I found this
"Babysitter (and nanny) tax time
If you paid more than $600 to any one nanny or babysitter this year, you're required by the IRS to report their wages and you may have to pay payroll taxes on their behalf, as well. Either way, you are going to need their social security number and home address, so go ahead and get that now. The question of the day is, are you an employer or a customer of your care provider? There are a couple of questions the IRS considers. First, is the work performed in your home? If all the care takes place under your roof, you're probably going to be considered an employer. Second, assuming that the care takes place outside of your home (in a nanny share, or in the babysitter's home), do you "control not only the work they do but how they do it"? If you do, you are an employer. You might not be an employer if, for instance, you have a nanny share outside your home where the nanny makes her own "lesson plans" and decides when to feed your child, whether to wash the dishes, etc. In this case, your nanny might be the employee of the primary parent (the one whose home in which the care is given), but would not be your employee. Another instance would be a stay-at-home mom who cared for a few other children in her own home. You might be able to get away with calling yourself a customer of your child's caregiver if the care was provided in your home, but your headstrong nanny told you at the beginning how things were going to work. Are you an employer? You may have to pay federal unemployment taxes, medicare and social security on behalf of your employee (you can choose to withhold your employee's portion, or pay it yourself if you're especially generous - or if you didn't think of this until after the wages were paid. Whoops.). Unless your employee is your spouse, child (under 21) or parent, or under 18, you have to pay social security and medicare taxes to the tune of 15.3% of the total wages. If you're withholding, you can withhold 7.65%. If the wages were over $1,000 for the year, and the employee is not your spouse, parent, or child under 21, you have to pay 0.8% of the total cash wages as federal unemployment tax, up to $7,000 of wages. If you have an employee, you need an EIN. You need to obtain one by January 31 of the year following the payment of wages (if you paid wages in 2004, you'll need one by January 31, 2005). You can obtain the EIN by calling 800-829-4933; by submitting a form; or you can apply online. Once you have an EIN, you'll need to submit a W-2 reporting your employee's wages. The form is here, but it's printed with special ink; you'll need to pick one up from a local accountant or order one from the IRS at 800-829-3676. You have to submit one page to the SSA by February 28 along with form W-3. If you're filing electronically, you have until the end of March. The employee's copies are due to the employee "generally by January 31." If you have determined your provider is not an employee, you'll have to submit form 1096. Like the W-2, this is printed with special inks and will have to be requested from 800-829-3676. Also, it is due by February 28 to the government, and as early as possible to your provider. For some reason, I haven't been able to find verification of this on the IRS web site, but an accountant friend told me this is what to do. Oh, and you DO put an "x" in the box, "if this is your final return, put an x here." Now that you've taken care of your care provider, it's time to take care of yourself. In most cases, you'll be able to deduct the child care expenses up to a limit (the worksheet on the form instructions will tell you how much). The form you need: 2441. Attach this to your 1040, enter your child care tax credit on line 47, and watch your refunds roll in. If you're an employer, you'll need to fill out and file Schedule H with your 1040, as well. What if you are the stay-at-home parent I referred to above? You're probably self-employed. If so, read on for more info."
I also found this pdf:
OrganizedWisdom Health - Human Powered Health Search
which focuses more on elder care and tax breaks to offset the taxes