Caregiver Agreement

A caregiver agreement documents a private or family caregiving arrangement by defining the care recipient, responsible payer or household, caregiver, authorized services, schedule, compensation, expenses, housing, records, authority limits, and transition plan.

A useful document turns the parties' actual arrangement into measurable duties, approvals, timing, remedies, and a reliable execution record. Its terms should be reconciled to the transaction rather than copied from an unrelated form.

• An adult pays a child, sibling, other relative, friend, or privately hired aide to provide recurring personal care, supervision, companionship, transportation, meals, or household support
• Several relatives contribute money or coordinate shifts and need one written allocation of employer, payer, scheduling, approval, reporting, and backup responsibilities
• A live-in caregiver and household need to distinguish working time from genuine off-duty time and separately define room, meals, utilities, privacy, guests, and move-out arrangements
• A participant-directed Medicaid or other public program permits a family or household member to be paid and the parties need an agreement that conforms to the approved plan of care, authorized hours, fiscal intermediary, and program rules

The document name alone does not determine the right structure. Consider a different instrument or qualified legal review when any of these conditions applies:

• Do not use a family agreement to label a caregiver an independent contractor, volunteer, companion, or exempt live-in worker when the actual relationship and governing federal, state, or local law produce a different classification or wage result.
• Do not use it to authorize nursing, medication administration, medical procedures, diagnosis, treatment decisions, restraint, transport, financial transactions, or other licensed or delegated acts beyond the caregiver's qualifications and applicable law.
• Do not treat the agreement as a health-care power of attorney, advance directive, HIPAA authorization, financial power of attorney, guardianship order, representative-payee appointment, or permission to sign for the care recipient.
• Do not backdate, inflate, prepay, or loosely describe services to justify an asset transfer, change an inheritance, qualify for Medicaid or another benefit, or convert earlier unpaid family help into a debt; agencies and courts apply their own eligibility, fair-market-value, capacity, fraud, probate, and estate-recovery rules.
• Do not rely on a private agreement where immediate safety, abuse, neglect, exploitation, capacity, family coercion, or emergency-care concerns require a clinician, mandated reporter, Adult Protective Services, emergency service, court, program administrator, or other qualified authority.

Record exact facts before clauses are written. Names, authority, dates, amounts, defined terms, dependencies, and incorporated materials should be verifiable and consistent.

• Care recipient, caregiver, contracting party, payer, household members, emergency contacts, family relationship, addresses, capacity, signing authority, and any agency, fiscal intermediary, insurer, guardian, agent, trustee, representative payee, or public program involved
• Care assessment and care plan; permitted assistance with activities of daily living and instrumental activities; companionship, supervision, meals, household tasks, transportation, errands, appointment support, and explicit excluded, licensed, or clinically delegated tasks
• Regular workweek, shift start and end times, on-call or waiting periods, overnight duties, travel, meal and sleep periods, uninterrupted off-duty time, breaks, substitutions, absences, backup coverage, schedule changes, and the method for approving additional hours
• Hourly or other lawful pay basis, regular and overtime rates, pay period, payroll method, taxes, required deductions, paid leave or other benefits, workers' compensation and unemployment coverage, public-program rates and hour caps, and which person or entity is the employer
• Mileage, supplies, meals, admission fees, purchases for the care recipient, cash limits, reimbursement rules, receipts, advance approval, prohibited commingling, and whether the caregiver has any separate financial authority
• If the caregiver lives in the home, the private room and shared areas, meals and utilities, lawful valuation or payroll treatment, privacy, visitors, keys, accessibility, property use, insurance, separate tenancy status, and an orderly move-out process
• Health conditions and preferences disclosed with consent, allergies, medication-assistance boundaries, provider contacts, emergency instructions, release-of-information documents, incident reporting, daily care notes, time and wage records, expense records, record access, confidentiality, retention, and secure return or destruction
• Existing will, trust, power of attorney, advance directive, guardianship, benefit eligibility, Medicaid or other long-term-care application, estate plan, expected gifts or inheritance, family contributions, conflicts of interest, prior unpaid care, and any contemplated transfer of money or property

These decisions shape the allocation of responsibility and should not be left for boilerplate to decide:

• Who is the employer and payer in fact, whether another family member, agency, state program, or fiscal intermediary may be a joint employer, and whether the relationship is employment, qualifying program-paid family care, or genuinely independent services under each applicable test
• Which tasks the caregiver may perform safely and lawfully, which require a licensed professional or documented delegation, and where assistance with medication, transport, finances, health information, and emergencies begins and ends
• What schedule and backup plan match the care recipient's assessed needs, how all actual work and interruptions will be recorded, and how minimum wage, overtime, travel, waiting, overnight, leave, and state or local domestic-worker rules affect cost
• Whether the caregiver will live in the home, whether occupancy is compensation or a separate housing arrangement, which time is truly duty-free, and what lawful process applies if caregiving or occupancy ends
• Which expenses may be incurred, who approves them, how funds remain separate, who reviews receipts and accounts, and what gift, loan, beneficiary, inheritance, or self-dealing boundaries reduce exploitation and family-conflict risk
• Whether and through which separate instrument the caregiver may receive health information or make health or financial decisions, and how the agreement will respect the care recipient's current choices and any existing agent, guardian, trustee, or representative payee
• How prospective duties, frequency, duration, pay, market-rate support, and completed services will be documented if Medicaid, SSI, a participant-directed program, tax treatment, probate, estate recovery, or a later family dispute may examine the arrangement
• Which relatives receive agreed reports, who can approve changes without overriding the care recipient, how concerns are raised without retaliation, and what neutral review, mediation, protective-service referral, termination, and replacement-care path applies

• Parties, family relationship, care recipient's informed participation and preferences, employer and payer identification, effective date, term, work location, governing care plan, and a statement that family status does not displace applicable worker protections
• Task-level scope distinguishing personal and household assistance from licensed, medically related, delegated, financial, legal, or prohibited acts, with competency, training, supervision, emergency escalation, and no-guarantee-of-outcome language
• Workweek, regular shifts, standby and waiting time, travel, overnight calls, sleep and meal periods, complete off-duty time, changes, substitutions, backup coverage, and contemporaneous recording of all time actually worked
• Compensation, regular and overtime calculation, minimum-wage compliance, paydays, payroll taxes and forms, authorized deductions, lawful treatment of lodging or meals, leave and benefits, program reimbursement, and correction of underpayments or record discrepancies
• Expense budget, mileage and purchase authorization, receipt and reimbursement process, ownership and return of purchased property, prohibition on commingling or personal use, and separate controls for any power to handle funds
• Live-in housing terms covering room, shared areas, meals, utilities, privacy, household rules, access, safety, guests, insurance, property damage, whether a separate tenancy exists, and notice and transition when either care or occupancy ends
• Care-recipient consent, dignity, privacy, choice, communication, access to family and professionals, complaint freedom, nondiscrimination, safeguarding, conflicts, gifts and loans, self-dealing, abuse or exploitation reporting, and nonretaliation
• Limited access to health information and records, acknowledgment that the agreement grants no treatment or financial decision power, cross-reference to any separate valid authorization or appointment, medication and emergency boundaries, care and incident logs, confidentiality, cybersecurity, and records handoff
• Monitoring and periodic care-plan review, family contacts and information-sharing permissions, invoice and record review, material-change notice, performance concerns, facilitated family meeting or mediation where safe, suspension for safety, termination, final pay and expenses, replacement care, move-out, and survival of record and confidentiality duties
• No promise of Medicaid, tax, benefit, probate, or estate result; disclosure and preservation of public-program documents; fair-market-value and prospective-services records; coordination with estate documents; severability; nonwaiver of mandatory rights; governing law; notices; amendments; signatures; and independent review opportunities

Every provision should use the same parties, dates, standards, defined terms, and document hierarchy. A clause that is reasonable by itself can still create a conflict when it is not reconciled with payment, default, termination, or another exhibit.

1. 01Describe the intended result and the relationship in plain language.
2. 02Confirm parties, authority, governing jurisdiction, dates, money, property, services, and approvals.
3. 03Resolve the key decisions and identify every schedule, exhibit, disclosure, consent, or filing.
4. 04Draft the provisions as one consistent system, then review the complete execution set before signature.

A signature cannot make family caregiving exempt from employment law or make a transfer fair market value. The actual control, employer structure, duties, location, hours, live-in facts, public-program plan, and federal, state, and local rules govern classification, wages, payroll, leave, insurance, and recordkeeping. Vague round-the-clock expectations create unpaid-time and safety risk; room and meals can create separate wage, tax, tenant, and eviction issues. A care agreement also does not give the caregiver medical, HIPAA, banking, fiduciary, guardianship, or estate authority. Payments, housing, gifts, asset transfers, beneficiary changes, and promised inheritance may affect benefits, Medicaid transfer review, probate claims, taxes, or estate recovery and can intensify conflict or exploitation concerns, particularly if capacity, market rate, prospective terms, service records, or independent review are weak. Program, licensing, mandated-reporting, elder-abuse, domestic-worker, and health-care rules vary materially by jurisdiction and facts.

The main agreement may establish the framework while schedules, exhibits, disclosures, consents, or operational records supply transaction-specific details.

• Current care assessment, physician or clinician instructions where appropriate, program-approved plan of care, task and exclusion schedule, weekly schedule, backup-care plan, emergency contacts, and evacuation or safety plan
• Time sheets, shift and overnight-interruption logs, wage calculations, pay stubs, payroll tax and employment-eligibility records, leave records, and any state domestic-worker notices or employment forms
• Expense policy, mileage log, receipts, reimbursement ledger, spending authorization, inventory of purchased items, and a separate accounting for any funds the caregiver is legally authorized to handle
• Room and shared-space schedule, household rules, property inventory, insurance information, and any separate lease, occupancy agreement, lawful lodging valuation, or required housing notice
• Health-care power of attorney or proxy, advance directive, HIPAA or provider release, financial power of attorney, guardianship order, representative-payee appointment, and caregiver acknowledgment, but only where separately valid and applicable
• Licenses, certifications, background or registry checks where lawful, training records, driving record and insurance, vaccination or screening records where required, workers' compensation policy, and agency or fiscal-intermediary materials
• Medicaid or other benefit correspondence, eligibility and renewal submissions, approved service hours and rates, fair-market-rate support, prior-care history, estate-plan excerpts relevant to payment or housing, family contribution ledger, conflict disclosures, and independent professional review notes

Each incorporated document should be identified precisely, use the same names and effective date, and follow a stated order of precedence if terms conflict.

Before work begins, confirm capacity and authority, identify the real employer and funding program, reconcile the agreement with the assessed care plan and every separate power or directive, verify worker eligibility and qualifications, select a lawful pay and payroll process, and document the basis for duties, rates, housing, and expected hours. Sign prospectively; give each party and any authorized program administrator a copy; keep contemporaneous time, wage, care, incident, expense, and reimbursement records; separate the care recipient's funds; and review the plan after hospitalization, functional change, schedule drift, a move, a new agent, or a benefit or program change. Do not backdate or promise a legal, tax, Medicaid, probate, or estate result. NOMOS provides drafting information, not legal, tax, employment, medical, benefits, fiduciary, housing, or estate-planning advice, and does not determine capacity, authority, classification, fair market value, eligibility, or required reporting.

• Confirm legal names, roles, capacity, addresses, and signing authority
• Reconcile dates, amounts, definitions, cross-references, schedules, and exhibits
• Confirm that duties, deadlines, approvals, acceptance standards, and payment triggers are measurable
• Check that default, termination, remedies, and surviving obligations work together
• Complete jurisdiction-specific forms, notices, witnesses, notarization, filings, or professional review when applicable
• Deliver and preserve the complete signed package with its incorporated documents

These sources provide federal, state-resource, regulatory, or institutional context. They do not replace checking the law and required forms applicable to the parties, transaction, and governing jurisdiction.

1. Source 1

   Fact Sheet: Application of the Fair Labor Standards Act to Domestic Service, Final Rule

   U.S. Department of Labor, Wage and Hour Division. Official federal guidance on domestic-service coverage and the current companionship and live-in exemptions, including limits for care and medically related services, household work for others, third-party employers, sleep and off-duty time, and the need to record actual hours.

2. Source 2

   Application of the Fair Labor Standards Act to Direct Care Workers

   U.S. Department of Labor, Wage and Hour Division. Official DOL rulemaking page describing the department's 2025 proposal to revise the federal companionship-services and live-in domestic-service regulations and linking the federal docket. The proposal underscores the need to check the effective regulation and current agency guidance when an agreement is used rather than treating an older summary as permanent.

3. Source 3

   Fact Sheet #79B: Live-in Domestic Service Workers Under the Fair Labor Standards Act (FLSA)

   U.S. Department of Labor, Wage and Hour Division. Official guidance explaining when a domestic-service worker is considered live-in, the present federal minimum-wage and overtime framework, reasonable agreements addressing bona fide meal, sleep, and off-duty time, the duty to pay for interruptions and all hours actually worked, and the need to revise an agreement that no longer matches actual hours.

4. Source 4

   Fact Sheet #79C: Recordkeeping Requirements for Individuals, Families, or Households Who Employ Domestic Service Workers Under the Fair Labor Standards Act (FLSA)

   U.S. Department of Labor, Wage and Hour Division. Official guidance describing employer responsibility for domestic-service employee records, including identifying and wage information, hours worked each day and week, total wages, claimed lodging or facility amounts, and overtime, while allowing the worker to submit the underlying time record.

5. Source 5

   Fact Sheet #79F: Paid Family or Household Members in Certain Medicaid-Funded and Certain Other Publicly Funded Programs Offering Home Care Services Under the Fair Labor Standards Act (FLSA)

   U.S. Department of Labor, Wage and Hour Division. Official guidance explaining that a family member can be an employee, and describing the limited circumstances in certain publicly funded home-care programs where a reasonable, program-approved plan of care can distinguish paid services from preexisting family support without permitting unequal treatment because the provider is related to the consumer.

6. Source 6

   Publication 926 (2026), Household Employer's Tax Guide

   Internal Revenue Service. Current official federal tax guidance for determining whether a household worker is an employee, completing work-eligibility and employer steps, handling Social Security, Medicare, FUTA and income-tax withholding rules, and filing Schedule H and wage forms for covered household employees.

7. Source 7

   Personal Representatives

   U.S. Department of Health and Human Services, Office for Civil Rights. Official HIPAA guidance explaining that a personal representative's status and scope derive from authority under applicable law to make health-care decisions, that limited authority produces correspondingly limited access, and that an involved family member may receive some information without automatically becoming the individual's personal representative.

8. Source 8

   POMS SI 01150.005 — Determining Fair Market Value

   Social Security Administration. Official SSA operational policy illustrating how an agency may evaluate services offered as compensation for a resource transfer, including the agreement and expectations when made, a knowledgeable-source check of market value, and documentation of the services' type, frequency, and duration. Medicaid and other programs apply their own governing rules.

9. Source 9

   Estate Recovery

   Centers for Medicare & Medicaid Services. Official federal overview of state Medicaid estate-recovery obligations for specified long-term-care and related services, optional broader recovery, limits involving certain surviving family members, trust recovery, liens, and required undue-hardship procedures.

10. Source 10

    What is a fiduciary?

    Consumer Financial Protection Bureau. Official consumer guidance distinguishing a financial caregiver appointed under a power of attorney, guardianship, trust, representative-payee arrangement, or VA appointment and emphasizing acting in the person's interest, careful management, separation of funds, and complete records.