Staying regional as a traveling healthcare worker is not always easy — but it is absolutely not impossible. In this article you’ll have the tools to better understand how to do it from someone who has actually done it, and done it for four years.
We all have our own reasons for traveling. Maybe you’re looking to increase your salary. Maybe you want to get paid to see new places. Or maybe you’re like I was — wanting all of the above without feeling stuck in one place.
I don’t know what it is in my brain, but staying in one location for more than a year always gives me cabin fever. I’ve worked and lived in the Northwest my entire life. I’ve been to other states for vacations and work, but I always found myself wanting to come back home. I wanted to stay close to family and friends and didn’t want to feel like I had to give up being a part of their lives just because I was trying to improve my own.
Sound familiar? Then keep reading — because I’m going to break down exactly how I made it work.
The 50-Mile Myth
There is a common trope in healthcare traveling that you have to live at least 50 miles away from a facility to get a contract. Your recruiter will tell you this. Other travelers will tell you this. And the problem is this:
It doesn’t exist. It’s made up by the industry.
If you’re a veteran traveler reading this, your eyes probably just widened. “What? How? Why?” The reason is simple — the 50-mile rule is just what healthcare industry lawyers have defaulted to in order to make sure workers don’t violate tax laws. It’s a company policy, not a federal law.
Let’s talk about that for a second and talk about everyone’s favorite uncle — Sam. You know how it goes. You love him one month out of the year and silently disdain him the rest. And if you’re unfortunate enough to have a three-letter agency working for him 12 months out of the year, well, you know the feeling.
Here’s what the IRS has actually determined: in order to be considered tax-deferred, a healthcare worker must be able to prove that a contract is “unreasonable to commute back and forth and would otherwise require rest and sleep before going back and forth from one’s current legal residency.”
Notice something? Nothing about mileage. Nothing about 50 miles versus 60 miles versus kilometers. The IRS cares about whether your commute is reasonable — not whether you hit some magic number on the odometer.
Now, before you fire off a text to your recruiter, keep in mind that they are just as in the dark on this as most of us. They will continue to default to their company’s 50-mile policy despite your newfound knowledge. That’s their job — to follow company guidelines.
So how do we work within the system and still stay close to home? That’s exactly what we’re going to cover.
1. Work With Multiple Agencies
This seems like a weird place to start, but hear me out — because I’ve noticed that both new and veteran travelers don’t always understand this.
Sometimes hospitals have exclusive contracts with certain agencies. And there’s this weird cultural thing in healthcare traveling where once you sign with one agency, you feel like you’re bound to them forever. This is the worst thing you could do for your career.
You’re a contractor now. You need to start thinking of yourself as a business, not an employee. Apply to multiple agencies. Never bind yourself to just one.
Here’s why: if you’re waiting on Agency A to land you a gig, but the hospital decided in a boardroom meeting that Agency B has been giving them better rates and will handle all their staffing needs going forward — and you’re not working with Agency B — you’ll be sitting at home wondering why no jobs are coming through.
They are coming through. You’re just not in the room where those conversations are happening because you only signed up with one agency.
We always recommend applying to at least three to five agencies if you’re serious about staying regional. The more eyes you have on local contracts, the better your odds.
2. Understand the Address Game
Disclaimer: I am not telling you to move, lie, or break any laws. I am not advocating anything that could put you in financial risk, harm, or trouble with the federal government. Please use your own best judgment and consult your own tax professional and legal advisor for anything related to your personal situation.
Now, with that out of the way — let’s talk about the reality of how addresses work in this industry.
Remember that IRS definition? If the 50-mile question ever came up, it’s up to you to prove to the IRS — not your agency — that you had an unreasonable commute. Your agency is using the 50-mile buffer as their own legal safety net. But they will check, and they will hold you to that standard regardless of what the tax code actually says.
So let’s get into the world of hypotheticals.
In an ideal world, you’d live right at that 50-mile mark. I’ve been lucky enough to do this. Did my commute suck? Absolutely. But we’re traveling for a reason.
Now let’s say you live in what I call a “cluster zone” — an area with several hospitals all within 50 miles of your home base. That’s a great position to be in, but your agency is eventually going to ask: “What is your current address?”
You need an answer. And hypothetically, maybe you are in the process of relocating to a family member’s or friend’s house that falls outside that 50-mile zone. The agency doesn’t need the details of your living situation — only the IRS does, and only if they audit you to verify your tax-deferred payments are legitimate.
For example, if your job is in Portland, Oregon, but you currently live in Vancouver, Washington — a 15-minute drive across the bridge — but by the time the contract starts, you’ve planned to move to a family member’s place in Seattle, Washington, where your mail will be forwarded… hypothetically, that changes the equation.
I have never personally been asked to show a utility bill or lease by an agency, though it’s possible in some cases. If that happens, you can always adjust and say something like, “The move is still in progress — but are there any contracts available in this other area?” That way nobody feels like you’re trying to game the system.
And one more thing: if your recruiter is cool and you have a good relationship, sometimes they’ll use a different route calculation that works in your favor. I’ve had a recruiter use the long way around and it put me just over 50 miles. It happens.
3. Extend, Extend, Extend
If you’ve landed a local contract and the work is at least tolerable, extend it. This is one of the most underrated strategies for staying regional.
I made this mistake when I first started out. I thought the grass was greener. I figured I could easily pick up another local gig. Three months later, I was looking like Jack Nicholson from The Shining, “Here’s Johnny!”-ing every agency and hospital trying to find something close to home.
It was a financially costly lesson. I ended up with a decent mini-retirement, all things considered, but I should have just extended.
Here’s the reality: not every local hospital near you will be hiring just because your current contract is ending. You’re competing with other travelers. Maybe the traveler currently there changed their mind and decided to stay. Maybe the hospital looked at the budget last minute and decided to cancel the position before you even started. These things happen, and if you’re trying to stay regional, you need to hold onto what you’ve got for as long as you can.
There’s also an added benefit: it looks great for future contracts. Your next hospital will see that you stayed at your last assignment for a year and think, “They must be reliable.” That kind of track record opens doors.
4. Network Like Your Career Depends on It (Because It Does)
In this industry, it’s not just what you know — it’s who you know. And I cannot overstate how important this is. Networking is by far the most powerful tool you have for staying regional.
If you’re new to the industry, this one isn’t going to help you right away — but start building these connections from day one so you can use them down the road.
Here’s the thing: you can’t be in the room when a department is making hiring decisions. But your fellow travelers who are currently working there can be. They can give you insider knowledge on things like whether the department has budget to hire, how many positions they’re looking to fill, which agency the hospital prefers, how soon they need someone, and what specialties they’re looking for.
Many of my local gigs came directly from these insider connections. Someone I’d worked with would reach out and say, “Hey, they’re about to post a contract here — get your name in before it goes public.” That kind of lead time is everything when you’re trying to stay local.
I owe a lot to the people I’ve worked with over the years, and I’ve always tried to pay that forward to other travelers whenever I can. Do the same.
5. Search With Obsession
One thing I’ve never understood — whether it’s new travelers or veterans — is why people don’t look for contracts more aggressively. If you really want to stay regional, you need to be searching constantly. To the point where your recruiter is mentally asking, “Does this person ever sleep?”
When I was just ending or between contracts, checking for assignments was the first thing I did when I woke up. Brushing my teeth — I was checking. On break — checking. At lunch — checking. Warming up my car — checking. Commercials came on — time to check.
I checked every agency I was working with and every job board. Weekly, daily, and yes, hourly.
Here’s why: time is money, and speed is everything.
A hospital may receive 50 applications within a single hour for one position. If you think being at the bottom of that stack is going to get you the job, you need to check your expectations — because you’re going to be disappointed over and over again.
Put yourself in the hiring manager’s shoes. They already have a full-time job managing their department. Do they really want to comb through all 50 applications? No. They’re going to pull the first 10, maybe 20 if they have time, and pick the best candidate from that group.
If you’re not treating the job search like your new version of scrolling social media, you’re going to get shut out — and it’s going to be people like me and the thousands of other healthcare travelers who really wanted that spot who beat you to it.
6. The Professional Edge
Last but definitely not least — use every advantage you have when it comes to the actual interview and application process.
If you know someone who currently works in the department you’re applying to, ask them to be your reference. Especially if they’re a hard worker with a good relationship with the hiring manager. A strong internal reference can move your application to the top of the pile faster than almost anything else.
One caveat: if they’re known as a difficult employee, do not use them as a reference. They will actually hurt your chances more than help. Choose your references wisely.
Also, if you have an insider, use them to prepare for your interview. Ask what the manager is like. Ask what the department is struggling with. Then tailor your interview to position yourself as the solution to that problem — without being too obvious about it.
Practice your interview skills. Be professional. Be prepared. These things seem basic, but you’d be surprised how many travelers phone it in because they assume the agency will handle everything. Your agency gets you in the door — you’re the one who has to close it.
The Bottom Line
If you made it this far, thank you for taking the time to read this. Staying regional as a healthcare traveler isn’t the path of least resistance — but with the right strategy, it’s absolutely doable. I did it for four years, and these are the same practices I used to make it happen.
To recap: work with multiple agencies so you never miss a local opportunity, understand how the address and tax rules actually work (and talk to a professional about your specific situation), extend contracts when you can, build a strong network of fellow travelers, search for assignments obsessively, and bring your A-game to every interview.
Please always seek your own legal counsel and tax professional for anything related to your personal situation. This article is meant to share what worked for me — not to serve as legal or financial advice.
This article is dedicated to all the other travelers who helped me along the way and is part of my continuing commitment to helping others navigate this industry.
If you have any questions, feel free to reach out to us on our Contact Page — and if you want to read honest reviews from other travelers about agencies, facilities, and insurance companies, that’s exactly what ScrubInformer was built for. Know Before You Go.
Best of luck on your next adventure, travelers.