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First of all, whenever you ask the IRS "Is this person an employee or a contractor?" The IRS will almost answer "The person is an employee". That being said, there are a lot of factors here that would tend to indicate that you are all set. First off, it sounds like the Nursing Home is paying her from their payables. So I would expect the Nursing Home to be responsible for issuing a 1099. But they are really on the hook for this.
Now I can expect you would call up the Nursing Home and say "are you sending her a 1099?" and the silence at the other end of the line.
Domestic employees and household help are normally for people that work at your home.
This person works at a business.
Here are what I think are your options:
1. Do nothing and sleep well.
2. Issue her a 1099 if you verify the Nursing Home isn't. YOu would need her name, address and SSN.
All of her personal aid expenses should be a deductible medical cost.
Let me know if you have any questions or comments.
I understood what the nursing home was doing. And I can appreciate why they would argue that "they are just the middle man" and will not be issuing a 1099. Frankly, that's an argument that many intermediaries would make. I think the IRS would see it differently.
My point is that it would not be unreasonable for somebody in your situation to assume that the "Nursing Home was handling it", but you are being particularly diligent.
You are looking for Form 1099-MISC, there are number of sites on the internet where you can prepare, print and e-file a 1099-MISC for a fee. I think they still have the blank form at Staples.
I assume you were paying the aid from her funds, and she was claiming the deduction. My bad.