Locum Tenens Physician Mortgage Nevada — 1099 Qualifying Guide
Program figures verified July 2026 — details change; confirm your scenario with us.
The 60-second answer
If you're a locum tenens physician — practicing on 1099 contracts at various Nevada (or out-of-state) hospitals — you face mortgage qualifying challenges that standard physician loan programs don't always address well:
- 1099 income (not W-2 from a single employer)
- Variable assignments (weeks at one facility, then another)
- Self-employment status (most physician loan programs prefer W-2 employment)
- Multiple facility income streams combined
- Tax-optimized deductions that may reduce net income
The solutions:
- our specialty non-QM programs (Mike's primary 1099 doctor path)
- Bank statement loans capturing real cash flow
- 2-year 1099 history with consistent earnings
- Specific 1099-friendly lenders
For Nevada locum tenens physicians earning $300K-$700K+ annually, specific 1099 physician loan paths exist — Mike's program network includes lenders comfortable with this scenario.
Why locum tenens is a specialty qualifying scenario
The 1099 challenge for physicians
Standard physician loan programs (Redwood Sequoia, Bank of America, BMO, KeyBank) typically prefer W-2 employed physicians. They're designed for the typical attending physician scenario: hospital W-2 + benefits + employer-provided malpractice insurance.
Locum tenens physicians break this model:
- 1099 from staffing agency or directly from facility
- Multiple income streams through year
- Self-employment status for tax purposes
- Variable income vs predictable salary
Why locum physicians can earn substantially more
Many locum physicians earn 30-100%+ more than equivalent W-2 attendings:
- Higher hourly rates for shortage specialties
- Premium pay for short-notice + difficult coverage
- No 9-5 commitment allows multi-assignment higher earning
- Tax optimization through 1099 status
For attractive locum specialties (EM, hospitalist, surgery), $400K-$700K+ annual income is common.
Locum vs traveling W-2 physician
- Locum tenens: 1099, multiple facilities, self-employed status
- Traveling W-2 physician: Single employer (like Banner Travel), W-2 income
- Different qualifying considerations
Qualifying paths for NV locum physicians
Path 1: our specialty non-QM programs
Best for: Most NV locum tenens physicians
Requirements:
- Eligible degree (MD, DO, DDS, DMD, DVM, CRNA, PharmD, DPM)
- 2 years of 1099 income history
- Documented multi-facility relationships
- Standard credit (typically 680+)
- our specialty non-QM programs
Pros:
- Designed for self-employed physicians specifically
- 100% LTV up to applicable limits
- No PMI
- Mike has direct access
Cons: Slightly higher rate than standard physician loan Best for: Most locum physicians
Path 2: Standard physician loan (with 1099 documentation)
Best for: Locum physicians with 2+ years stable history at single primary facility
Requirements:
- 2 years 1099 income history
- One primary facility with bulk of income
- Reasonable secondary facilities
Pros: Standard physician loan terms Cons: Many programs prefer W-2; not all accept 1099
Path 3: Bank statement loan
Best for: Locum physicians whose tax returns understate cash flow
Requirements:
- 12 or 24 months of personal bank statements
- Documented deposits
- Expense factor applied
Pros: Captures real cash flow regardless of tax deductions Cons: Higher rate than physician loan; standard processing
Path 4: Standard self-employed conventional
Best for: Locum physicians with strong 2-year self-employment + tax returns
Requirements:
- 2 years tax returns
- Schedule C net income
- Standard conventional qualifying
Pros: Lowest advertised number Cons: Uses net income (may significantly understate cash flow)
Path 5: P&L only loan
Best for: Sophisticated self-employed locum physicians with CPA-prepared P&L
Requirements:
- CPA-prepared YTD P&L
- 1099s as supporting docs
Pros: Captures business reality Cons: Less common; specific lender access needed
Common NV locum tenens scenarios
Scenario 1: Locum EM physician across multiple LV hospitals
- 4 years locum EM
- Income: $485K (1099 across multiple LV facilities)
- Wants: $725K Henderson home
- Path: our specialty non-QM programs
- Outcome: Locum-specific physician loan path
Scenario 2: Locum hospitalist between Vegas + Reno
- 3 years locum, rotating between LV + Reno + occasional out-of-state
- Income: $385K (1099 multiple facilities)
- Wants: $625K NW Vegas home
- Path: Bank statement loan captures all income
- Outcome: Multi-state income captured cleanly
Scenario 3: Locum trauma surgeon
- 2 years locum trauma surgery
- Income: $625K (high specialty premium)
- Wants: $1.2M Henderson Anthem home
- Path: our specialty non-QM programs
- Outcome: Specialty income + locum status accommodated
Scenario 4: Locum CRNA across multiple NV facilities
- 5 years locum CRNA (Certified Registered Nurse Anesthetist)
- Income: $385K (premium for shortage specialty)
- Wants: $625K Reno home
- Path: CRNA eligible for Redwood Sequoia + 1099 documentation
- Outcome: CRNA + 1099 specialty combination
Scenario 5: Locum + private practice physician
- 50% private practice (Schedule C) + 50% locum income
- Combined: $425K
- Wants: $725K Henderson home
- Path: Bank statement loan captures all sources
- Outcome: Multi-source income documented
Locum-specific lending considerations
Tax treatment + qualifying income
Locum physicians can deduct substantially:
- Travel + lodging
- Continuing medical education
- Malpractice insurance
- Locum agency fees
- Vehicle expenses
- Home office deductions
These reduce Schedule C net income → reduce conventional mortgage qualifying capacity.
Bank statement loans bypass this by looking at actual deposits.
Reserves typically higher
Self-employed physicians typically need 6-12 months of reserves vs 2-6 months for W-2 attendings. Verify your specific scenario.
Multiple facility documentation
Many locum physicians work 5-10+ facilities per year. Standard documentation requires aggregating all sources.
Disability insurance + professional liability
Self-employed physicians typically purchase their own coverage. Affects monthly cash flow but doesn't reduce qualifying income.
State licensing complications
Locum physicians may hold licenses in multiple states. Generally doesn't affect mortgage qualifying.
Locum tenens in Nevada specifically
Why NV is good for locum physicians
- No state income tax = 0% additional state burden on 1099 income
- Strong demand at LV + Reno hospitals (EM, hospitalist, surgery, anesthesia)
- Premium pay rates for shortage specialties
- Active locum agency presence (Weatherby, CompHealth, Locumtenens.com, others)
NV major locum facility users
- UMC of Southern Nevada (frequent EM + hospitalist locum)
- Sunrise Health System (multiple facilities)
- Valley Health System (multiple facilities)
- Renown Health Reno (specialty locum)
- Rural NV hospitals (Pahrump, Mesquite, etc. — frequent locum)
Locum agency relationships
- Most NV locum work is through national agencies
- Some hospitals contract directly
- 1099 documentation similar across both arrangements
Frequently asked questions
Can I qualify for a physician loan as a locum physician?
Yes — specifically with our specialty non-QM programs. Standard physician loan programs may decline 1099; specialty non-QM programs specifically accepts locum scenarios.
How many years of 1099 history do I need?
Typically 2 years. Some lenders accept 1 year with strong documentation + compensating factors.
What if I'm transitioning from W-2 to locum?
If your most recent 2 years include any W-2 portion, conventional qualifying may use W-2. Some 1099 lenders accept transitioning physicians with 12+ months of 1099 history.
Can I write off my home office for tax purposes + still get mortgage?
Home office deductions don't affect mortgage qualifying per se. They reduce Schedule C net income (which affects conventional qualifying). Bank statement loans bypass this concern.
What about my malpractice insurance + locum agency fees?
These are legitimate business deductions. They reduce taxable income. Mortgage qualifying considers them as expense; doesn't deny the locum scenario.
Can I use locum income for VA loan?
Yes — VA loan accepts 1099 income with 2-year history. Mike originates VA + our specialty non-QM programs.
What about specialty premiums for shortage specialties?
Premium pay for shortage specialties (EM, hospitalist, certain surgeries) counts as income with 2-year documented history. Higher locum rates support higher home purchases.
Can I be locum + own a practice + work for hospital?
Multi-source income common for some physicians. Each source documented separately; combined for qualifying.
What's the rate premium for 1099 physician vs W-2 physician loans?
Priced above standard W-2 physician loans — quoted at the file level. Worth it for higher qualifying capacity + locum income capture.
Can I qualify for jumbo as a locum physician?
Yes — combination of bank statement jumbo + locum income documentation. Specific lender access needed.
Talk to Mike about your locum tenens scenario
Free 30-minute call. Bring your situation — degree, years locum, income (W-2 + 1099 combined), facility mix, target NV home + budget.
(480) 296-6513 · Mike Certo, NMLS #260555 · Cornerstone First Mortgage NMLS #173855
Sources
Mike Certo · NMLS #260555 · Cornerstone First Mortgage NMLS #173855 · Equal Housing Lender. Educational content, not a loan commitment. Loans subject to buyer and property qualification.