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I may need to hire an independent contractor to care for mom fulltime. I like her a lot and so does mom. What should I be concerned with when hiring someone outright and paying them ourselves?

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The real question is how much care Mom needs. If she requires 24/7, it is not possible for one person to safely care for her.
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My dad’s helper was hired privately outside of an agency and it worked out very well. The two of them worked out her hours and pay, the taxes and payroll handled by a lady who organized a large group of workers like his caregiver. They were former CNA’s who grew frustrated for various reasons with working for agencies or nursing homes but enjoyed working privately. We couldn’t have asked for a better person, and are still grateful to her
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I would encourage you to read the IRS.gov caregiver independent contractor requirements. This will help you protect everyone involved and help clarify how this needs to be done legally. Easy reading.

If she meets those requirements and she wants a 1099 at the year end, she needs to have a valid business licenses they're like 50.00 annually and fills out a W9.

If she doesn't qualify as independent contractor;

I would contact a payroll company and utilize their services to pay her legally as an employee. This service costs about 25% of her paycheck and it covers ALL state and Federal labor requirements. Well worth the charge when you consider that this pays your half of FICA, provides unemployment insurance, workman's comp insurance and ALL the required filings. It, also, means you nor your homeowners insurance can be sued, you cannot sue an employer when you are covered by worker's comp. It is a win-win decision to use a P/R service.

Best of luck with the caregiver.
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You will need to check the labor laws for your Mom's state. Hiring privately makes her an employer (in most states). Pay by check or some way that leaves a trail (ie, not cash unless she signs a receipt). Make sure to have a solid written contract, no matter how much you like this person. Some states (and even counties) have rules/laws that govern overtime and other employment matters. You may want to consider a bookkeeper who will help with the quarterly withholding taxes and year end documents like W2s. Your Mom should have liability insurance that covers this person.

Also, you need to have a plan for when this person calls in sick or goes on vacation or quits abruptly.
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Make sure that you understand your responsibilities to pay SS and FICA on her wages.

Have a contract that clearly spells out responsibilities, wages, conditions. Discuss things like who pays for food, if she may bring her children to your home.
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