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

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

The 2025 overtime tax rules do affect you as an employer of caregivers. Even though the tax deduction goes to your employees, you have new tracking and reporting duties that start with 2026 W-2 forms.

Under the current law, employees can deduct a capped amount of qualifying overtime pay from their federal income taxes. This deduction runs through 2028. The intent is to give workers who regularly earn overtime some tax relief. For your caregivers who work overtime shifts, this could mean a meaningful tax benefit on their personal returns.

Your responsibility as the employer is to track qualifying overtime hours and wages precisely and report them on W-2 forms starting with the 2026 tax year. The IRS needs this information to verify that employees are claiming the deduction correctly. If your records are incomplete or inaccurate, your employees may not be able to claim their full deduction, and you could face questions about your reporting.

This matters more for home care agencies than for many other businesses. Caregiving work often involves overtime. Extended shifts, overnight stays, weekend coverage, and short-notice scheduling can easily push caregivers past 40 hours in a week. Our payroll system setup and training configures your system to track overtime properly from day one, so you’re not scrambling before the 2026 forms are due.

The records now serve two purposes. You need them to pay employees correctly and stay compliant with wage laws. You also need them for the new W-2 reporting requirement. Getting the tracking right from the start is easier than trying to reconstruct hours at the end of the year. This is one area where bookkeeping for medical businesses connects directly to payroll and tax compliance.

A properly configured payroll system can build this tracking in automatically. When overtime hours are flagged and recorded at the time they’re worked, the data is there when you need it for reporting. If your current setup doesn’t capture overtime cleanly, now is a good time to fix that before the new reporting requirements take effect.

Note that the specific rules around qualifying overtime, deduction caps, and reporting formats may be updated by the IRS as implementation continues. Verify the current requirements with your accountant or payroll provider.

If you have questions about how this affects your agency or want help setting up your payroll to handle the new requirements, book a consultation to talk it through.

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More Questions

What should an hour of care actually cost me to deliver?

An hour of care costs far more than the caregiver's wage. Add employer payroll taxes, workers comp, travel time, training, and unbilled gaps, and the fully loaded cost can run 30 to 50 percent above the wage itself.

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Am I supposed to collect sales tax at my spa?

Probably yes, at least on retail products. Services like injectables are typically exempt, but skincare, supplements, and take-home products are usually taxable. The rules vary by state, and uncollected tax becomes your personal liability.

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What does your payroll setup include for an agency with hourly caregivers?

The setup includes a fully configured payroll system, typically Gusto, with overtime handling, correct withholdings and tax filings for your state, employee records, and the reporting your books need. You also get hands-on training so you or your admin can run payroll confidently going forward.

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Where do caregiver overtime rules stand right now?

The federal rules are in flux. The DOL has proposed reinstating the companionship exemption for agencies, but the change is not final and many states require overtime regardless. The safe approach is to budget and pay as if overtime applies.

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I have a feeling my old returns left money on the table. Is it recoverable?

A prior-return review sometimes finds missed deductions, credits, or elections that can be recovered through amended returns filed within about three years of the original deadline. Beyond that window, any findings become forward-looking fixes rather than refunds.

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How should injectables be handled in my books?

Injectables are inventory, not an expense at purchase. Record them as an asset when they arrive, then move cost to expense as units are used on clients. This approach shows you true cost per treatment and surfaces waste.

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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.

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