Regarding federal income tax: A private-duty nurse working in the patient's home is generally considered a household employee, not an independent contractor or self-employed. Your employer is the person you are caring for instead of the agency. If the patient pays you $2,800 or more in 2025 she must pay Social Security and Medicare taxes, and she can withhold your share of the Social Security and Medicare taxes from your pay, just like any other employer that you work for. She must also give you a W-2 at the end of the year. You would enter the W-2 in your tax return, the same as a W-2 from any other employer. You would not pay self-employment tax. The amount of tax that you would pay would be the same as if you earned the same amount at any other job where you get a W-2.
Since you do not have to pay any additional tax as a household employee, it seems to me that a fair hourly rate would be the same amount that the agency would pay you for the same work. But that's just my opinion. I'm not an authority on compensation for nurses, and there may be other considerations that I am not aware of. As I said earlier, we can help you with your tax return, but we cannot advise you about your pay.
