Can You Hire an Independent Nurse Contractor for Home Care?

An independent nurse contractor is able to do pretty much everything a nursing employee can do. From a Certified Nursing Assistant to a Licensed Practical Nurse, from a Registered Nurse to an Advanced Practice Registered Nurse, the different levels of skilled nursing services and professional training are nearly identical. Instead, the key difference between an employee and a contracted nurse is how the household worker is classified and paid.


To be an independent contractor of any kind, you’re supposed to control the schedule and work production, including any relevant supplies. You’re also more likely to get paid on a monthly basis, rather than a weekly paycheck. This is an impractical, or at the very least an uncommon, employment practice in much of the modern healthcare industry. Especially with its managed care networks, healthcare providers require employees follow the organization’s scheduling needs.

Home Care Independent Nurse Contractors

There is one notable exception to this rule, however. Skilled nursing professionals and private households have more choices when it comes to their worker status than the typical home care employee relationship. Even still, many home health and private duty nurses choose to work exclusively as an employee. Especially if they are looking for “steady” work and traditional employee benefits, many nursing professionals will stay away from this type of work relationship. On the other hand, by taking on these payroll taxes and income reporting on your own, independent contractors can often demand a higher hourly wage, or at least a proportional increase.

There’s also the question of how to provide adequate coverage for clients who may need intensive or round-the-clock care? There are home health agencies that help connect independent nursing contractors and home care clients. The agency may pay the contractors directly, or they may simply refer the contractors and have the home care client pay the contractor. These agencies help identify clients who need this type of specialized medical care services. Again, more standard personal care services almost always fall under an employer-employee relationship.

With this mind, there’s no definitive scheduling threshold that disqualifies a private duty nurse from being an independent contractor and working 60+ hours a week. In fact, the two parties can largely work out whatever arrangement they want so long as there’s no expectation that the employee accommodates a client’s strict scheduling needs as a condition of the work.

Employer Filing Support for Independent Nurse Contractor

Whether you’re a private household employer or a home health agency, it’s great to sidestep the more involved for filing requirements that come with hiring employees. Nevertheless, you’ll still want to invest in a caregiver payroll software that supports your Form 1099-MISC filings. Advanced Micro Solutions (AMS) is the industry leader for 1099 & W2 Software for individual employers, small businesses, and professional accountants. Check out what our intuitive platform and modular software products can do for your employee and independent contractor filing forms. We recommend starting with AMS Payroll Software , our semi-automated payroll software designed to provide user-friendly and intuitive support.

Online Resources for Additional Guidance

  • Not sure if the work relationship you have in mind allows you to pay the worker as an independent nurse contractor? You can file Form SS-8 with the IRS to make an official determination. Moreover, you don’t want to make the costly mistake of paying someone who’s actually an employee as an independent contractor.
  • Trying to make it work as a private employer, while still protecting your personal and financial self-interest. We’re not lawyers, but we do think this online tutorial for writing a contract for nursing services is a good place to start. You may also want to check out this older, but still relevant, forum discussion on the employment status of different private duty nurses.


Software Solutions from AMS

Our W-2 and 1099 Forms Filer is our only required platform. From there, users pick the services they need. Choose from the tools below to build out your customized accounting software.