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For many seniors in Fort Myers and Cape Coral, the hardest part of a doctor’s appointment is simply getting there. When leaving the house becomes difficult, two kinds of support can make a real difference — and they work well together: a physician who comes to you, and an in-home caregiver who helps at home.

Abby Services has spent years helping families across Southwest Florida find experienced private caregivers. We’re not a medical provider, but we know the area because we live here, and we’re glad to point families toward the local resources that help people stay safe and independent at home. House-call and concierge medical practices are one of those resources.

What is a mobile physician or house-call doctor?

A mobile physician — sometimes called a house-call doctor — brings primary or specialty medical care to the patient’s home instead of requiring a trip to the office. These practices typically focus on homebound patients, people with limited mobility, and those managing complex or chronic conditions. Some operate through Medicare and standard insurance; others use a concierge model with a membership fee. Coverage areas, services, and costs vary, so it’s worth calling to confirm the details for your situation.

Local house-call and concierge medical practices serving our area

The practices below serve Fort Myers, Cape Coral, and surrounding Southwest Florida communities. Abby Services is not affiliated with any of them and does not coordinate medical care — we’re simply sharing them as community resources. Please contact each practice directly to confirm current services, coverage area, and insurance.

Lee Health House Calls (Homebound Senior Care)

Part of the Lee Health system, House Calls brings medical care into the home for homebound and limited-mobility patients throughout Lee County. Care is provided by an advanced registered nurse practitioner, and the program accepts most insurance plans.

Phone: 239-343-9219

Private Physicians of Southwest Florida

A concierge medical practice founded in 1997 by Gary M. Price, MD — the first practice of its kind in Florida. An annual membership covers care wherever you need it: in the office, in the hospital, or at home. Offices in Fort Myers, Bonita Springs, Sanibel, and Clewiston.

Phone: 239-415-1111

IMLWP (Concierge Medicine, Fort Myers)

A membership-based concierge practice whose physicians stay involved across settings — including advocating for their patients during hospital stays at Lee County hospitals such as Gulf Coast, HealthPark, and Lee Memorial. A good fit for families who want a doctor closely involved at every step.

Website: imlwp.com

LPG House Calls

A house-call practice based in Fort Myers, currently accepting new patients and accepting both Medicare and Medicaid.

Location: 12600 Creekside Ln, Ste 6, Fort Myers, FL 33919

How an in-home caregiver works alongside a house-call doctor

A house-call doctor handles the medical side of things. An in-home caregiver handles everything around it — the day-to-day support that helps someone stay safe and comfortable between visits.

The caregivers Abby Services refers are experienced, screened private caregivers who are independently employed and directed by the client. You decide when, where, and how much support you’d like, and you stay in control of the arrangement. In our experience, pairing a house-call physician with a dependable caregiver at home is one of the most effective ways to help someone remain independent.

What caregivers referred through Abby Services can help with

Caregivers referred through Abby Services can assist with a wide range of everyday tasks, including:

Every situation is different. Tell us what kind of help you’re looking for, and our office will work to match you with caregivers whose experience and availability fit your needs. If a caregiver isn’t the right fit, you’re always free to request another.

Not sure if in-home care is right? Ask your doctor.

Your physician — or a visiting mobile physician — can help you decide whether in-home support makes sense. It’s often helpful when someone has trouble with one or more activities of daily living (ADLs), such as bathing, dressing, or moving safely around the home.

If you have questions, call Abby Services at 239-590-0861 to speak with our office.

Do you need Veteran in home care now? Abby Services of Fort Myers and Cape Coral can help.

Yes, many families seek veteran in home care. However much of the information available is confusing and unclear. That is why we are excited for the following announcement about veteran in home care.

Abby Services has partnered with Vet Assist to help families manage veteran in home care.

Through a partnership with the VetAssist Program, Abby Services is excited to offer our fantastic In-Home Caregiver Services to veterans participating in the Aide and Attendance Program throughout Fort Myers, Cape Coral, and Lee County.

The VetAssist Program will:

Even after you receive your pension, the VetAssist® Program keeps working for you to help manage veteran in home care.

Getting the veteran in home care you need

Veterans Home Care can provide you with assistance including:

About the Veterans Aid & Attendance Pension benefit that helps pay for veteran in home care

In 1952 Congress passed Title 38 of the United States Code, creating what we now call the Department of Veterans Affairs (VA), and authorizing benefits for veterans. One of these benefits is the Non-Service Connected Pension, with “Aid & Attendance.” (Veterans Aid & Attendance Pension benefit.)

Even though the pension has been around for 60 years, very few people know about it or understand how it works. Veterans Home Care has 14 years’ experience successfully helping veteran families apply for and receive the pension. Let us help you, too.

Eligibility

Do You Have the “3-Ms”?

Did you serve during one of the *VA Defined War Periods

Click here for an online referral form.

Making sure an older loved one eats well is one of the most common worries families in Fort Myers and Cape Coral bring to us. Good nutrition keeps seniors stronger, steadier on their feet, and more independent, but shopping and cooking get harder with age. The good news is there are several kinds of help, and they work well together: Lee County’s Meals on Wheels program, private meal-delivery services, and in-home caregivers who shop, cook, and make sure meals actually get eaten. Here’s how each one works.

Lee County Meals on Wheels

Lee County Meals on Wheels, run locally by Community Cooperative (CCMI), delivers nutritious home-delivered meals along with a friendly, safety, and security check to eligible homebound neighbors who can’t shop or cook for themselves. Recipients include seniors as well as disabled or chronically ill adults, and meals may be short-term, while recovering from an illness or surgery, or long-term, to help someone remain safe and independent at home. The program supports over a thousand elderly and homebound residents in the greater Fort Myers area.

Meals on Wheels brings more than food. Volunteers provide daily companionship and a wellness check, and the program has added services over the years, including food and care products for recipients’ pets, and a home-safety and fall-prevention initiative developed through a partnership with the Home Depot Foundation. For many families, that daily friendly visit is as valuable as the meal itself.

Because eligibility rules, application steps, and contact information can change, the best place to confirm current details or apply is Community Cooperative directly. You can find the Lee County Meals on Wheels program and its application through Community Cooperative or the national Meals on Wheels America locator.

Private Senior Meal-Delivery Services

Meals on Wheels is a wonderful program, but not everyone qualifies, and some families want more choice over menus, dietary needs, or delivery frequency. A range of private meal-delivery services can fill that gap, from national prepared-meal companies that ship frozen, senior-friendly meals, to local restaurants and grocery delivery. Options worth considering include:

When choosing a service, look at dietary options, portion sizes, ease of heating, and whether the packaging is easy for older hands to open. The best choice depends on the person’s health needs, budget, and how much they can do for themselves.

How an In-Home Caregiver Helps With Meals

Delivered meals solve the food-supply problem, but they don’t solve everything. Many seniors have plenty of food in the house and still don’t eat well, because opening, heating, and sitting down to a meal has become difficult, or because eating alone is lonely. This is where an in-home caregiver makes a real difference.

A caregiver referred through Abby Services may assist with the whole picture around mealtime: planning meals, grocery shopping, preparing fresh food to the person’s tastes and dietary needs, and providing the company that makes a meal something to look forward to. A caregiver can also notice the early warning signs families miss, such as unexplained weight loss, spoiled food in the refrigerator, or skipped meals, which often signal that more support is needed.

Meal preparation pairs naturally with the other daily help a caregiver provides, such as light housekeeping, medication reminders, and companionship, so a few hours of caregiver support can cover far more than food alone.

Need help making sure a loved one eats well at home?

Find an In-Home Caregiver in Fort Myers & Cape Coral

Putting It Together

These options aren’t either-or. Many Southwest Florida families combine them: Meals on Wheels or a delivery service for some meals, and an in-home caregiver for shopping, fresh cooking, and companionship the rest of the time. If you’d like help thinking through what fits your loved one’s needs, Abby Services has been helping Lee County families find caregivers since 1997.

Call 239-590-0861 to talk about in-home caregiver support.

Frequently Asked Questions

Who qualifies for Meals on Wheels in Lee County?

Lee County Meals on Wheels, run by Community Cooperative, generally serves homebound seniors and disabled or chronically ill adults who can’t shop or cook for themselves, short-term or long-term. Because eligibility and application details change, confirm current requirements directly with Community Cooperative.

What if my loved one doesn’t qualify for Meals on Wheels?

Private senior meal-delivery services and grocery delivery are good alternatives, and an in-home caregiver can shop for and prepare fresh meals tailored to your loved one’s tastes and dietary needs. Many families combine a delivery option with caregiver support.

Can an Abby Services caregiver cook and shop for meals?

Yes. Caregivers referred through Abby Services may assist with meal planning, grocery shopping, meal preparation, and companionship at mealtime, along with other daily support like light housekeeping and medication reminders. You direct what the caregiver helps with.

Sources


In-home rehabilitation means receiving physical therapy, occupational therapy, or speech therapy at home, usually through a Medicare-certified home health agency after a hospital or rehab stay. Here is what surprises most families: those skilled therapy visits are short and intermittent, often 30 to 60 minutes a few times a week. Everything in between, the meals, the exercises you were told to practice, getting to the bathroom safely at 2 a.m., is up to the patient and family. That gap is where a private caregiver comes in, and it is often the difference between a recovery that sticks and a return trip to the hospital.

What In-Home Rehabilitation Covers

The goal of any rehabilitation program is to increase a patient’s level of independent functioning. When rehab moves home, a home health agency typically provides some combination of:

These services are valuable, and Medicare covers them when a doctor orders them and the patient meets the requirements. But they are visits, not coverage. The therapist leaves, and the rest of the day begins.

The Gap Between Visits Is Where Recovery Happens

Therapists will tell you themselves: progress depends on what happens between appointments. Patients recovering at home still need to eat well, move safely, practice their prescribed exercises, keep up with medications, and avoid the falls and setbacks that undo weeks of work. For someone living alone, or with a spouse who has limitations of their own, that is a lot to manage.

A private caregiver fills that gap. Working under your direction, a caregiver can:

To be clear about roles: a private caregiver is not a therapist and does not provide skilled therapy. The caregiver reinforces the plan your licensed therapists created, with hands-on personal care and daily living support that skilled visits do not include.

When In-Home Rehab Follows a Facility Stay

Often patients discharged from a hospital are not ready to go straight home and spend time at a rehabilitation facility first. Even the best inpatient rehab stay ends, sometimes because the patient has plateaued, and sometimes simply because the covered days run out. Either way, most people leave rehab improved but not fully recovered.

Arranging caregiver support before that discharge, not after, is one of the most effective ways to prevent a readmission. Our hospital and rehab discharge support page covers how to plan that transition, and if the recovery follows an operation, see our guide to after-surgery home care. For stroke recovery specifically, where rehab often continues for months, caregivers experienced with stroke recovery support are available as well.

Support That Shrinks as You Recover

One advantage of private care during rehabilitation: it scales down as you improve. A patient might start with daily visits, drop to three mornings a week as strength returns, and end care entirely once independence is back. You set the schedule, you can decrease the level of support as you continue to recover, and you stay in control of the care the whole way.

Who Pays for What

This is where families most often get caught off guard:

Coming home from a hospital or rehab stay?

See How Discharge Caregiver Support Works

If you or a loved one is completing in-home rehabilitation in Fort Myers, Cape Coral, or anywhere in Lee, Collier, or Charlotte Counties, Abby Services can help you find a screened, credentialed private caregiver to support the recovery. We have been helping Southwest Florida families since 1997, and contacting us before discharge gives us the best chance of having care in place the day your loved one comes home.

Call 239-590-0861 for a free consultation.

Frequently Asked Questions

Does Medicare pay for a private caregiver during in-home rehab?

Not typically. Medicare may cover the skilled services (PT, OT, speech, intermittent nursing) when requirements are met, but personal care, homemaking, and companion services from a private caregiver are usually paid through long-term care insurance, VA benefits, or private pay.

Can a caregiver do therapy exercises with my loved one?

A caregiver can encourage, remind, and provide standby assistance with the home exercise activities a licensed therapist prescribed, at your direction. Caregivers do not provide skilled therapy or change the therapy plan; that stays with the therapists.

How long do people usually need a caregiver after rehab?

It varies with the condition and the person. Many families start with daily support for the first weeks home, then taper as strength and confidence return. Schedules can be adjusted or ended at any time, so you are never locked into more care than you need.

Sources

If you’re caring for someone with Alzheimer’s or dementia in Fort Myers, the most important thing to know is that you are not alone — and you don’t have to figure it out alone. Southwest Florida has genuinely good memory care resources, and the best of them is free. This guide covers The Dubin Center, other local and national support options, and how in-home caregiver support fits into the picture.

What is The Dubin Center?

The Dubin Center is an Alzheimer’s and dementia resource center that has served Southwest Florida since 1995 — more than 30 years of helping local families navigate memory loss. Their mission centers on caregiver health, strength, and resilience through education, information, hope, and compassion. They are a United Way partner agency, and their services are offered at no cost, funded by community donations and fundraising.

In our experience, families dealing with a new dementia diagnosis often don’t know where to start. The Dubin Center is where to start. Their social workers provide individualized, confidential guidance for exactly this situation.

Programs and services at The Dubin Center

The center’s current offerings include:

The Dubin Center recently moved into a new home and has expanded its reach beyond Lee County, now also serving Sarasota and Manatee counties.

How to reach The Dubin Center

The Dubin Center
12511 World Plaza Ln. #50
Fort Myers, FL 33907
Phone: 239-437-3007
Email: [email protected]

Their website’s “I’m New Here” page is designed for families just beginning this journey.

Other memory care resources for Fort Myers families

A few more places worth knowing about. The Alzheimer’s Association operates a free 24/7 helpline at 800-272-3900 with trained staff who can answer questions at any hour — including the 2 a.m. ones. Locally, United Way 211 of Lee County can connect you with additional community services, from transportation to meal programs. And memory concerns are worth raising with your loved one’s physician early: age-related memory impairment affects roughly 40% of adults over 65, but not all memory change is dementia, and a proper evaluation matters.

When in-home support becomes part of the picture

Many spouses and adult children provide dementia care themselves for as long as they possibly can. But Alzheimer’s is progressive, and as needs grow, even the most devoted family caregivers run a real risk of caregiver burnout. Supervision needs often expand toward around-the-clock attention, and that is more than one person can safely sustain alone.

That’s where private in-home caregivers come in. Abby Services is a Florida-licensed nurse registry in Fort Myers — since 1997, we’ve helped local families find screened, experienced caregivers for Alzheimer’s and dementia support. The caregivers we refer meet Florida’s required Alzheimer’s and dementia training standards, and you stay in control: you choose the caregiver, set the schedule, and direct the care. Many families start with a few hours of respite care each week so they can attend a Dubin Center support group, rest, or simply run errands — and adjust from there as needs change.

Between The Dubin Center’s free education and support, and the right in-home caregiver, families in Fort Myers, Cape Coral, and across Southwest Florida can keep their loved ones safe, comfortable, and at home. If you’d like to talk through your situation, start here or call us at 239-590-0861 — and if we’re not the right resource, we’ll point you toward whoever is.

Frequently asked questions

Is The Dubin Center free?

Yes. The Dubin Center’s support groups, caregiver education, memory screenings, and social worker guidance are offered at no cost, funded by community donations and fundraising. They serve Lee County and have expanded to Sarasota and Manatee counties.

Where is The Dubin Center located?

The Dubin Center recently moved to a new home at 12511 World Plaza Ln. #50, Fort Myers, FL 33907. You can reach them at 239-437-3007 or [email protected].

What memory care resources are available in Fort Myers?

Key local resources include The Dubin Center (free dementia education and caregiver support), United Way 211 (community service connections), the Alzheimer’s Association 24/7 helpline at 800-272-3900, and Florida-licensed nurse registries like Abby Services that can refer screened in-home caregivers with dementia experience.

How do I know when my loved one with dementia needs in-home help?

Common signs include safety concerns like wandering or leaving the stove on, increasing difficulty with bathing and dressing, and family caregiver exhaustion. If caregiving is affecting your own health, sleep, or work, that’s a signal worth acting on. A conversation with your loved one’s physician and a call to a resource like The Dubin Center or Abby Services can help you sort out next steps.

In-home respite care gives family caregivers a real break: a caregiver comes to your loved one’s home for a few hours, a few days, or longer while you rest, travel, or catch up on your own life. It helps in five main ways: it shares the daily workload, gives you back quality time with your loved one, brings trained hands for tasks you are uncomfortable doing, provides peace of mind while you are away, and creates a smooth path to ongoing care if needs grow. Here is how each one works.

Family Caregiving Is a Second Job, and It Takes a Toll

Caregivers have the perfect name. They are always giving of their own time and energy for the benefit of a loved one. According to AARP and the National Alliance for Caregiving, tens of millions of Americans care for an older, disabled, or chronically ill family member, many of them putting in the hours of a part-time or full-time job on top of everything else.

Family caregivers are often responsible for bathing, feeding, and dressing a loved one. Caring for someone you love can be deeply rewarding, but it is also exhausting, and caregivers report poor eating habits, missed doctor appointments, and depression at higher rates than the general population. Burnout affects family caregivers physically, emotionally, and mentally. If you are seeing it in yourself, our guide to identifying and managing caregiver burnout can help you recognize the signs.

Offering care for a loved one is admirable, but you do not have to do it alone. Here are five ways in-home respite care helps.

1. Respite Care Shares the Daily Workload

Just as the name implies, respite care provides rest, a genuine break from daily responsibilities. In-home respite is a partnership: a caregiver shares the load so the burden is not yours alone. A respite caregiver can help with household chores as well as personal care and daily living assistance, giving you a much-needed break while your loved one stays in the safety and comfort of their own home.

2. You Get Quality Time Back

Maybe the responsibilities of caregiving are getting in the way of actually enjoying your loved one’s company. With a respite caregiver handling the daily jobs, you can focus on talking, playing cards, and taking walks instead of washing dishes, taking out the garbage, and doing laundry. Respite care lets you step out of the caregiver role and back into being a spouse, a daughter, or a son.

3. Trained Help for the Hard Parts

You try to do everything possible for your loved one, but some tasks are physically difficult, clinically tricky, or simply uncomfortable for family to perform, bathing and toileting chief among them. Caregivers referred through Abby Services are screened and credentialed, and many have experience with exactly these situations. If there are tasks you dread, respite care can be the answer.

4. Peace of Mind While You’re Away

In-home respite care can be there when you cannot be. Whether you are at work, out of town, or finally taking a vacation, a caregiver in the home watches for risks and provides personalized, compassionate attention. You benefit from knowing your loved one is safe and supported in their own home, even when you are not around.

5. A Natural Path to Ongoing Care

The needs you face today will not be the same tomorrow. Respite care is often how families discover what regular in-home care would look like: your loved one gets comfortable with a caregiver, you see how the arrangement works, and if care needs grow, the transition to a regular schedule is simple. Arrangements scale from occasional visits and hourly caregiver schedules all the way to live-in and around-the-clock care. You set the schedule, you can adjust it anytime, and you stay in control of the care.

Respite Care in Fort Myers, Cape Coral, and Southwest Florida

If you are a family caregiver in Lee, Collier, or Charlotte County running on empty, taking a break is not a luxury and it is not giving up. It is how you keep caregiving sustainable. The ARCH National Respite Network puts it simply: respite protects the health of the caregiver, and the caregiver’s health protects everyone who depends on them.

Ready for a real break?

Learn About Respite Care Through Abby Services

Abby Services has been helping Southwest Florida families find caregivers since 1997, including short-notice and temporary respite arrangements. Contact us as early as you can, especially ahead of a planned trip, so there is time to find the right fit.

Call 239-590-0861 for a free consultation.

Frequently Asked Questions

How long can respite care last?

Anywhere from a single visit to several weeks. Families use respite for an afternoon off, a weekend away, a vacation, or recovery from their own illness or surgery. The client and caregiver determine the schedule and terms of the arrangement.

Will my loved one accept a stranger in the house?

This worry is common and usually short-lived. Starting with short visits focused on light tasks and companionship lets your loved one build trust gradually. If the personality fit is not right, you can request a different caregiver at any time.

Is respite care only for emergencies?

No, and it works best when it is not. Regularly scheduled respite, even a few hours a week, prevents burnout instead of just responding to it. Emergency and short-notice arrangements may be possible depending on caregiver availability, but planning ahead gives you the best options.

Sources

Abby Services in-home caregivers of Fort Myers and Cape Coral is doing their part to end elder abuse.

Lee Elder Abuse Prevention Partnership or LEAPP is a coalition of local businesses and services dedicated to preventing elder abuse.

Update: LEAPP no longer exists.

While it was an excellent partnership and program LEAPP no longer exists. Those suspecting Elder Abuse are encouraged to contact

The Department of Children and Families Abuse Hotline at 1-800-96-ABUSE  To report abuse, neglect, or exploitation, please call toll-free 1-800-962-2873. The Abuse Hotline investigates allegations of physical, sexual, and mental abuse, neglect, and exploitation of vulnerable persons.

Elder Abuse can be a silent problem.

According to the National Council On Aging, up to five million older Americans are abused every year, and the annual loss by victims of financial abuse is estimated to be at least $36.5 billion.

Elder abuse can include physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment. Perpetrators include children, other family members, and spouses—as well as staff at nursing homes, assisted living, and other facilities.

Abby Services works to prevent elder abuse.

For at least the past 5 years Abby Services has supported and has been involved with LEAPP. L

EAPP stands for the Lee Elder Abuse Prevention Partnership. LEAPP is a coalition among Lee County, Florida human service providers and agencies.

The goal of LEAPP is, “To promote a Lee County community where older adults live safe, value and dignified lives.” and their mission is “to create community partnerships that effectively promote awareness of elder abuse, neglect, and exploitation.”

LEAPP Member Agencies include:

Alvin A. Dubin Alzheimer’s Resource Center
Abby Services In-Home Care
Able Health Care Services
Abuse Counseling & Treatment (ACT)
Adult Protective Services – Florida Department of Children & Families
Agency for Health Care Administration – State of Florida
Arden Courts – Ft. Myers
Area Agency on Aging for Southwest Florida
American Elder Care
Bonita Fire & Rescue
Cape Coral Police Department
City of Ft. Myers – Mayor Henderson’s Office
Coastal Behavioral Health
Comfort Keepers
Community Cooperative Ministries (CCMI)
Congressman Connie Mack’s Office
Cypress Cove
Direct Access Home Health

Dolores Bertolini – Caregiver and Retiree
Dr. Piper Center
Elder Law Office of Norma Hand Brill
Florida Gulf Coast University School of Nursing
Florida Gulf Coast University School of Social Work
Florida Rural Legal Services
Ft. Myers Police Department
Good Wheels
Gulf Coast Village
Heartland Health Care Center
Helen Fallert – Retired Social Worker
Hope HealthCare Services
Iona-McGregor Fire District
JBH Behavioral Health
Lee County Health Department
Lee County Department of Human Services
Lee County Housing Authority
Lee County Library System
Lee County Public Safety
Lee County Sheriff’s Office
Lee Memorial Health System
Long Term Care Ombudsman – Southwest Florida
Lynda Leonard-Boyce – Professional Guardian
Mederi Care Tenders
Millennium House
National Association of Social Workers (NASW) – Southwest Florida Chapter
National Alliance Mental Illness (NAMI)
Neuropsychiatric Research Center of Southwest Florida
Office of Financial Regulations – State of Florida
Osterhout, McKinney & Prather Elder Law Attorneys
Parkinson’s Action Network
Prudential Financial
Redi-Care
Right at Home
Sanibel Fire & Rescue
Sanibel FISH
Schlager, Schlager & Levin
Senior Behavioral Health at Lee Memorial
Senior Friendship Centers
Senior Home Companions
Sherri Graham – Professional Guardian
Signature Healthcare
Southwest Florida Community Foundation
St. Michael and All Angels Episcopal Church
State Attorney’s Office
Superior Residences at HealthPark
The Honorable Archie B. Hayward, Jr. – Lee County Judge
United Way of Lee, Hendry & Glades
United Way 211
University of Florida Lee County Extension Service
Visually Impaired Person (VIP)

Through Abby Services’ involvement with LEAPP, we are able to help ensure our local seniors remain safe in their homes and can help support those seniors and their families who are at risk for abuse.

Abby Services was a lead supporter of the LEAPP Shred-a-thon.

Recently Abby Services supported the LEAPP shred-a-thon. The Shred-a-thon is an annual event around tax season which provides an opportunity for local residents including seniors to securely destroy sensitive documents. All donated proceeds go to help support LEAPP initiatives through a local partnership with The United Way.

By shredding sensitive documents Abby Services In-Home Care helps to reduce the risk of fraud, and financial abuse. Abby Services In-Home Care is proud to support LEAPP and all local initiatives in LEE County, Fort Myers, and Cape Coral who support our seniors and help keep them safe and in their home, regardless if they require in-home care or do not require in-home care.

For more information on how Abby Services In-Home Care and LEAPP protect our local seniors please visit www.leeelderabuse.org

Long-Term Care Insurance can be challenging to navigate.

Abby Services helps seniors navigate confusing long-term care insurance policies to be sure they get all of the in-home care benefits they are entitled to.

Abby Services has helped Fort Myers and Cape Coral seniors navigate confusing long-term care insurance policies since 1997!

With many clients we see, their long-term care insurance policies were purchased years ago. Clients may not remember clearly what policy details are or may incorrectly remember information about their long-term care insurance policy.

It’s no wonder clients can be unclear about coverage benefits or requirements to access their policy. Often the language in long-term care insurance policies can be challenging and confusing to understand.

That is why when a client has a question about their long-term care insurance policy, or benefits, they should schedule a complimentary appointment with one of our owners and  RN Scott Strachan.

Although these meetings can take about an hour, it is important to thoroughly review a long-term care policy, and fully explain its benefits and how they are accessed.

Understanding your long-term care insurance policy.

It is important to understand what you are entitled to under your Long Term Care Policy. More important than understanding your Long Term Care Benefits is how to actually access those benefits.

Even when you are armed with accurate information, and thoroughly understand your policy, some insurers have been known to act inappropriately. Here is an article I found with a quick google search:

Florida nurse registry claims insurer improperly denying benefits on long-term care policies

USA February 4, 2011

A class-action lawsuit filed by a Florida nurse registry claims that Transamerica Life Insurance Company’s (Transamerica) long-term care insurance policies improperly deny coverage by requiring a level of certification for home health aides that exceeds state requirements and that Florida law does not allow Transamerica to deny coverage meeting those state requirements.

According to a complaint filed in the District Court for the Southern District of Florida on January 21, 2011, American Nursing Resources Inc. (American Nursing) arranges home health care services for clients, regularly receives insurance-benefit assignments from its clients, and bills insurance companies directly for its services.

American Nursing alleges that its home health aides have provided services to Howard Boteler since October 31, 2009. Mr. Boteler assigned American Nursing his benefits under a long-term care policy issued by a predecessor of Transamerica. American Nursing alleges that when it attempted to collect benefits under the policy,

Transamerica denied its claim on the basis that the services were not provided by a “Home Health Aide” as defined in the policy. According to the complaint, the policy provided for reimbursement for the services of a “Home Health Aide” if the aide was: (1) eligible for reimbursement under Medicare; (2) employed by a state-licensed or accredited home health care agency; or (3) employed by a provider of home health care services accredited by the National League of Nursing, American Public Health Association, or the Joint Commission on Accreditation of Hospitals.

American Nursing alleges that, by its definition of “Home Health Aide,” Transamerica effectively requires a nurse registry such as American Nursing to either: arrange for the provision of basic services by nurses or other individuals with a level of certification greater than that of a home health aide; become eligible for reimbursement under Medicare; or be licensed as a “Home Health Care Agency.”

American Nursing alleges that this violates Florida statutes governing long-term care insurance, which provide that a long-term care policy cannot: require services to be performed by an individual with a higher level of certification than the services require; require services to be provided by a licensed home health agency when they can be provided by a nurse registry, or require that services be required by Medicare-certified agencies or providers. See FLA. STAT. ANN. § 627.94071.

The complaint alleges that “Defendant cannot define ‘Home Health Aide’ and implement its policy in a manner which violates Florida law by excluding or discriminating against nurse registries as covered home health service providers for basic services. … To do so, violates the Florida Statutes and Rules which by law are incorporated into Defendant’s Policy and give rise to an action for breach of the Policy.”

American Nursing seeks, for itself and on behalf of similarly situated providers, damages for breach of contract and an injunction preventing further denial of benefits on these grounds.

American Nursing has defined the class narrowly to include only Florida licensed nurse registries which, from January 1, 2006, through January 21, 2011, were assignees under a Transamerica long-term care policy and had a claim for benefits for home health-care services provided in Florida denied on the basis that the services were not provided by a “Home Health Aide” under the policy.

The class is also defined to include any Florida-licensed nurse registries currently named as assignees under such a policy. The case is American Nursing Resources, Inc., v. Transamerica Life Insurance Company, No. 0:11-cv-60146 (S.D. Fla.)

Are issues with long-term care insurance common?

Unexpected issues with long-term care insurance are more common than many think.

The situation described in the article above has occurred with a State Farm Long Term Care Insurance Policy a client of Abby Services has. As long-term care insurance experts, we are helping them to work through the insurer’s confusion and hopefully, State Farm will do the right thing.

What do you mean “hopefully the long term care insurance provider will do the right thing”?

Doing the “right thing” would be allowing a claimant to easily and appropriately access the long-term care insurance policy they have paid for as required by law. The specific law the article references is listed below.

Florida Statute 627.94071 which covers life insurance for seniors contracts and rates:

627.94071 Minimum standards for home health care benefits.—A long-term care insurance policy, certificate, or rider that contains a home health care benefit must meet or exceed the minimum standards specified in this section. The policy, certificate, or rider may not exclude benefits by any of the following means:

(1) Providing that home health care cannot be covered unless the insured or claimant would, without the home health care, require skilled care in a skilled nursing facility.(2) Requiring that the insured or claimant first or simultaneously receive nursing or therapeutic services in a home setting or community setting before home health care services are covered.(3) Limiting eligible services to services provided by registered nurses or licensed practical nurses.(4) Requiring that a nurse or therapist provide services covered by the policy that can be provided by a home health aide or by another licensed or certified home care worker acting within the scope of his or her license or certification.(5) Requiring that a licensed home health agency provide services covered by the policy that can be provided by a nurse registry licensed under chapter 400.(6) Excluding coverage for personal care services provided by a home health aide.(7) Requiring that the provision of home health care services be at a level of certification of licensure greater than that required by the eligible service.(8) Requiring that the insured/claimant have an acute condition before home health care services are covered.(9) Limiting benefits to services provided by Medicare-certified agencies or providers.(10) Excluding coverage for adult day care services.

Do you have a long-term care insurance complaint?

If you are confused about your policy or believe you are being inappropriately denied long-term care insurance benefits you are entitled to you should review the Florida Department of Financial Services website. They are the entity best suited to help resolve most long-term care insurance issues. Sometimes, despite attempts to educate insurance providers on regulations in our state, (regulations that they should already be familiar with) you need an attorney familiar with specific state laws, to help fight for the benefits you are entitled to. Below is an attorney you may want to consider. Stephen DunnPhone: (410) 321-8368Email: [email protected]: https://www.sdunnlawoffices.com/

If you’re a caregiver working with a Florida nurse registry, you are almost certainly a 1099 independent contractor, not a W-2 employee. In Florida this isn’t a gray area or a judgment call: state law specifically defines caregivers referred by a licensed nurse registry as independent contractors. That means you run your own small business, you receive a 1099 rather than a W-2, and you’re responsible for your own taxes. This page explains what that means, why it’s the case, and where to get help.

A quick, important note. My name is Scott Strachan. I’m a Registered Nurse and the owner of Abby Services, and I am not a tax professional. Nothing here is tax advice for your specific situation — always speak with a CPA. What this page does is explain how a Florida nurse registry works and point you toward reliable information, because we’ve seen a lot of misleading and even false tax guidance aimed at caregivers, and you deserve accurate sources.

You’ll See Conflicting Information Online. Here’s Why.

If you search for caregiver taxes, you’ll find many articles insisting that caregivers must be treated as W-2 household employees, not 1099 contractors. That advice isn’t wrong — for the situation it describes. It’s aimed at families who directly hire a caregiver and control how, when, and where the work is done. When a family sets the schedule, directs the tasks, and controls the pay, the IRS generally does consider that caregiver a household employee.

A nurse registry is a different arrangement. A registry refers self-employed caregivers to clients and provides administrative support; it does not employ, supervise, direct, or control the caregiver’s work. That distinction is exactly why the classification comes out differently, and it’s backed by both Florida law and federal guidance.

The Florida Law: Caregivers Referred by a Registry Are Independent Contractors

Florida spells this out directly. Under Florida Statute § 400.506(6)(d), a registered nurse, LPN, certified nursing assistant, home health aide, companion, or homemaker referred for contract by a nurse registry “is deemed an independent contractor and not an employee of the nurse registry under any chapter.”

The same statute requires the registry to tell the client, at the time of contract, that the referred caregiver is an independent contractor and that the registry may not monitor, supervise, manage, or train the caregiver. In other words, the independent-contractor relationship isn’t a workaround a registry chooses — it’s how Florida defines and regulates the nurse registry model.

The Federal Guidance: DOL Field Assistance Bulletin 2018-4

On the federal side, the U.S. Department of Labor addressed this specific question in Field Assistance Bulletin No. 2018-4, “Determining Whether Nurse or Caregiver Registries Are Employers of the Caregiver.” Its long-standing position: a registry that simply refers caregivers and provides administrative services — recordkeeping, invoicing, collecting and disbursing payment — is not the caregiver’s employer under the Fair Labor Standards Act. A registry only becomes an employer if it starts controlling the terms of the work: setting the caregiver’s pay rate, hiring and firing, or directing the schedule.

One point worth being precise about: FAB 2018-4 concerns the FLSA (federal wage-and-hour law), which is a separate question from how the IRS classifies a worker for taxes. But both frameworks turn on the same core idea — who controls the work — and both point the same direction for a properly operated registry. The IRS applies its own control and “economic reality” test to decide employee vs. independent-contractor status.

What Abby Services Does — and Doesn’t Do

Abby Services is a state licensed nurse registry overseen by Florida’s Agency for Health Care Administration (AHCA). Our role, consistent with Florida law and DOL guidance, is limited to referral and administration:

What we do not do — and legally may not do — is employ, supervise, direct, or set the pay of the caregivers we refer. The caregiver and client set their own rate and schedule directly. We refer 1099 caregivers to families throughout Fort Myers, Cape Coral, Naples, and Bonita Springs.

What Being a 1099 Caregiver Means for Your Taxes

As an independent contractor, you operate your own business, which changes how taxes work compared with an employee:

To make tax time easier, keep good records of your earnings throughout the year. Abby Services works together with CareLink, a secure platform where the caregivers we work with can receive client payments and track those earnings for tax reporting, and we issue your annual 1099.

Interested in working as an independent caregiver in Southwest Florida?

Learn About Caregiver Opportunities With Abby Services

Abby Services stays informed on the changing federal and state guidelines that affect nurse registries and the 1099 caregivers we work with, in part through our involvement with industry groups like the Private Care Association (PCA). We’re always glad to explain how our business operates. For questions about your own tax situation, please talk with a CPA.

Questions about working with Abby Services? Call 239-590-0861.

Frequently Asked Questions

Are caregivers referred by Abby Services employees or independent contractors?

Independent contractors. Under Florida Statute 400.506(6)(d), a caregiver referred for contract by a licensed nurse registry is deemed an independent contractor and not an employee of the registry. The caregivers we refer operate their own businesses; we provide referral and administrative services only.

Why do some websites say caregivers must be W-2 employees?

That guidance is generally aimed at families who directly hire and control a caregiver, in which case the IRS often treats the caregiver as a household employee. A nurse registry is a different arrangement — the registry refers self-employed caregivers and does not control their work — which is why Florida law and DOL Field Assistance Bulletin 2018-4 treat registry-referred caregivers as independent contractors.

Will I get a 1099 from Abby Services?

Yes. We issue a 1099 for each caregiver we work with, reporting annual earnings to the IRS, as required for anyone earning $600 or more in a tax year. You use the 1099 to file your taxes.

Do I have to pay my own taxes as a 1099 caregiver?

Yes. As an independent contractor, no taxes are withheld for you. You’re responsible for income tax and self-employment tax (Social Security and Medicare), and you may need to pay estimated taxes quarterly. A CPA can help you set up the right approach for your situation.

Sources

This article is general information about how a Florida nurse registry operates, not tax or legal advice. Consult a CPA or qualified professional about your specific situation.


A Florida nurse registry is a state-licensed referral service that connects clients with screened, credentialed, independently employed caregivers for in-home care. The registry maintains a list — a registry — of qualified private caregivers, verifies their credentials and background screening, and matches them with clients seeking their services. The client, not the registry, directs the care.

Abby Services has operated as a Florida-licensed nurse registry in Fort Myers since 1997, so this is a question we answer nearly every day. Here is what the term actually means, how the model works, and why it matters for families comparing their in-home care options.

Nurse registry vs. home health agency: what’s the difference?

Florida law recognizes two distinct types of licensed in-home care businesses. A home health agency employs its caregivers: it hires, schedules, supervises, and directs them, and builds those employment costs into its rates. A nurse registry does not employ caregivers at all. It refers self-employed, independent caregivers based on the criteria the client provides, and the client decides what services to request and when.

Neither model is “better” — they suit different situations. But the difference is real, and it affects cost, control, and caregiver consistency. Unfortunately, some competitors blur this distinction to steer consumers, which only creates confusion. In our experience, an educated customer is a happy customer, so let’s look at what the state of Florida itself concluded.

Florida studied nurse registries — and kept them

In 1999, the Florida House of Representatives conducted a formal review titled Repeal of Nurse Registry Regulation? examining whether the nurse registry statute should be eliminated. The findings were clear: nurse registries deliver in-home care at a 20–30% lower cost than home health agencies, and eliminating them would raise costs and reduce consumer choice. The report’s recommendation to lawmakers: do not repeal the statute.

That statute, Section 400.506, Florida Statutes, still governs nurse registries today. It even requires registries to tell every client, in writing, that referred caregivers are independent contractors — transparency is built into the law.

How Florida regulates nurse registries

Nurse registries are licensed and overseen by the Agency for Health Care Administration (AHCA), the same state agency that regulates hospitals and nursing homes. Before a caregiver can be referred, a registry must verify that they meet Florida’s standards, including:

These requirements exist to protect the vulnerable population registries serve. The screening is one of the biggest practical differences between finding a caregiver through a licensed registry and hiring someone “off the street” — a private hire has been through no screening at all unless you arrange it yourself.

How the referral model actually works

Think of a nurse registry like a realtor or a matchmaking service. A realtor doesn’t build or own the houses they show you — they help you find the right one. A nurse registry doesn’t employ or control caregivers — it helps you find the right one.

Here’s what that looks like in practice. A family contacts Abby Services looking for help with things like bathing, dressing, meal preparation, and light housekeeping. We learn about the client’s needs, schedule, location, and budget, then search our registry of screened independent caregivers to identify good potential matches. Our RN is available to help you identify the type of support your loved one needs — you decide what to request.

The caregiver decides whether to accept the referral, and the client decides whether the caregiver is a good fit. Caregivers referred through a registry are 1099 independent contractors who set their own rates, choose their own clients, and run their own one-person businesses. Because the caregiver works for the client rather than for us, we don’t reassign your caregiver to another case or rotate staff — which is why families working with registries often see better caregiver consistency than they expected.

What a nurse registry does not do

Honesty about the model matters, so let’s be direct. A nurse registry does not provide, supervise, train, or manage caregivers. Care direction belongs to the client, the family, or the client’s physician. The registry’s role is screening, matching, referring, and providing administrative support — things like invoicing and recordkeeping. If you want a company that employs and supervises the caregiver for you, that’s what home health agencies do, at a correspondingly higher price. Both options have their place; what matters is choosing knowingly.

Why families choose a nurse registry

Three reasons come up again and again with the families we work with:

If you’re in Fort Myers, Cape Coral, Naples, or anywhere in Southwest Florida and want to talk through whether the registry model fits your situation, start your caregiver search here or call us at 239-590-0861. And if you’re a caregiver interested in registry referrals, visit our work as a caregiver page.

Frequently asked questions

What is a Florida nurse registry in simple terms?

It’s a state-licensed matching service for in-home care. The registry screens independent caregivers, verifies their credentials and background checks, and refers them to clients. Caregivers are matched based on the client’s criteria, and the client directs the care; the caregiver works for the client, not the registry.

Is a nurse registry the same as a home care agency?

No. An agency employs and supervises its caregivers. A registry refers independent, self-employed caregivers and does not provide, supervise, or manage the care. Florida licenses both under separate statutes, and the registry model typically costs 20–30% less.

Are caregivers referred by a nurse registry screened?

Yes. Florida requires registries to verify Level 2 fingerprint-based background screening and confirm credentials and training before referring any caregiver. That’s a key protection compared with hiring privately, where no screening happens unless you arrange it yourself.

Who directs the care when you use a nurse registry?

The client, their family, or their physician. The registry can help you identify the type of support needed — at Abby Services, our RN is available for exactly that — but you decide what to request, and the caregiver you select provides it.

Does a nurse registry guarantee caregiver availability?

No registry can honestly guarantee that. Caregivers are independent and may accept or decline any referral. What a good registry does is maintain a deep enough roster, and learn your needs well enough, to find you strong matches — and keep looking if the first match isn’t right. In our experience, you don’t marry the first person you go on a date with.