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In some cases, a nanny's employment is handled through a nanny agency. Nanny agencies may be responsible for issuing paychecks to their nannies. In this case, the families are responsible for paying the nanny agencies. Then, the agencies are responsible for paying the nanny payroll tax. However, if you do not pay a nanny agency directly for your nanny, you are responsible for paying nanny taxes, including Social Security, Medicare, federal unemployment, and state employment and disability.