As staffing shortages continue to challenge skilled nursing facilities (SNFs), one question arises: what happens when staff members no longer need the facilities?
“We’re seeing an increased demand for the CNAs and caregivers, but their wages currently compete with gig work,” says Julie Tate, VP of Express Healthcare Staffing. “People are leaving CNA or caregiver positions because they can make the same amount of money picking up groceries for Instacart or driving for Uber and Lyft.”
This shift underscores the need to distinguish between W2 staffing and 1099 contractors. As noted by Express Healthcare Staffing, a leading provider of temporary staff across 16 locations in the U.S., Canada and Australia, skilled nursing facilities must adapt recruitment strategies to navigate staffing shortages. Employers must offer competitive pay and flexible hours to attract individuals into healthcare careers.
Recognizing the competitive edge provided by partnering with W2 staffing agencies like Express Healthcare Staffing is crucial. These agencies not only ensure that temporary staff are fully credentialed and vetted but also offer consistency and reliability that independent contractors often cannot.
W2 vs. 1099: Four Key Differences to Know in 2025
Many SNF leaders believe that hiring temporary staffing services helps reduce costs. Yet as Tate explains, this may come with hidden risks.
“While the bill rate for temporary employees is typically lower, there are hidden costs that can add up quickly,” she says.
Independent contractors might not be insured, for instance, bringing a level of legal and financial risk.
“Beyond just the bill rate, there are additional costs, including reputational damage,” Tate says. “If an incident occurs because an independent contractor is not properly vetted or credentialed, the facility may face more than just financial losses. It can also harm their reputation and result in lost business.”
A quick look at W2 vs. 1099 employee classifications shows four key differences:
- Liability: A W2 staffing agency assumes the legal and financial risks, including labor law compliance. They provide professional liability and workers’ compensation insurance for temps in your building. How 1099s fall short: Most 1099 staffing firms do not offer professional liability or workers’ compensation insurance for staff working through their platforms.
- Credentialed staff: The temporary staff you receive are fully credentialed. Their skills are vetted, and they have documented experience in their skill. “It’s critical for us to ensure that not only are we providing a service of a staff member but we’re also taking it to the next level and ensuring we’ve done testing on them and checked all the credentials,” Tate says. “Then, when they’re on assignment, we ensure that if something does happen, we have the proper protocols in place to deal with that incident by having an on-site clinical director.” How 1099s fall short: Credential verification is minimal. In some cases, only a worker’s license is checked before they can work shifts.
- Payroll taxes and benefits: The staffing agency pays payroll taxes and other employer costs, including benefits. How 1099s fall short: As the operator, you may be viewed as the employer because you are supervising the work. This could make you liable for payroll taxes and other work-related costs.
- Quality: Employees who are hired through a W2 staffing agency are typically more committed, loyal, and productive because they receive benefits, training, and support all the way from the top. “We don’t hire new grads — somebody fresh out of a program or fresh out of school,” Tate says. “We won’t place them. They must have a minimum level of experience when they come to us before we put them on assignment.” How 1099s fall short: Independent contractors often work under minimal supervision, without ongoing evaluations from the company that recruited them. That potentially puts your patients at risk.
As a W2 agency, Express Healthcare Staffing prioritizes the well-being of the patient, ensuring high standards are both set and met consistently.
One of the ways Express Healthcare Staffing achieves this is through their Joint Commission certification. This prestigious certification, awarded as part of an independent evaluation by The Joint Commission, is awarded to health care staffing organizations that meet rigorous performance standards in providing quality, safe and effective patient care.
That’s a huge difference maker and something SNFs don’t always see with 1099 workers.
“Our investment in quality is reflected in our Joint Commission certification,” Tate says. “Although skilled care facilities don’t require us to have this certification to do business with them, we pursue it because we believe in maintaining a high level of quality. That commitment sets us apart.”
This Views article is sponsored by Express Healthcare Staffing. To learn more, visit ExpressHealthcare.com.
