Also known as a Private Duty Home Care Agency, are companies or businesses that are licensed by the State they operate in to offer primarily custodial care in individual’s homes. These agencies are called private duty or private pay because individuals pay out of pocket in most instances. By law, the Caregivers that are employees of these agencies are prohibited from performing duties such as medicine management, giving supplements, changing dressings (bandages), or cleaning catheters, to name a few. Mostly, they are there to help a Careseeker with activities of daily living. The vast majority of agencies are franchisees of a larger organization. The Caregivers are hired by the agency directly and are dispatched to Careseeker’s residences. In many situations, the Careseeker has no choice in selection of the Caregiver, and often they may have two to three different Caregivers on any given week. In addition, most Agencies require of minimum amount of care on any day or any visit, and usually require a Careseeker to guarantee a minimum amount of care per week or they charge a surcharge on top of the hourly rate. In addition, the Private Duty Agency Industry has has a chronic problem dealing with Caregiver truancy or no-shows according to their own reporting.