A recent court ruling has sent a powerful message to caregiver registries across the country: the decisions you make every day—how you refer caregivers, how you communicate, how your agreements are structured—can determine whether you’re operating as a true registry or inadvertently acting as an employer.
The U.S. Court of Appeals for the Fourth Circuit recently upheld a $9.3 million judgment against a nurse registry and its owner for unpaid overtime. The reason? The court determined that the registry had been functioning as an employer under the Fair Labor Standards Act (FLSA), rather than as a neutral referral source.
This case has significant implications—especially for registries operating in Maryland, North Carolina, South Carolina, Virginia, and West Virginia—but the lessons apply far beyond those states.
Understanding What Went Wrong
The court found that the registry exerted too much control over caregivers in ways that made the independent contractor relationship look more like a traditional employment arrangement. The red flags included:
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Assigning caregiver schedules instead of facilitating matches
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Dictating aspects of care delivery
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Using language in contracts that reflected an employer-employee relationship
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Making payments in a manner that resembled payroll rather than independent contractor invoicing
These behaviors, while often well-intentioned or done in the spirit of efficiency, eroded the registry’s legal protections and exposed the business—and its owner—to significant financial liability.
Why This Matters to Every Registry
Caregiver registries are built on the independent contractor model, which allows for flexibility and autonomy for both the caregiver and the client. But when a registry steps too far into the role of manager or employer, it can lose those legal distinctions.
Once that line is crossed, a registry may be held responsible for:
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Overtime pay and back wages
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Employment taxes and penalties
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Potential personal liability for the owners
And these consequences don’t just apply to registries in the Fourth Circuit. This case sets a precedent that other courts may look to in future decisions.
Are You Acting Like a Registry or an Employer?
This is the moment for registry operators to pause and evaluate their practices. Key questions to consider:
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Are caregivers offered matches—or are they being assigned shifts?
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Does your caregiver agreement clearly define the independent contractor relationship?
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Is the language you use with caregivers neutral and professional—or directive and supervisory?
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Are you allowing clients and caregivers to negotiate terms—or stepping in to manage that process?
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Do your billing and payment systems reflect an independent contractor model?
These are not just legal questions—they’re operational ones that affect the core of your business model.
Best Practices from Registry Advocates
The Private Care Association (PCA), a long-standing advocate for caregiver registries, has emphasized for years the importance of maintaining clear boundaries between registries and employers. This recent case validates those concerns and reinforces the need for registries to carefully review their workflows, agreements, and communication practices.
Now is not the time for assumptions or guesswork. Even small missteps can create significant exposure, especially as federal and state scrutiny continues to grow.
How Ally Helps Protect the Registry Model
Ally was built specifically to support caregiver registries—not agencies—and our entire platform is structured to reinforce the independence of both clients and caregivers.
From compliant contract templates and IC-friendly scheduling tools, to documentation that reflects the non-employment nature of the relationship, our goal is to help registries operate in alignment with best practices and regulatory expectations.
Our system supports:
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Transparent, client-approved invoicing
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Accurate caregiver payment records
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Documentation of referral-based matching, not scheduling
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Seamless workflows that limit unnecessary intervention
Most importantly, we stay aligned with legal experts and industry leaders to help ensure that your systems evolve alongside the changing regulatory landscape.
A Final Word
This ruling is a reminder that maintaining the registry model requires more than intention—it requires structure. If your systems, contracts, or workflows are even slightly misaligned, the risk is real. The good news is that these risks can be managed and mitigated with the right tools and awareness.
If you’re unsure where you stand, now is the time to act. A proactive review today could prevent significant consequences down the road.
Want to learn more about how Ally supports registry best practices?
