Does long term care insurance cover the costs of a certified nurse aide (CNA)?

A fellow caregiver asked...

My mother has long term care insurance that will pay for a CNA home health aide. I understand that a private duty aide will be classified as an employee, and as such, I will, as POA for mom, need to make withholdings for federal and state taxes, but I don't know the procedure or who to contact to get this set up. Additionally, does the long term care insurance cover the cost of these aide related taxes? Do I see an attorney, accountant, both, or someone else? Also, is there a liability if the aide is injured while on duty?

Expert Answer

Merrily Orsini, MSSW, was a pioneer in the business of providing geriatric care managed in-home care. She currently serves on the board of the National Association for Home Care and Hospice and is Chair of the Private Duty Homecare Association. She holds a master's degree in social work and is a nationally known writer and speaker on aging, elder issues, and in-home care.

First, check with your LTCi agent to make certain that you pay directly to the aide and be reimbursed, and not through an agency. Each policy is different as to what constitutes the event that triggers coverage, and what is covered and by whom. Your agent is the best one to cover this with you. And your questions about taxes and coverage will be answered there. Should you be able to hire privately and get reimbursed, go to http://www.irs.gov/publications/p926/ar02.html#d0e95. This is the official IRS Web site and there are forms and lots of answers there. You most likely need to maintain a payroll system including withholding state and federal payroll taxes, paying unemployment insurance to the state, paying and matching Medicare, and Social Security.

Liability while the aide is in the home: most states require employers to provide workers' compensation protection. Most homeowners' insurance usually specifically excludes employees in the home.

So, first check with your LTCi agent. This is one time I would personally suggest a geriatric care manager who you could get to do an assessment and assist you through all these decisions. You can hire an attorney and an accountant, but you would need to make certain that they both are familiar with elder care and in-home care, and you would probably save money in the long run by getting a professional assessment first (find a care manager in your area at www.caremanagaer.org) and getting assistance from a professional who understands all the nuances of in-home care and LTCi.