Legal Right to Work in the U.S.?

Federal law (Immigration Reform and Control Act) requires ALL employers to verify work authorization.

What YOU must do if you’re the employer:

Complete Form I-9 — Employment Eligibility Verification

  • Must be completed within 3 days of hire
  • Requires examining original documents (passport, driver’s license + Social Security card, or other approved documents)
  • Must retain form for 3 years after hire or 1 year after termination (whichever is later)

Consider using E-Verify — optional but recommended

  • Free government system that verifies work authorization
  • Provides additional protection if later audited

Penalties for non-compliance (2026):

Based on the latest DHS/ICE adjustments (effective January 2, 2025):

I-9 Paperwork Violations — Form completion/retention/production issues

  • $281 to $2,861 per violation (first offense)

Knowingly Hiring or Continuing to Employ Unauthorized Workers

  • 1st offense: ~$698 to $5,579 per unauthorized worker
  • 2nd offense: ~$5,579 to $13,946 per worker
  • 3rd and subsequent: ~$8,369 to $28,619 per worker

Other Potential Penalties

  • Document abuse or unfair immigration-related employment practices have separate fine schedules
  • Criminal penalties may apply for egregious patterns or fraud

If you use a licensed agency, the agency handles all I-9 verification and assumes liability for hiring authorized workers.


2. Does the Caregiver Understand Employment Is “At-Will”?

California is an at-will employment state — you can terminate employment at any time for any legal reason (or no reason).

But here’s what you MUST understand:

If you terminate “without cause,” the caregiver can file for unemployment insurance — and you’ll pay for it.

California unemployment insurance:

  • You pay 3.4% (average) of wages into the unemployment fund
  • If the employee is terminated and files for unemployment, your rate increases
  • Claims average $450-600/week for up to 26 weeks = $11,700-15,600 per claim

If you never registered as an employer with EDD:

Back taxes owed — for the ENTIRE employment period

100% penalties — on top of back taxes

Interest compounding

Potential criminal charges — for willful evasion

Real case (2024): San Diego family hired a private caregiver for 3 years without registering as an employer. The caregiver was terminated and filed for unemployment. EDD investigation revealed:

  • $24,000 in back taxes
  • $24,000 in penalties (100%)
  • $7,200 in interest
  • Total: $55,200

If you use a licensed agency, the agency handles unemployment claims — their rates increase, not yours.


3. Should the Caregiver Have a TB Test?

Absolutely yes.

Tuberculosis facts:

  • TB is spread through the air (coughing, sneezing, speaking)
  • Seniors with weakened immune systems are highly vulnerable
  • Latent TB can become active at any time
  • Once infected, TB can be fatal for elderly patients

Requirements:

  • California Title 22 requires TB testing for all home care workers
  • The test should be performed within 12 months before starting work
  • Retesting recommended every 2 years (or annually for high-risk workers)

What is required:

  • Negative TB skin test (Mantoux test) OR
  • Negative chest X-ray (if skin test is positive but not active TB) OR
  • Blood test (IGRA — QuantiFERON or T-SPOT)

If you use a licensed agency, the agency handles TB testing as part of caregiver screening. All Heart Home Care requires current TB tests for all caregivers.


4. What Background Checks Are Needed?

When you hire privately, you have limited access to background check systems.

What you can do:

  • Commercial background check services ($30-100)
  • County criminal records search
  • Reference checks (if provided)
  • Sex offender registry search

What you CANNOT access:

  • FBI criminal database
  • DOJ Live Scan fingerprint records
  • Elder abuse registry
  • Multi-state criminal records
  • Sealed or expunged records

The problem: Many dangerous individuals pass commercial background checks because their records are in databases you can’t access.

Real case (2023): A San Diego family hired a caregiver who passed a commercial background check. Later, it was discovered that the caregiver had an elder abuse conviction in a different state. By then, $47,000 had been stolen.

If you use a licensed home care agency, California requires it to conduct DOJ Live Scan fingerprint background checks on all caregivers, including access to FBI and California criminal databases that individuals cannot access.


5. What Insurances Are Required?

If you’re the employer, you need multiple insurance policies:

Workers’ Compensation Insurance (LEGALLY REQUIRED)

California law requires ALL employers — including household employers with ONE employee — to carry workers’ compensation insurance.

Cost: $1,000-$3,000+ per year (depending on hours and claims history)

What it covers:

  • Medical treatment for work injuries
  • Temporary and permanent disability payments
  • Death benefits
  • Legal defense costs

What happens if you don’t have it:

  • $10,000 minimum penalty from California DIR
  • Personal liability for ALL injury costs (often $100,000-500,000+)
  • Criminal misdemeanor charges are possible

CRITICAL: Your homeowner’s insurance does NOT cover workplace injuries. It specifically EXCLUDES domestic employees.


Employer’s Liability Insurance (STRONGLY RECOMMENDED)

Covers claims not covered by workers’ comp:

  • Discrimination
  • Harassment
  • Wrongful termination
  • Other employment-related lawsuits

Cost: $500-$1,500 per year

Why you need it: Average employment lawsuit defense costs $50,000-150,000 — even if you win.


Bonding (Theft Protection)

An employee dishonesty bond covers theft by your employee.

Cost: $200-500 per year

Coverage: Typically $10,000-$25,000

Why you need it: Homeowner’s insurance EXCLUDES theft by employees. Without bonding, you have no recourse if your caregiver steals.


If you use a licensed agency:

Ask for their Certificate of Insurance showing:

Workers’ compensation

General liability — $1M+ recommended

Professional liability

Employee dishonesty bond

All Heart Home Care offers comprehensive coverage that protects both caregivers and families.


6. How Will You Ensure Ongoing Quality of Care?

When you hire privately, YOU are responsible for supervision and quality control.

Questions to ask yourself:

  • Can you be present regularly to observe care?
  • Do you know what good care looks like for your loved one’s specific conditions?
  • How will you know if medications are being given correctly?
  • How will you know if personal care is being performed properly?
  • What will you do if quality slips?
  • How will you handle termination and the search for a replacement?

What happens when you’re not there:

  • Care quality may decline
  • The caregiver may spend time on the phone or watching TV
  • Tasks may be skipped
  • Problems may go unreported

If you use a licensed agency:

Professional supervision — and regular home visits

Care plan documentation — and monitoring

Communication with family — about care quality

Immediate replacement — if the caregiver is not meeting standards

Training and ongoing education — for caregivers

24/7 on-call support — for emergencies


7. What Will This Actually Cost?

Here’s where the math gets real.


The REAL Cost of Hiring a Private Caregiver in San Diego (2024-2025)

What Families THINK They’re Paying

Private caregiver advertised rate: $24-30/hour

“That’s way less than agencies charging $37-45/hour! We’ll save thousands!”

What Families ACTUALLY Pay (When Done Legally)

Let’s do the math for a caregiver at $24/hour, 40 hours/week:

Expense Category Cost Explanation
Base wages $24/hour What you pay the caregiver
Employer payroll taxes +$3.12/hour (13%) Social Security, Medicare, FUTA, SUI, ETT, SDI
Workers’ compensation insurance +$1.50/hour Required by California law
Employer liability insurance +$0.60/hour Protection against lawsuits
Employee dishonesty bond +$0.30/hour Theft protection
Payroll processing +$0.50/hour Service to handle taxes, pay stubs, and filings
Paid sick leave +$0.50/hour 40 hours/year required by California law
Overtime premium Varies 1.5x for hours over 8/day or 40/week
TOTAL HOURLY COST $30.52+/hour Before any overtime

Monthly cost breakdown (40 hours/week, 4 weeks):

Expense Monthly Cost
Base wages ($24 × 160 hours) $3,840
Employer payroll taxes (13%) $499
Workers’ comp insurance $240
Employer liability insurance $96
Employee dishonesty bond $48
Payroll processing service $80
Paid sick leave accrual $80
TOTAL (no overtime) $4,883/month

BUT WAIT — What if you need 10-hour days (common for full-day care)?

10 hours/day × 5 days = 50 hours/week

California overtime rules:

  • Hours 1-8 each day: $24/hour (straight time)
  • Hours 9-10 each day: $36/hour (1.5x overtime)

Weekly pay calculation:

  • 40 hours × $24 = $960
  • 10 overtime hours × $36 = $360
  • Weekly total: $1,320 (not $1,200)

Monthly with overtime: $5,280 in wages alone (before taxes and insurance)

Add employer costs (taxes, insurance, etc.): $5,280 × 1.27 = $6,706/month


What All Heart Home Care Costs (For Comparison)

Same 40 hours/week (8-hour shifts, 5 days):

Service Rate Monthly Cost
8-hour shifts Starting at $37/hour $5,920/month
Includes: Payroll taxes, workers’ comp, liability insurance, bonding, background checks, TB testing, supervision, backup coverage, 24/7 support, quality oversight $0 extra Included
Your personal liability $0 Zero

Same 50 hours/week (10-hour shifts, 5 days):

Service Rate Monthly Cost
10-hour shifts Starting at $37/hour $7,400/month
Includes: Everything above + overtime compliance handled $0 extra Included
Your personal liability $0 Zero

The Real Cost Comparison

Scenario Private Caregiver (Legal) All Heart Home Care Difference
40 hrs/week (8-hr days) $4,883/month + unlimited liability $5,920/month, zero liability +$1,037/month for agency
50 hrs/week (10-hr days) $6,706/month + unlimited liability $7,400/month, zero liability +$694/month for agency
60 hrs/week (12-hr days) $8,500+/month + unlimited liability ~$8,880/month, zero liability +$380/month for agency

Key insight: The more hours you need, the smaller the cost difference — because agencies handle overtime compliance efficiently.

And the “difference” buys you:

Zero personal legal liability

DOJ background checks — not just commercial

Guaranteed backup — when caregiver is sick

Professional supervision — and quality control

24/7 on-call support

Immediate replacement — if the caregiver is not working out

All tax filings — and compliance handled

Peace of mind

For an extra $400-1,000/month, you eliminate $50,000-500,000 in potential liability.


The Hidden Costs You’re Not Calculating

1. Your Time

Managing a private caregiver requires 5-10+ hours per month:

  • Payroll processing (or paying for service)
  • Tax filings (quarterly and annual)
  • Scheduling and coordination
  • Supervision and quality monitoring
  • Finding backup when the caregiver is sick
  • Handling problems and conflicts
  • Paperwork and record-keeping

Your time has value. At $50/hour equivalent, that’s $250-500/month in lost productivity.


2. Finding and Hiring Costs

What happens when your caregiver:

  • Quits with no notice?
  • Gets injured and can’t work?
  • Takes a vacation?
  • Gets sick for a week?

You pay for:

  • Finding a new caregiver (weeks of searching)
  • Background checks ($50-100)
  • TB testing ($30-50)
  • Lost work time while you provide care
  • Emergency facility placement if you can’t find a replacement

Average cost of caregiver turnover: $1,500-3,000 per occurrence

With agency: Backup caregiver sent immediately at no additional cost.


3. The Liability You’re Ignoring

Potential costs if things go wrong:

Scenario Potential Cost
Caregiver injured in your home (no worker’s comp) $100,000-500,000+
Wage claim for unpaid overtime $20,000-100,000
IRS/EDD audit for unpaid taxes $20,000-75,000
Wrongful termination lawsuit $50,000-250,000
Caregiver theft (no bonding) $10,000-100,000+
Discrimination or harassment claim $75,000-300,000

One incident wipes out YEARS of “savings” from hiring privately.


California Labor Laws You MUST Follow (2026)

California has the strictest labor laws in the nation. Here’s what applies to household employers:

Minimum Wage (2026)

California statewide: $16.90/hour
San Diego City: $17.75/hour (as of January 2026)
Increases scheduled annually

You cannot pay less than the minimum wage — even if the caregiver agrees.


Overtime (Domestic Workers)

California overtime rules for household employees:

Daily overtime:

  • Hours 1-9: Straight time (for personal attendants in private homes)
  • Hours 10-12: 1.5x pay
  • Hours 13+: 2x pay

Weekly overtime:

  • Hours 1-40: Straight time
  • Hours 41+: 1.5x pay

7th consecutive day:

  • Hours 1-9: 1.5x pay
  • Hours 10+: 2x pay

Note: Overtime thresholds differ slightly for live-in caregivers and care provided in facilities.


Meal and Rest Breaks

Meal breaks:

  • 30-minute unpaid meal break if working 5+ hours
  • Second 30-minute break if working 10+ hours
  • Must be “duty-free” (cannot require caregiver to remain on-call)

Rest breaks:

  • 10-minute paid break for every 4 hours worked
  • Cannot be waived

Penalty for violations: 1 hour of pay per violation per day

Annual penalty exposure (if you miss every break):

  • 2 breaks/day × 250 days × $24/hour = $12,000+/year in penalties

Paid Sick Leave (SB 616 — Updated 2024)

California requires:

  • 40 hours (5 days) of paid sick leave per year (increased from 24 hours in 2024)
  • Accrual method: 1 hour for every 30 hours worked
  • Must be available for use after 90 days of employment

Cost: At $24/hour, that’s $960/year in paid sick leave


Pay Stub Requirements

Every pay period, you must provide a detailed pay stub showing:

  • Gross wages
  • Total hours worked
  • Hourly rate(s)
  • Deductions (itemized)
  • Net pay
  • Pay period dates
  • Employer name and address
  • Last four digits of SSN or employee ID

Penalty for non-compliant pay stubs: $50-$4,000 per employee per pay period


Record Keeping Requirements

You must maintain for 3-4 years:

  • Time records (start/stop times, meal breaks)
  • Pay records
  • I-9 forms
  • W-4 forms
  • Tax filings
  • Workers’ comp documentation

Penalty for inadequate records: Shifts the burden of proof to the employer in wage claims — assumed guilty until proven innocent.


Tax Filing Requirements (If You’re the Employer)

Federal Requirements

Forms you must file:

W-4 — Employee’s withholding certificate (obtain at hire)

W-2 — Wage and tax statement (provide to employee by January 31)

Schedule H (Form 1040) — Household Employment Taxes (file with your personal tax return)

  • Required if you pay $2,700+ to any household employee in 2024

Form 940 — Federal unemployment tax (FUTA)

  • Due January 31 for prior year

Form 941 — Quarterly federal tax return (or pay with Schedule H)


California Requirements

DE 4 — California withholding certificate

Register with EDD — Required within 20 days of hiring

DE 9 and DE 9C — Quarterly contribution return and report

  • Due quarterly (April 30, July 31, October 31, January 31)

Pay state taxes:

  • Unemployment insurance (UI): ~3.4%
  • Employment training tax (ETT): 0.1%
  • State disability insurance (SDI): 1.1% (employee pays, you withhold)

What Happens If You Don’t File

Agency Penalty
IRS 100% of unpaid taxes + 0.5% per month + interest
California EDD 100% of unpaid taxes + 10% per year interest
California DIR $10,000+ for no workers’ comp
Combined exposure $50,000-100,000+ for multi-year non-compliance

The “Under the Table” Fantasy

Many families think, “We’ll just pay cash. No one will know.”

Here’s how you get caught:

1. Caregiver Files for Unemployment

When you terminate the caregiver (or they quit and claim termination), they file for unemployment.

EDD investigates → Discovers unreported employment → Back taxes + 100% penalties


2. Caregiver Gets Injured

Caregivers slip, fall, and hurt their back.

Without workers’ comp:

  • They sue YOU personally
  • Homeowner’s insurance REFUSES to cover (employment exclusion)
  • You pay $100,000-500,000+ out of pocket

OR:

  • They file a workers’ comp claim
  • DIR investigates → You have no coverage → $10,000+ penalty + personal liability for all injury costs

3. Caregiver Reports Wage Violations

Angry caregiver (or just one who knows their rights) files wage claim with the California Labor Commissioner.

Investigation reveals:

  • No overtime paid
  • No meal/rest breaks provided
  • No pay stubs
  • No records kept

Result: Back pay + penalties + interest + attorney fees = $20,000-100,000+


4. IRS or EDD Audit

Random audits happen. They’re increasing under new enforcement funding.

IRS now has 87,000 additional agents (2024 Inflation Reduction Act funding) with domestic employers as a focus area.

Audit triggers:

  • Large regular cash withdrawals from your bank account
  • Caregiver reports income on their tax return (implicating you as employer)
  • Caregiver applies for benefits (Social Security credits, disability)

5. Medicaid Application

If your parent ever needs Medicaid (nursing home coverage), applications require disclosure of all financial transactions.

Large unexplained cash withdrawals = Investigation for asset hiding = Application denied or fraud charges


Alternatives: Your Real Options

Option 1: Hire Directly and Do It RIGHT

If you choose to be the employer, do it legally:

Register with the IRS — get an EIN — and the California EDD

Complete I-9 — for work authorization

Get workers’ compensation insurance

Get employer liability insurance

Get an employee dishonesty bond

Use payroll service — HomePay, SurePayroll, etc.

Pay all required taxes

Comply with wage/hour laws — overtime, breaks

Provide paid sick leave

Keep accurate records

Provide compliant pay stubs

Total cost: $30-40/hour all-in (for $24/hour base wage)

Plus: You assume all liability and management burden


Option 2: Use IHSS (In-Home Supportive Services)

California’s Medicaid-funded program for low-income seniors.

How it works:

  • State acts as “employer of record”
  • State handles payroll taxes and workers’ comp
  • You supervise day-to-day care
  • Caregiver wage: ~$16-18/hour (San Diego County)

Eligibility requirements:

  • Medi-Cal eligible (income and asset limits)
  • Determined to need in-home care
  • Living in one’s own home (not a facility)

If eligible, this is the only situation where you can have someone work in your home without being the employer.


Option 3: Use a Licensed Home Care Agency

The agency is the employer. You have zero employment liability.

All Heart Home Care provides:

DOJ Live Scan background checks — not just commercial

TB testing and health screening

All payroll taxes and compliance

Workers’ compensation insurance

General liability insurance — $1M+

Professional liability insurance

Employee dishonesty bonding

Overtime compliance handled

Paid sick leave handled

Backup caregivers — when yours are sick

Professional supervision and quality control

24/7 on-call support

Immediate replacement — if the caregiver is not working out

Care coordination — with medical providers

All Heart Rates (San Diego, 2024):

Service Level Rate
Per-visit care (under 4 hours) $175 per visit
Hourly care (4+ hours) Starting at $37/hour (longer shifts = lower rates)
Couples care (under 4 hours) $195 per visit
Facility-based care Starting at $38/hour
24-hour home care $960/day (no overtime)
24-hour couples care $1,080/day (no overtime)

No hidden fees. No in-home visit required to get pricing. Call (619) 736-4677.


The Bottom Line: Real Math, Real Decisions

Let’s be completely honest:

Private Caregiver (Done Legally)

Cost: $30-40+/hour all-in

Your responsibility:

  • All employer registrations and filings
  • Payroll processing
  • Workers’ comp, liability, and bonding insurance
  • Background checks (limited access)
  • TB testing
  • Supervision and quality control
  • Finding backup when the caregiver is sick/quits
  • Managing problems and terminations
  • All liability for injuries, lawsuits, and claims

Time investment: 5-10+ hours/month
Liability exposure: $50,000-500,000+


All Heart Home Care (Licensed Agency)

Cost: Starting at $37/hour (longer shifts = lower rates)

Your responsibility:

  • Pay invoice
  • Communicate care preferences
  • Enjoy peace of mind

Time investment: Minimal
Liability exposure: Zero


The Real Question

Is saving $1,000/month (or less) worth:

  • 5-10 hours of your time monthly?
  • Managing payroll taxes and filings?
  • Risk of $50,000-500,000+ liability?
  • Scrambling for backup when the caregiver is sick?
  • Lower quality background checks?
  • No professional supervision?
  • No guarantee of quality?

For most families, the answer is clearly no.


How to Get Started With All Heart Home Care

Getting your exact rate is simple — no in-home visit required:

Step 1: Call (619) 736-4677

Speak with a live care coordinator immediately — no transfers, no voicemail.

Step 2: Share Your Needs

  • Schedule (hours per day, days per week)
  • Type of care needed
  • Home or facility

Step 3: Get Your Exact Rate Within Minutes

  • Clear explanation of pricing
  • All costs explained upfront
  • No hidden fees

Step 4: Decide With No Pressure

  • Take time to consider
  • Compare with other options
  • No sales pitch

Step 5: If You Proceed, Schedule Free In-Home Assessment

  • But you already know the cost before that happens

We’ve been serving San Diego County families for 11 years with transparent, honest pricing and professional care.


Resources

If You Choose to Hire Privately:

If You Need Care:


Employer Compliance Checklist

If you hire privately, you MUST complete ALL of these:

☐ Obtain Employer Identification Number (EIN) from IRS

☐ Register with California EDD as a household employer

☐ Complete Form I-9 (work authorization)

☐ Obtain W-4 and DE 4 (withholding certificates)

☐ Purchase workers’ compensation insurance

☐ Purchase employer liability insurance

☐ Purchase employee dishonesty bond

☐ Set up payroll system (or hire payroll service)

☐ Track hours worked (including start/stop times and breaks)

☐ Pay overtime correctly (California rules)

☐ Provide meal and rest breaks

☐ Provide paid sick leave (40 hours/year)

☐ Provide compliant pay stubs every pay period

☐ File quarterly taxes (DE 9, DE 9C)

☐ File annual taxes (W-2, Schedule H, Form 940)

☐ Keep records for 3-4 years

☐ Conduct background check

☐ Require TB test

If you can’t or won’t do ALL of these, use a licensed agency.

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About the author

Eric Barth, co-founder and CEO of All Heart Home Care San Diego

Eric Barth

CEO, All Heart Home Care

Eric Barth is the founder and CEO of All Heart Home Care™, an award-winning San Diego agency dedicated to providing compassionate, personalized in-home care for seniors. As the writer behind the All Heart Home Care blog, Eric shares insights and stories drawn from years of hands-on experience leading one of San Diego’s most trusted home care teams.

Additional FAQ's on Digital Home Care System

Yes. HITRUST CSF Certified security—same gold standard hospitals use. More secure than paper.

Extremely rare (99.9% uptime), but caregivers can work in offline mode if connectivity is temporarily lost. Care continues without interruption. Documentation syncs automatically when connection returns.

Caregivers document throughout their shift in real-time. Notes are typically finalized and visible in Family Room within minutes of the caregiver clocking out.

We can set up Family Room accounts for as many family members as you want—local siblings, children in other states, anyone you authorize. Everyone sees the same information. No limit on number of accounts.

Yes. Family Room includes secure document storage. Upload medical records, insurance cards, POLST forms, medication lists, doctor’s instructions, photos—anything important. All authorized family members can access these documents. No more searching for forms.

We update the digital care plan immediately, and all caregivers receive instant notification of changes. This is one of the biggest advantages over paper—updates reach everyone simultaneously, not gradually over days or weeks.

Absolutely. Family Room is a tool for families who want it, not a replacement for human connection. We’re always reachable by phone at (619) 736-4677. Many families use both—portal for quick updates, phone calls for detailed conversations.

We train every caregiver on the WellSky mobile app before their first shift. The app is intuitive—designed specifically for caregivers, not engineers. If someone can text and use GPS navigation, they can use our caregiver app. And we provide ongoing support.

Yes. The Family Room care calendar shows upcoming shifts with caregiver names and times. You’ll know exactly who’s coming and when. No more surprise caregiver switches.

Use the two-way messaging feature in Family Room. Send your message, and the caregiver receives an instant notification on their mobile app. They’ll see it and can respond or confirm receipt immediately.

Yes. All notes are searchable. Want to see every mention of “appetite” from the past month? Type it in the search bar and find all relevant notes instantly. No more flipping through pages of handwritten entries.

You can access the complete care history from the day Family Room access began. Review notes from last week, last month, or since care started. Historical data helps identify patterns over time.

Family members cannot delete caregiver documentation—that’s protected and maintained by All Heart for record-keeping purposes. You can delete your own uploaded documents, but we can often recover those if needed within a certain timeframe.

With your authorization, we can provide limited Family Room access to healthcare providers. This allows better coordination between home care and medical teams. You control exactly who has access and what they can see.

Family Room works both ways. You can access it through any web browser (Chrome, Safari, Firefox, Edge) on your computer, or download the mobile app for easier access on your phone or tablet. Your choice.

All authorized Family Room users see the same care information—we can’t create different access levels for different family members. However, you (as the primary contact) control who gets Family Room access in the first place. If family dynamics are challenging, you decide who receives login credentials.

The messaging system shows when messages are delivered and read. You’ll see confirmation that the caregiver received and opened your message. For critical information, you can also call our office to ensure the message was received.

Yes. You can print individual shift notes, date ranges, or specific types of documentation (like Change of Condition reports) directly from Family Room. Useful for doctor appointments or insurance purposes.

If your loved one transitions to hospice, hospital, or another care setting, we can maintain your Family Room access for a transition period so you have complete records. After care ends, we provide a final data export if requested, then access is closed according to your wishes and legal requirements.

Yes. Family Room is accessible from anywhere with internet connection. If you’re traveling abroad, you can still check on your loved one’s care. The system works globally.

Family Room doesn’t support selective information sharing—all authorized users see the same care documentation. For private family communications, you’d need to use personal email, phone, or text outside the Family Room system.

Change of Condition reports automatically alert you when caregivers document significant health changes. For custom alerts (like specific behaviors or situations), talk to our office—we may be able to add special flags to your loved one’s care plan that trigger notifications.

We typically set up Family Room access during your initial care planning meeting, before the first caregiver shift. You’ll have login credentials and a brief tutorial on how to use the portal. Most families are viewing their first shift notes within 24 hours of care beginning.

Complete Security & Privacy Information

HITRUST CSF Certification - What This Means

HITRUST CSF (Common Security Framework) is the most rigorous security certification in healthcare. It's harder to achieve than HIPAA compliance alone. This certification requires:

Why it matters: If it’s secure enough for hospital patient records, it’s secure enough for your loved one’s care information.

Bank-Level Encryption Explained

Data in Storage (At Rest):

Data in Transmission (In Transit):

What this means: Even if someone intercepted the data (extremely unlikely), they would only see scrambled, unreadable information.

Strict Access Controls

Who Can See What

Family Member Access:

Caregiver Access:

Staff Access:

Audit Trail:

HIPAA Compliance - Federal Protection

The Health Insurance Portability and Accountability Act (HIPAA) establishes federal standards for protecting health information. Our compliance includes:

Privacy Rule Compliance:

Security Rule Compliance:

Breach Notification:

Business Associate Agreements:

Continuous Backup & Disaster Recovery

Automated Backups:

Redundancy:

Disaster Recovery Plan:

What this guarantees: Your loved one’s care information is never truly lost. Even if an entire data center were destroyed, complete backups exist elsewhere.

99.9% Uptime Guarantee

What “99.9% uptime” means:

Monitoring:

If the system goes down:

Multi-Factor Authentication (Optional)

For families who want extra security, we can enable multi-factor authentication (MFA):

Mobile Device Security

Caregiver Phones:

Your Devices:

Security Incident Response

In the extremely unlikely event of a security concern:

Digital vs. Paper Security Comparison

Security Concern
Paper Binders
WellSky_Color

Who can read it?

Anyone who enters the home

Only authorized users

Can it be lost?

✔︎ — permanently

— backed up continuously

Can it be damaged?

✔︎ — spills, fires, floods

— stored digitally

Is access tracked?

✔︎ Access logged & audited

Encryption protection?

✔︎ — bank-level encryption

Updates reach everyone?

— printing/distribution delays

✔︎ — instant notification

Survives disasters?

✔︎ — redundant backups

HIPAA compliant?

— difficult to prove

✔︎ — certified & audited

Can be accidentally discarded?

✔︎

— requires a password

Verdict: Digital is significantly more secure than paper in every measurable way.

Common Security Questions

"What if I forget my password?"

Secure password reset process via email or phone verification. We verify your identity before resetting access.

"Can hackers access the system?"

Multiple layers of security make unauthorized access extremely difficult. Regular penetration testing simulates attacks to identify and fix vulnerabilities before hackers can exploit them.

"What if my phone is stolen?"

Change your password immediately from any other device. The thief would still need your password to access Family Room.

"Can All Heart staff see my credit card information?"

No. Payment processing is handled by a separate, PCI-compliant payment processor. We never see or store your full credit card number.

"What happens to the data if I stop using All Heart?"

Your data is retained according to legal requirements (typically 7 years for healthcare records), then securely deleted. You can request a copy of your data at any time.

This isn’t just secure—it’s among the most secure systems available in healthcare.

Your information is safer in our digital system than it ever was in a paper binder sitting on a kitchen counter.

Complete Care Plan Contents:

Care Goals & Priorities

Emergency Contact Information

Medical Conditions & Health History

Mental Health & Cognitive Status

Medications & Supplements

Mobility & Transfers

Personal Care Routines

Meal Preparation & Dietary Needs

Daily Routines & Schedules

Activities & Engagement

Home Environment Details

Transportation & Driving

Additional Important Information

This comprehensive information ensures every caregiver provides consistent, personalized care from day one.

Tracking health changes that matter.

The Change of Condition form documents significant shifts in your loved one’s health—new symptoms, changes in mobility, behavioral differences, or improvements in their condition. This isn’t about minor day-to-day variations; it’s about meaningful changes that physicians, families, and caregivers need to know about.

Why have a separate form for this?

Instead of searching through weeks of caregiver narratives to find when symptoms started or conditions changed, this form puts all significant health changes in one easy-to-reference place. When doctors ask “when did the difficulty walking begin?” or family members want to understand the progression of a condition, you’ll have clear, dated documentation right at your fingertips.

What gets documented:

Each entry includes:

Why this form matters:

Early detection changes outcomes. When caregivers notice something different—increased confusion, difficulty walking, loss of appetite, or even positive improvements like better mobility—documenting it immediately allows for faster responses.

Your family stays informed about meaningful health changes. Physicians receive accurate updates during appointments instead of relying on memory. Incoming caregivers know exactly what’s changed and what new precautions or assistance your loved one needs.

One form. Complete health timeline. Better care.

Whether tracking a temporary change after a fall or documenting the progression of a chronic condition, the Change of Condition form creates a clear health timeline. This helps everyone—doctors, family members, and our San Diego caregiver team—understand how your loved one’s needs are evolving and respond appropriately.

Proactive monitoring isn’t just good practice. It’s essential senior care.

How the Caregiver Narrative works.

Each caregiver documents their shift using a simple timeline format that captures the essential details of your loved one’s day. This structured approach ensures consistency across all caregivers and makes information easy to find.

What we document in every narrative:

Narrative Format:

Each entry follows this structure:

Why this format works:

This timeline approach provides clear, chronological documentation that’s easy for incoming caregivers to read and understand. Instead of wondering what happened during the previous shift, they can see exactly what your loved one ate, how they felt, what activities they enjoyed, and any health changes observed.

One record. Every shift. Complete continuity.

Whether care is short-term, long-term, or evolving, the Caregiver Narrative ensures nothing gets missed and nothing gets repeated. Your family can review the journal at any time during visits, or we can share photos of recent narratives with long-distance family members who want to stay connected and informed.

Complete transparency and peace of mind, right when you need it.

Your loved one's complete care roadmap, now available digitally.

The All Heart Customized Care Plan is completed during your initial assessment and tailored to your loved one’s specific needs, preferences, mobility level, and safety requirements.

Now fully digital and accessible on every caregiver’s phone.

We’ve gone paperless. Your care plan is accessible through our digital platform—caregivers reference it anytime, anywhere. Updates happen in real-time, so when something changes, every caregiver sees it immediately.

What's included:

Care goals, emergency contacts, medical conditions, mental health & cognitive status, medications & supplements, mobility & transfers, personal care routines, meal prep & dietary needs, daily routines, activities & engagement, and home environment details.

One plan. Every caregiver. Consistent care.

This digital approach ensures every San Diego caregiver has the same accurate, up-to-date information from day one—promoting safety, continuity, and person-centered care.

See how we organize care information. This form becomes your loved one’s digital care roadmap.