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Proudly serving families in Fort Myers, Cape Coral, Naples, Bonita Springs, and surrounding Southwest Florida communities.
If you’re a caregiver working with a Florida nurse registry, you are almost certainly a 1099 independent contractor, not a W-2 employee, because that is exactly what Florida law requires. Florida law addresses this directly: Florida Statute 400.506 specifically defines caregivers referred by a licensed nurse registry as independent contractors, not employees of the registry. 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.
If you search online about caregivers working as independent contractors in home care, you’ll find some people making false blanket statements, such as “you can’t do that” or “you’ll get in trouble.” Those people are either misinformed or misleading you. It’s true that some states have no laws on this, and some expressly prohibit caregivers from working as independent contractors in home care. But Florida law specifically outlines, describes, and governs independent contractors working in home care.
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 is written for a different arrangement: a family that hires a caregiver directly and becomes that caregiver’s employer. Some states actually encourage this domestic employer model, where the client becomes the caregiver’s employer and handles payroll taxes. It’s a legitimate option, but it isn’t how a Florida nurse registry works.
A nurse registry is a different arrangement. A registry refers self-employed caregivers to clients and provides administrative support. That is why the classification comes out differently, and it’s backed by both Florida law and federal guidance.
Caregivers referred through a nurse registry run their own businesses. You set your own rates, choose which referrals to accept, and can work with more than one client. Your clients decide what help they want, and you decide how best to provide it, using your professional training and judgment.
Think of it like seeing a doctor. Patients are in control of their own health care: they share their concerns and decide which treatment they’re comfortable with. The doctor decides how to deliver that treatment, using their own training and judgment. Being in charge of your own care doesn’t make you your doctor’s employer.
Caregiving works the same way. A client might ask you to change the bed for a loved one who can’t get up. You know how to change the sheets with a full-grown adult still in the bed, safely turning and positioning them as you work. That’s a professional skill, and how it’s done is up to you. A client asking for clean sheets is describing the help they want. It doesn’t make them your employer.
Health care already works this way. Many of the physicians you see in a hospital are not hospital employees. At NCH, for example, emergency, anesthesia, radiology, and pathology physicians come from contracted physician groups that bill patients separately. Even Medicare-certified home health agencies, which follow strict federal rules, are allowed to arrange services such as physical therapy through outside providers under written agreements.
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.
In Field Assistance Bulletin No. 2018-4, “Determining Whether Nurse or Caregiver Registries Are Employers of the Caregiver,” the Department of Labor made its position clear: a registry that refers caregivers and provides administrative services, such as recordkeeping, invoicing, and collecting and disbursing payment, is not the caregiver’s employer under the Fair Labor Standards Act.
It is the most direct federal guidance on the nurse registry model, and it lines up with how Florida law defines it.
That’s why Abby Services leaves rates and schedules for clients and caregivers to agree on together.
One point worth being precise about: FAB 2018-4 concerns federal wage-and-hour law, which is a separate question from how the IRS treats a worker for taxes. Caregivers referred through a nurse registry operate as independent professionals and receive a 1099. For questions about your own tax situation, talk with a CPA.
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.
The strongest answer to anyone who questions your independent-contractor status is how you actually work. The IRS and the Department of Labor both look at whether a worker is truly in business for themselves. These habits show that you are:
The IRS Self-Employed Individuals Tax Center is a good place to start for the tax side.
As an independent contractor, you operate your own business, which changes how taxes work compared with an employee:
Running your own business also means protecting it. We strongly encourage caregivers to carry their own private malpractice insurance. It protects both you and the clients you care for, and many families ask for it.
Families hear their share of tax myths too. If a client has been told they will be responsible for your taxes, point them to the Big Four nurse registry myths.
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, track those earnings for tax reporting, and view and receive their annual 1099.
Interested in working as an independent caregiver in Southwest Florida?
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.
Have questions about care at home?
Talk it through with a registered nurse.
You are your own boss. As an independent professional, you make the important decisions about your business: which referrals to accept, what rates to set, and how you provide your services. Abby Services is here as a resource and to support your business behind the scenes, including:
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.
That guidance is written for families who hire a caregiver directly and become that caregiver’s employer. A nurse registry is a different arrangement: the registry refers self-employed caregivers who run their own businesses, which is why Florida law and DOL Field Assistance Bulletin 2018-4 treat registry-referred caregivers as independent contractors, not employees of the registry.
Your 1099 is available to view and download through CareLink, the secure platform where you receive client payments and track your earnings. You use it to file your taxes. All of your earnings are taxable, even if they fall below the 1099 reporting threshold.
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.
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.
