Can I pay my caregivers as 1099 contractors or do they need to be W-2 employees?
There's a simple, unequivocal answer: home care agencies are legally required to classify and pay their employees as W-2 employees, not 1099 contractors. This law has been in effect for several years and makes no exceptions.
It's useful to draw the distinction between home care agencies and home care registries.
An agency employs caregivers and has an admin staff that is responsible for scheduling the caregivers and coordinating with clients. A registry essentially offers access to a list of caregivers, who act autonomously to set their own schedules with clients.
These are separate business models with many differences, but the easiest litmus test is whether caregivers set their own schedules with no help/direction/intervention from you, or whether you're creating their schedules.
A registry exists simply to provide a list of caregivers that potential clients can contact; their involvement ends there.
If you have a competitor down the street who is paying/classifying their caregivers as 1099 contractors, they're either breaking the law or they're actually a registry. There is no other option.