Home Care Worker Companionship Exemption for Over-time Pay Necessary for Live-in Care Services, Not Hourly Care

Companionship senior care services can legally be exempt from providing caregivers with overtime pay and minimum wage in SOME situations.  Now legislation is being discussed to change this, with perhaps the White House supporting this move.  But the issue that is being debated is largely confused.  Here is a run-down of the law that allows for companionship caregiver exemption from overtime pay, what it really is when applied in the work place and why the current laws meet the needs of both seniors and caregivers.

Caregiverlist would like to bring clarity to this issue since some of the folks debating the topic definitely have a heart for wanting to deliver overtime pay to everyone but unfortunately are missing the fact that licensed senior care corporations do pay overtime, do provide benefits and really do go the extra mile to make sure both the caregiver and the seniors are very, very happy with the care duties.

The overtime pay exemption is needed for live-in senior caregivers, not for hourly caregivers, in order to keep care in the home affordable.  The companion care overtime exemption addresses the reality of the work and the extra benefits that are given which are not the same as hourly caregiver work.

Let's take a look at the facts and how seniors will be impacted if the current laws are changed.

What is the "Companionship Overtime Pay Exemption for Home Care Workers"? 

In 1974, legislation was passed to make home care workers exempt from the Fair Labor Standards Act if they were providing "companion" care.  Companion care is when someone  is not providing hands-on nursing aide care but is simply providing companion care to make sure meals are being eaten, medications being taken and acting as a friendly companion to make sure the senior's day goes smoothly. Think of it as the same as when you visit your Grandmother or elderly parent.  While visiting with them, you are making sure she has her house in order, groceries in the pantry and all of her doctor's appointments and medications on track. You assist with anything she might need help with such as changing a hearing aid or sorting the mail but you are not providing hands-on care with bathing and bathroom visits.  It makes sense that some seniors are going to need just companion care when their relatives do not live near by, right? And this is why senior care in the home has grown by 40% since 2008 as nearly half of adult children do not live in the same town as their parents and 67% of adult children work full-time.

The current law defines "companionship services" as fellowship, care and protection for a person who because of advanced age or mental or physical infirmity cannot care for his or her own needs Allows for 20% limitation for incidental general household work and unlimited care services such as meal preparation, bed making, washing of clothes and other similar services.

The law excludes care and protective services that are performed by trained personnel.

Hourly Care vs. Live-in Care

Hourly caregivers working for licensed senior home care companies do receive over-time pay but more commonly, they are simply not staffed to work for more than 40 hours a week so over-time pay is not an issue.  Those of us who are in senior care understand that there is an emotional component to caregiving and the quality of care will decline if an hourly caregiver does not receive proper time off.

Note: there is also a shortage of quality senior caregivers to work for professional senior care companies - many people still do not know this is a professional career with benefits and training and career advancement opportunities.  In addition, as the hours can be around-the-clock as well as part-time, a very wide variety of schedules must be filled and what is more common is caregivers will work just part-time (20 to 30 hours a week). Any company would be hard-pressed, even if they wanted to do so, to find someone who would work more than 40 hours a week without overtime pay. This is simply not an issue for licensed senior care companies.  When a client needs around-the-clock care, when they are on hospice care at the end of their life, for example, the senior care company will rotate multiple caregivers so that nobody exceeds a 40-hour work week.

Live-in Caregivers are NOT Paid for Overtime Hours but Paid a DAILY STIPEND

This is where the current law exempting over-time pay for companionship care works and works really well.

Seniors are choosing to age-in-place in their homes.  However, when memory loss is present, they will need a companion caregiver with them around-the-clock.  Some seniors also prefer a live-in caregiver to assist with household tasks they can no longer easily do and assist with meal preparation and managing appointments along with being there for safety issues. Companion live-in caregivers receive a flat daily fee for their pay, receive a couple hours of down-time in the evenings and must be able to sleep at night.  They also receive meals (they may prepare the meal and share it with the senior or be provided their own food and sometimes go out to restaurants to eat with their senior client).  These caregivers do not receive over-time pay.  And this works for everyone.  As they are not doing a consistent task around-the-clock, it would not be possible to hold the caregiver accountable for a task in order to be monitored hourly and paid for over-time pay.

Instead, live-in senior caregivers are paid from $120 to $180 a day, on average, depending upon where in the country they are located.  This works for the caregiver and works for the senior. As the former owner of a senior care agency I never once had a live-in caregiver ask for over-time pay.  Instead they loved their jobs and would actually recruit additional people to apply for the live-in caregiver jobs when a new case started.  There can be so many benefits of working as a live-in caregiver beyond the pay and the pay is considered extremely fair as the add-on benefits are many.  For instance, the caregiver may be enjoying staying in a gorgeous home and benefiting from sharing in all of the senior's activities.  

Did you ever see the movie "The Holiday"?  The actress Kate Winslet assists the senior neighbor with finding his way home and then assists with more tasks and ends up having him invite her to escort him to the Oscar's (or something really similar to the Oscar's - you know, great dress, limo, he is given an award for his career in the movie business).  Certainly not every single live-in senior client takes their caregiver to the Oscar's with them but working as a live-in caregiver comes with many perks along with the benefit of having a senior share a lifetime of wisdom.  Experienced live-in caregivers love their work and their pay, as it does work out to be a fair wage.  Realize that two caregivers rotate to provide live-in care for a senior client - earning a full week's pay in a few days and only needing to commute back and forth once each week, not daily, which also saves time and money for the caregiver.  When I owned a senior home care agency we would even have to work with the seniors at the holidays because they would sometimes prefer to be with the caregivers over their family and even schedule a double Thanksgiving or Christmas meal so they could have a holiday with the caregiver.  Live-in caregiving really does have many advantages and with the fair flat daily-pay rate, it pays the caregiver well and is affordable for the senior.

Compare In-Home Live-in Care to Nursing Home Care (1-on-1 Care vs. 1 C.N.A. to 15 Residents)

Live-in caregivers assist seniors in their own home and provide one caregiver dedicated to one senior.  Compare this to a nursing home where most nursing homes staff 1 Certified Nursing Aide (C.N.A.) to every 12 to 15 residents with 15 being most common (staffing ratios are available in the Caregiverlist Nursing Home Directory and provided through the health inspection reports).

Live-in Senior Home Care Costs per Day (which include all payroll taxes, insurances and necessary management):  $180 to $250 per day

Nursing Home Daily Costs:  $200 to $400 per day - - take a look at the actual nursing home daily costs in Caregiverlist's nursing home directory to see that on average the costs will be $250 per day and that is sharing 1 C.N.A. with at least 10 to 15 other nursing home residents.

The one-on-one care needs of seniors in nursing homes is such an issue that many nursing homes will tell a senior's family they must privately hire an additional caregiver if they want the senior to participate in activities and have a full slate of services as the 1 C.N.A. simply will not have time to provide the quality care they are seeking.  The home care agency I owned, for instance, in downtown Chicago, regularly provided private caregivers to be hired for residents of Warren-Barr nursing home in downtown Chicago. When a C.N.A. is caring for more than 10 seniors, as you can imagine, if one senior has a bathroom accident or another incident, that senior can take up all of the C.N.A.'s time and the other residents will have to wait for the next shift for any additional care needs.

The companionship exemption allows seniors to stay in their own home for around $200 per day and have one-on-one care services - - - that is much better than paying what would work out to be $400+ per day with over-time pay.  I'll stay away from that math calculation but it is killer when you add in the hourly fees for worker's compensation, payroll taxes, etc.  The flat daily fee works for everyone and includes payroll taxes and benefits.  The senior can afford it.  They most likely can't afford $350 or more per day to pay over-time pay while a caregiver sleeps at night.

The companionship exemption makes sense.

Apparently there may be some government care programs somewhere that do not pay minimum wage and overtime and if that is the case then the government should fix that.  But private duty senior care companies do follow employment laws and pay well over minimum wage, provide training and over-time pay.

Professional caregivers are paid on average $10 per hour as you can see in the Caregiverlist Employment Index. Caregiverlist has more than 1,000 professional caregivers apply for professional caregiving jobs each week and they tell us how much they are being paid.  In addition, the thousands of senior care agencies who subscribe to our hiring platform share with us what they pay their caregiver workers (and our founders owned senior home care agencies). 

The Supreme Court upheld the Companionship Exemption from overtime pay when Evelyn Coke, a 73-year-old retiree who worked for more than 20 years as a home-care provider sued Long Island Care at Home because she was not paid overtime for her long hours and overnight care.  I wonder why she accepted the assignments if she didn't like the pay and why she didn't stop at 40 hours a week, but anyway, she sued and her team of lawyers argued the exemption was not what lawmakers intended.  The Supreme Court did not agree with her lawyers and upheld the companionship overtime exemption.

Review Frequently Asked Questions about the Companionship Services Exemption from Overtime directly from the Department of Labor.

Home Instead and Right at Home are two large senior home care companies with multiple franchise locations nationwide.  Both companies are headquartered in Omaha, Nebraska and as major stakeholders in providing quality senior care their Nebraska state representative, Rep. Lee Terry, introduced legislation to block the Department of Labor from removing the care worker exemption.  This legislation is called the "Companionship Exemption Protection Act" and is S.3280 (112th): Companionship Exemption Protection Act if you would like to follow this bill which is on deck to be heard by 

You may review the Companionship Exemption Act (always fun to read the legal documents) and right now this bill is waiting to be heard by a committee - we'll update you when firm dates are announced (the news is that this will be delayed while the more important issues, such as an operating budget are being hashed out by Congress).  

Remember that while it is fun to poke fun at the inefficiencies of government, it is important to be grateful our voices can be heard in the U.S.A. so let your Congressman know your stand on this bill.  

Caregivers and seniors may find their Congressmen and Congresswomen along with their contact information to make your voice heard.

Caregiving jobs remain plentiful - for both hourly and live-in caregivers.  Apply to a professonal senior caregiver job on Caregiverlist or refer-a-friend to a caregiving job and be entered for the chance to win $50.  More quality caregiver workers are always needed to deliver quality care to the growing number of aging seniors.


Live-in Caregiver Jobs: Popular Questions About Live-in Positions

Live-in senior caregivers are hired to assist seniors with not only their personal care but also their household management.  The term “live-in”, however, is a little misleading as professional senior caregivers do not move in and live with the senior permanently.  Instead, they go to the senior’s house and stay overnight for 2 to 3 nights in a row and then go back to their own home.

Caregiverlist assists senior caregivers to find professional jobs in their area.  While the majority of senior care job positions are for part-time or full-time schedules, some positions do require live-in caregivers.  Seniors who desire to age-in-place in their homes may often

Live-in Caregiver FAQ’s

What is the Live-in Caregiver Job Description?  In addition to assisting the senior with “Activities of Daily Living”, you will assist with household duties such as laundry and maintaining a clean household and managing a shopping list and meal preparation.

What is the Live-in Caregiver Schedule?  A live-in senior caregiver will stay with the senior client for 2 to 3 days at a time and then return to their own home.  The schedule is booked by the day, instead of by the hour.

What is the Live-in Caregiver Pay?  Live-in caregivers are paid a daily stipend rate, which they qualify for as long as they are able to have a few hours of downtime in the evening and sleep at  night.  It is acceptable for the live-in caregiver to need to get up in the night to assist the senior but they are primarily there as extra security for the senior for any nightly needs.  Once a senior has acute care needs and requires a caregiver to be up at night, they will need a night-time caregiver to rotate with a day-time caregiver - this usually only occurs during end-of-life care for seniors who are receiving hospice care.   Live-in care pay ranges from $80 to $180 per day, depending on the level of care needed.  Added benefits are the inclusion of food and any entertainment shared with the client.

What are the advantages of becoming a Live-in Caregiver?  Live-in caregivers have the advantage of earning a week’s pay in a few days of work and not needing to commute back and forth each day to a job location.  In addition, many live-in caregivers enjoy the relationship they build with the client and when matched with the right client, many times the caregiver is paid for companionship as much as for hands-on caregiving duties.

Apply for a Live-in Caregiving job on Caregiverlist and let others know that this can be an attractive job positions for those who no longer have children at home and are looking for a caregiving position that will allow them to manage all the care activities during the day.  As one senior caregiver told me when I owned a senior home care agency, “I wouldn’t be married for 15 years if I weren’t working as a live-in caregiver”.  She had worked as a C.N.A. in her younger years and then became a live-in caregiver as she enjoyed being with the client for a few days in a row and managing the entire show herself as she had years of caregiving experience.

Caring individuals can learn to be a live-in caregiver and be trained by their senior home care agency employer, as long as they are able to pass a criminal background check.  Professional senior caregiver training certification is available in a 10-hour online course.

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Live-in Caregiver Jobs: Earn a Full Week's Pay in a Few Days

Live-in senior caregivers are in demand – wait, you say, I don’t want someone to move-in with my mother or father, or, if you are a senior caregiver, you are thinking you don’t want to move-in with a senior.


But wait, we say, because it doesn’t work that way.


Live-in caregivers do not actually move-in with a senior when they are working for a licensed senior home care agency.  Many states actually have passed legislation which requires all professionals referring seniors to caregiver services to only refer to licensed senior care companies. Why?  Well, it turns out the #1 type of senior abuse is financial abuse. Usually this takes place by a relative or caregiver.


We also always like to point out that senior care is not at all like babysitting – yes, we know some babysitter websites have tried to dabble in senior care and we also know that has not worked out so well for them – nobody wants to lose a lifetime of a senior’s assets to a hire-direct caregiver, not to mention the lack of payroll taxes, insurance and training that is missing in a hire-direct situation (one fall or injured back and there goes the family’s assets).


Northwestern University in Chicago also released a caregiver study recently which expressed concern over lack of language skills and training for hire-direct senior caregivers. You won’t find this when working with professionally licensed senior care companies - they deliver one-on-one care which can even be superior to care in an institutional setting.  Look for more and more states to pass legislation to protect both seniors and caregivers from the lack of insurances and benefits in the hire-direct situations.


Senior care requires managing care for perhaps a senior who is

resistant to help.  Combine this with memory loss and the senior care services can take a toll on a caregiver.  Senior home care agencies provide emotional support and Care Management for live-in senior caregivers and provide the same level of professional services a senior would find in a nursing home (except there is one C.N.A. or caregiver providing one-on-one care where nursing homes will have one C.N.A. for every 10 to 15 residents). Review the daily costs of nursing homes to see that most nursing homes will charge from $200 to $350 per day for the care services (and the sharing of one C.N.A. for as many as a dozen residents).


Seniors are dealing with age-related illnesses which advance at different paces, along with the emotional challenges of losing loved ones.  This requires proper training and support by professional senior care companies.  In addition, senior caregivesr deserve the benefits that senior care companies provide, such as Social Security benefits, Worker’s Compensation insurance and Unemployment insurance.


Having your friends pass away every other month and then waking up in the morning only to discover a new body ache would not be pleasant at any age, right?  My brother and sister and I always joke that our parent’s social life is going to funerals.  But the truth of the matter is that funerals are just part of their monthly mix of activities.


Back to live-in caregiving – this is exactly why live-in senior care is in demand – because there is some comfort in knowing that while you are losing many things you are not losing your home and all the memories that come with it.  All of us in senior caregiving can tell you stories about the senior who relocated to an Assisted Living community or to a child’s house and passed away the next day or week.  Home is where the heart is, for some, and a live-in caregiver keeps the senior’s heart at home.


What do live-in caregivers do?


Job Description for a Live-in caregiver includes assisting the senior to “age-in-place”.  The caregiver will spend the night a few days in a row and keep the household running.  And then they will go back to their own home.


As the former owner of a senior home care agency in Chicago, my company provided live-in senior care services for many senior clients.  I very much enjoyed working with these seniors, as usually they did not have family members who lived nearby and just wanted to find some joy in their last days within their own home and the neighborhood that they knew.  As I grew up on a family farm which has been home to our family for more than 150 years, I very much appreciate the sense of home and having roots – deep, deep roots which support the tree of life.  Of course the tree won’t survive if you separate it from it’s roots – I totally understand the need to age-in-place in your own home.


Live-in caregivers usually work in a team of two caregivers who will rotate every few days.  Somehow, the stars align and a senior home care agency can always staff the best team of caregivers for a live-in senior care client.  I truly can tell you that we would always find just the right two caregivers for each client.  The senior could have the live-in caregiver who talked a lot for a few days and then have the live-in caregiver who had few words for the rest of the week.  You interview the senior and understand their needs and you always find just the right combination of caregivers.


Why don’t live-in caregivers actually move in?  Well, for the same reason the senior prefers to remain in their own home for the aging process – it is their home, they don’t want one person moving in and encroaching on their turf.  They want to keep their home as they know it.  A professional live-in senior caregiver stays at the senior’s home for 2 to 3 days and leaves everything as it is – they bring just their over-night bag with them.  It is a job, not their home. 


Live-in caregivers receive a few hours of down-time each evening and are paid a daily stipend (the Supreme Court has approved this = no over-time pay is required as long as the senior caregiver can sleep at night and have a few hours to themselves each evening).  They are able to prepare and enjoy meals with the senior (and if the senior must eat a special diet, they are provided with the food of their choice).  Many senior care companies will use a meal delivery service such as Peapod to deliver groceries to the senior each week.  This way the live-in caregiver can plan meals and make sure they are meeting the nutrition guidelines for the senior’s medical conditions.


Senior home care agencies will make sure the senior’s house is appropriate for live-in caregivers.  From proper sleeping arrangements, to all the little things like fresh new sheets and towels, the caregiver will be made to feel at home while they are caring for the senior.


Another advantage of working as a live-in caregiver is that you just have to take public transportation or drive to and from work once a week.  Many more mature ladies enjoy this type of arrangement.  One of my favorite caregivers who had burned out from working as a C.N.A. at nursing homes and moved on to only do live-in care, told me she would not still be married if she did not do live-in.  “it is perfect,” she would tell me, “just when I am sick and tired of my husband and he is sick and tired of me, it is time for me to run off for my 3-day live-in shift and by the time I come home he is missing me and my cooking!”


A few more answers to the questions you may have around working as a live-in senior caregiver.


Job Description for Live-in Senior Caregivers:


Assist senior with Activities of Daily Living (ADL’s), including meal preparation, light housekeeping, laundry, grocery shopping, meal preparation, medication monitoring, physical exercise and manage calendar and escort to doctor appointments and personal appointments.  Assistance with physical care may be required in some situations.  Seniors on hospice care may be bed-ridden and require more hands-on care assistance.  Companionship is also a top requirement of caregivers. Review the caregiver job description in the Caregiverlist Career Center.


Live-in Senior Caregiver Pay Wages:


Live-in senior caregivers receive a daily stipend – this was actually approved by the Supreme Court to over-ride over-time pay as long as the caregiver can sleep during the night and have down-time for themselves each evening. The Fair Home Health Care Act of 2007 upholds a long-standing U.S. Dept. of Labor regulation which exempts home care companions from overtime payment.  This works for both the caregiver and the senior as hourly pay would just not make sense nor be affordable. Live-in senior caregivers receive the benefits of 3 meals a day, time to rest and from $100 to $160 per day.  Other perks include being able to accompany a senior on trips and to special events and activities.


Apply for a live-in caregiving job near you to begin a career as a live-in senior caregiver.


Live-in Caregiver Contract:  Is there one?


No, the senior care company will have a Service Agreement with the family but in a professional live-in position with a senior care company you are an employee and there is no contract.  The live-in caregiver receives days off, benefits such as Social Security taxes, Unemployment and health care insurance, vacation pay and bonuses.  Ongoing caregiver training is also provided.  As an employee, the senior care company will re-staff you should the senior pass away.


Live-in Caregiver Training:


Senior caregivers receive basic non-medical caregiver training.  The 10-hour Caregiverlist Caregiver Certification meets the training standards in most states and prepares anyone for the job of caregiving.  Senior care companies will provide training in age-related illnesses such as Alzheimer’s disease, Parkinson’s disease and assisting seniors who are rehabilitating from strokes, hip replacements and heart surgery.


How to find and apply for a Live-in Caregiver Job:


Many seniors do prefer to remain in their own home (or vacation home) as they age.  Many times live-in senior care will become a sudden need.  You may submit one caregiver job application on Caregiverlist and be considered for current and future job openings with senior care companies in your area.


Apply for Live-in Caregiver Jobs near you now – spread the word to others who may be interested in working as a senior caregiver – remember, the rewards are beyond the paycheck.  Many times early retirees enjoy the fulfillment that senior care delivers.  As long as you are a caring person and can pass a criminal background check, you can begin working as a companion caregiver which is the basic care services many seniors need.  Visit Caregiverlist’s Career Center to learn more.

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