Ranked: Types of Private Duty Nursing Providers

Verdict: The first call for families in SC, NC, GA or TN: employed nurses, a named team with backups, and the Medicaid, VA and long-term care billing handled for you.

A licensed home health and private duty nursing agency with offices across the four states, accredited by ACHC since 2014. It starts every private duty case with an RN assessment at home and a written staffing plan that names the primary nurses and the backups.

Who it suits: Families in South Carolina, North Carolina, Georgia or Tennessee who need shifts of four to twenty-four hours for an adult or a child with complex needs, such as a trach, a ventilator, a feeding tube or seizures.

Cost: Not published. Private-pay rates are quoted in writing before care starts, with no deposit and no minimum contract length (Vantor Care's insurance page). Medicaid, long-term care insurance and VA cases are billed to the payer.

Vantor Care private duty nursing →

Verdict: The safest default for most families: someone else is the employer, the supervisor and the backup.

The agency hires the nurses as its own employees, supervises them with an RN, schedules the shifts, fills them when a nurse is out and bills the payer it is contracted with.

Who it suits: Most families, and almost everyone whose nursing is paid by Medicaid or insurance or whose loved one has complex, round-the-clock needs.

Cost: Not published nationally. Ask each agency for its RN and LPN hourly rates, minimum shift length, and overnight, weekend and holiday rates in writing.

Verdict: A workable middle option for private payers, if the contract says who supervises and who covers a missed shift.

A registry finds and refers nurses, often for a fee on top of the nurse's rate. The nurses are usually independent contractors, not the registry's employees, so supervision and backup depend on the contract.

Who it suits: Families paying privately who want more say over the nurse, need someone quickly, and can take on some of the oversight themselves.

Cost: Not published nationally. Ask for the nurse's rate and the registry's fee separately, in writing, and whether the fee repeats.

Verdict: Good when you already trust the nurse and have a backup plan; risky as the only option for complex care.

A licensed nurse who runs their own practice and contracts directly with the family. You get one relationship and one rate, and you take on everything an agency would otherwise handle.

Who it suits: Private payers who already know and trust a nurse, often for set, predictable hours, and who can arrange their own backup.

Cost: Set directly with the nurse. There is no published benchmark; ask local agencies for their private-pay rate to compare.

Verdict: Most control, most work: right for families ready to be an employer, wrong for anyone who needs a backup nurse tonight.

The family recruits, hires, pays and manages the nurse as its own employee. Some state Medicaid programs let families self-direct care this way, with a fiscal agent handling payroll.

Who it suits: Families ready to be an employer, wanting full control over a long, stable schedule, including those in a self-directed Medicaid program where the state allows the family to hire.

Cost: You set the wage. On top of it come employer payroll taxes and any insurance your state requires; IRS Publication 926 explains the federal side.