Industries
Tax and compliance for healthcare staffing agencies.
Travel nurse, allied health, locum tenens and per diem staffing firms face stipend rules, clinician classification and payroll obligations in every state where they place staff. We set up the programs, run multi-state compliance and defend audits.
Issues we solve
Where we focus in healthcare staffing
Every industry has its own tax rules, reporting requirements and cost pressures. These are the ones our advisors see most often.
Speak with an advisor- Per diem and travel stipendsAccountable plans, tax home documentation and wage recharacterization risk for travel nurse and allied staffing.
- Worker classificationW-2 versus 1099 for nurses, therapists, home health aides, locum tenens physicians and PRN staff, under IRS, DOL and state rules.
- Multi-state registrationWithholding, unemployment insurance, foreign qualification and income tax nexus in each state where clinicians work.
- Employment tax auditsIRS and state payroll audits of staffing agencies and home health providers.
- State taxes on staffing servicesSales and gross receipts taxes that some states apply to temporary staffing.
- Facility contracts and cash flowRevenue recognition, receivables financing and audited financial statements for lenders and health systems.
- Owner compensation and entity choiceS corporation salary, distributions and multi-entity structures.
- Buying or selling an agencyQuality of earnings, working capital and payroll tax diligence.
Services for this industry
Where we usually start.
Business Tax
Tax planning and compliance for mid-size businesses: S corporations, partnerships, C corporations, multi-state nexus, sales and use tax and entity structuring.
Learn moreTax controversyIRS Audit Representation
CPA representation for IRS and state tax audits, appeals, collections and penalty abatement.
Learn moreAssuranceAudit & Assurance
Independent financial statement audits, reviews, compilations and employee benefit plan (401(k)) audits for private companies, government contractors and nonprofits.
Learn moreTransactionsMergers & Acquisitions
Buy-side and sell-side financial due diligence, quality of earnings (QoE) reports, net working capital analysis, tax due diligence and business valuations for middle-market transactions.
Learn moreGuides for healthcare staffing companies
Detailed rules and recent court cases.
Per Diem Tax Rules for Healthcare Staffing Companies
Per diem and housing stipend compliance for healthcare staffing companies that place travel nurses and allied staff: accountable plans, tax home verification, wage recharacterization risk, 2026-27 IRS rates and the court cases that shape IRS audits.
Learn moreEmployment tax1099 vs W-2 Worker Classification: Rules, Audits and Court Cases
Independent contractor or employee? IRS common-law test, Section 530 relief, the Voluntary Classification Settlement Program, Virginia misclassification penalties, the 2026 DOL proposal, and recent Tax Court cases, with audit defense for businesses.
Learn moreIndustryCPA and Tax Advisors for IT Staffing and Software Development Companies
Tax and compliance advisory for IT staffing, consulting and software development companies: multi-state payroll registration, state income and sales tax nexus, remote employees, H-1B and C2C contractors, worker classification and R&D credits.
Learn moreQuestions
Healthcare staffing FAQ
If your question isn't here, call (703) 880-8412 and you'll reach a person.
Do you work with healthcare staffing agencies?
Yes. We advise staffing companies that place travel nurses, therapists, allied health and locum tenens clinicians on per diem and stipend programs, worker classification, multi-state payroll and IRS or state payroll audits.
Can our nurses or therapists be paid as 1099 contractors?
Only if they truly operate independently. When the agency sets schedules and rates, can remove the clinician and the work is its core business, the IRS and courts usually find employment, as the Tax Court did for a home health agency's nurses in Pediatric Impressions Home Health (2022). Virginia also presumes paid workers are employees.
Are travel nurse housing and meal stipends tax-free?
Only when the clinician is away from a genuine tax home on a temporary assignment and the agency pays under an accountable plan. Stipends that replace pay or go to local clinicians are taxable wages.
Do we need to register in every state where clinicians work?
Generally yes. Most states require withholding and unemployment insurance accounts when an employee works there, and placements usually create income tax nexus because staffing is a service.
Are staffing services subject to sales tax?
In some states. A few states tax temporary staffing or treat it based on the service performed, so taxability needs to be checked state by state.
Staffing and IT companies
Multi-state payroll, nexus and classification.
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