Bookkeeping and tax for medical businesses • Personal tax returns for individuals

Call or Text: (312) 772-3170

Where do caregiver overtime rules stand right now?

The short answer is that the federal rules are in flux. The Department of Labor has proposed reinstating the companionship services exemption for third-party employers like home care agencies. Enforcement of the 2015 rule that eliminated this exemption has been suspended while the proposal moves forward. But the change is not final, and private lawsuits under the current law can still proceed even while enforcement is paused.

What makes this complicated is that many states have their own overtime requirements for caregivers. California, New York, Massachusetts, and others require overtime for home care workers under state law regardless of what happens at the federal level. If your state mandates overtime, you pay overtime no matter what the DOL decides. Federal rules set the floor, not the ceiling.

For home care agencies trying to plan around this uncertainty, the practical approach is to budget and run payroll as if overtime applies. If the exemption comes back and your state allows it, you will see some cost relief. If the exemption does not materialize or your state requires overtime anyway, you are already paying correctly. The risk of underpaying and facing back wages, penalties, and legal fees is much higher than the cost of paying overtime now.

This is where clean books matter. Labor cost is the biggest line item in this business, and you need to see overtime broken out clearly rather than lumped into a general wages figure. When you evaluate profitability by client or decide whether to adjust rates, you need the real numbers. Medical practice accounting built for this industry keeps those figures visible so you can make decisions based on actual costs, not approximations.

The rules I have described here should be verified with current sources. Talk to an employment attorney about your state’s specific requirements before changing how you pay caregivers. Hunter Green CPA handles the bookkeeping and keeps your labor costs accurate in the books, but we do not provide legal advice on employment matters.

If you want to make sure your books are showing the true cost of caregiver labor, reach out to book a consultation.

Your Trusted CPA

Next Step:
A Short Conversation

Tell us about your business and what you need help with. We'll ask a few questions, explain how we can help, and tell you exactly what it will cost.

More Questions

What deductions do medical business owners commonly miss?

Medical business owners often miss vehicle and mileage expenses, continuing education costs, professional insurance premiums, and retirement contributions. The common thread is poor documentation throughout the year.

Read answer

Everyone in home care argues about 1099 versus W-2 caregivers. What is the truth right now?

Hourly caregivers whose schedules and work an agency controls generally look like employees under the classification tests that matter. The cost of misclassification is severe, including back wages, penalties, and potential personal liability for agency owners.

Read answer

Do you take over my bills and invoicing if I want that too?

Yes. Hunter Green CPA offers accounts payable and accounts receivable as add-on services starting at $100 per month each. Bills get tracked and paid on time, invoices go out promptly, and everything is recorded in your books.

Read answer

Gift cards, series discounts, GLP-1 program fees: how does all this get booked?

Gift cards, prepaid packages, and recurring program fees are all recorded as liabilities when cash is received, not as revenue. Revenue is recognized when services are actually delivered, keeping your books accurate and your margins visible.

Read answer

I financed a $120,000 device. How does it hit my taxes and my cash?

You can likely deduct most or all of the device cost in year one even though you financed it, thanks to Section 179 and bonus depreciation. But your monthly payments continue for years regardless of that deduction, creating a mismatch between your tax bill and your cash flow.

Read answer

Do the new overtime tax rules affect me as an employer of caregivers?

Yes, you have new reporting duties starting with 2026 W-2 forms. The law allows employees to deduct qualifying overtime pay, but employers must track and report that overtime precisely.

Read answer

Hunter Green CPA provides bookkeeping, tax preparation, and tax strategy for medical business owners across the United States. Alongside its business services, the firm prepares personal tax returns for individuals and families. Based in Oak Park, Illinois and led by Mason Hunter, a CPA with 10 years of tax experience and a background in corporate tax management.

  • Forest Park Chamber of Commerce & Development member badge
  • Oak Park-River Forest Chamber of Commerce member badge
  • Better Business Bureau badge

© 2026 Hunter Green CPA