1099 Caregivers and Taxes: How Independent Contractors Work With a Florida Nurse Registry

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:

• We verify that caregivers meet Florida’s registration, training, and Level 2 background-screening standards before referral.
• We refer screened caregivers to clients whose needs may match the caregiver’s experience and availability.
• We provide administrative support — invoicing, recordkeeping, and collecting and disbursing client payments.
• At tax time, we issue a 1099 for each caregiver we work with, reporting their annual earnings to the IRS, just as a W-2 reports an employee’s earnings.

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:

• No taxes are withheld for you. A client doesn’t withhold income tax or FICA from your pay the way an employer would. You’re responsible for setting money aside.
• You pay self-employment tax. Independent contractors pay both the employee and employer share of Social Security and Medicare (15.3%), because there’s no employer covering half.
• You may owe estimated taxes quarterly. Rather than settling up once on April 15, self-employed individuals generally pay estimated taxes throughout the year.
• You’ll receive a 1099. A 1099 is required for anyone earning $600 or more in a tax year. It reports your earnings; you use it to file.
• You may be able to deduct business expenses. As a business owner, certain work-related costs may be deductible — a CPA can tell you which apply to you.

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.

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.

Frequently Asked Questions

Sources

• Florida Statutes § 400.506 — Licensure of nurse registries (see subsection (6)(d))
• U.S. Department of Labor Field Assistance Bulletin No. 2018-4
• IRS: Independent Contractor (Self-Employed) or Employee?

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.