Who this covers
- 1099 travel and contract nurses paid by an agency per contract, often across several agencies in a year.
- CRNAs and locum tenens physicians invoicing facilities or locum companies, frequently through a single-member LLC or S-corp.
- Per-diem and PRN clinicians picking up shifts at multiple hospitals and surgery centers, paid on 1099.
- Therapists, counselors and dietitians in private practice or contracted to group practices, with client and insurance deposits.
- Dental hygienists, sonographers and other specialists working temp or contract assignments through platforms and agencies.
Why the tax return works against you
A contract clinician's Schedule C carries licensing in multiple states, CEUs, malpractice insurance, travel and housing between assignments, scrubs and equipment, a home office and the self-employment tax deduction — and, for anyone organized as an S-corp, a deliberately modest salary. The net that reaches a bank underwriter is a fraction of the deposits. Two-year averaging then punishes anyone who moved from staff to contract and doubled their income.
How healthcare-contractor deposits are read
- Agency changes do not matter. Deposits from four agencies in 12 months are read together. Nobody calls an agency.
- Gaps between contracts are visible in context. Two weeks off between a 13-week contract and the next is a normal pattern on 12 months of history, not a red flag.
- Locum invoices paid net-30 or later arrive as deposits when they arrive; the timing is read as it happened.
- Practice owners qualify on the practice's operating account, including insurance reimbursements and patient payments, not on the salary or K-1.
- Deposits are not credited dollar-for-dollar. An expense factor is applied to arrive at qualifying income; it depends on the file, so a soft-pull conversation is the way to a real number.
A note for W-2 travelers with stipends
Many travel nurses are W-2 employees of the agency with tax-free housing and meal stipends that never appear in taxable wages — so the W-2 understates what actually arrived. That is a mixed-income file rather than a pure 1099 one, and it is handled differently; the 1099 plus W-2 page explains how. Say which you are at the start.
Common questions
I've worked for four agencies this year. Is that a problem?
No. Twelve months of deposits from all of them are read together. No agency is contacted.
I'm a CRNA billing through an S-corp. Which account do you read?
The one that receives your locum or facility payments — the business account — not the salary you pay yourself.
I'm a W-2 traveler with big tax-free stipends. Does that count?
That is a mixed-income file and it is handled differently from a pure 1099 file. Tell us at the start; the stipend deposits are part of the picture.
I'm on assignment in another state. Can I still close?
Yes. Everything is electronic. The property has to be in one of the 30 states; you can be anywhere.