When you compare home care options, one distinction rarely makes the brochure but changes everything: whether caregivers are W-2 employees or 1099 independent contractors. It sounds like an accounting footnote. It’s actually about who is responsible when something goes wrong.
Whether a caregiver is a W-2 employee or a 1099 contractor decides who carries the liability, taxes, supervision, and insurance — the agency, or your family.
What the labels actually mean
A W-2 caregiver is an employee of the agency. The agency withholds taxes, carries workers’ compensation and liability insurance, runs background checks, and provides RN supervision. A 1099 caregiver is an independent contractor — cheaper on paper, because many of those protections simply don’t exist, and the responsibility quietly shifts to you.
The risk families don’t see coming
If a 1099 contractor is injured in your parent's home, your family may be liable — a risk a W-2 agency absorbs through workers' compensation coverage.
Picture a caregiver who strains their back transferring your father, or is hurt on the stairs. With a 1099 arrangement and no employer carrying workers’ comp, the injured worker may look to the household. Hiring through an agency with W-2 caregivers moves that exposure off your family entirely.
Oversight and continuity
W-2 employment is what makes supervision and continuity possible — an agency can train, oversee, and direct an employee in ways it cannot a contractor.
Employment is also what makes a named-caregiver model work. An agency can train, schedule, and supervise an employee, and coordinate the care directly. It cannot lawfully direct a contractor that way, which is why 1099 arrangements so often leave families managing the logistics themselves.
The Maryland rule most agencies skirt
Maryland requires personal-care workers to be supervised employees, not contractors — a rule many agencies quietly ignore and EagleWings follows without exception.
Maryland’s Residential Service Agency framework requires personal-care staff to be employees working under RN supervision. It’s a rule that exists to protect clients — and one that plenty of agencies skirt to cut costs.
Want to know exactly who will be in your parent’s home, and who’s accountable for them? A free RN assessment is where those questions get straight answers.