Per diem therapy staffing can fit facilities with changing or shift-specific staffing needs, while contract staffing may make more sense for a defined temporary need. A permanent or full-time hire may be a better fit for an ongoing position. For facilities evaluating respiratory therapist staffing or other therapy roles, the right staffing model depends on the schedule, expected duration, qualifications, and long-term purpose of the opening.
Flagstar Rehab is a therapy staffing and recruiting agency that helps healthcare and educational facilities reach and connect with qualified therapy professionals. For decision-makers across the healthcare industry who are facing staffing shortages or open roles, understanding how these models differ can make it easier to choose an approach that fits the facility’s workforce needs.
Per diem, contract, and full-time staffing are related concepts, but they do not always describe the same part of an employment arrangement. Per diem often describes how work is scheduled, contract staffing describes an engagement for a defined workforce need, and full-time generally describes the clinician’s work schedule.
For this guide, full-time hiring refers mainly to an ongoing position that a facility intends to fill permanently. Exact arrangements can vary by employer, staffing agreement, role, location, and applicable requirements.
Per diem therapy staffing generally involves clinicians working according to a facility’s as-needed coverage requirements. A facility may consider per diem therapy when staffing needs change from one shift, day, or period to another.
This flexible staffing model may help facilities address individual open shifts, changing schedules, or periods when additional therapy professionals are needed. The exact hours, work schedule, and employment arrangement depend on the position.
Contract therapy staffing generally supports a defined temporary workforce need. A facility may consider this model when additional clinicians will be needed for a known period rather than for individual shifts as they arise.
Contract length, schedule, and expectations vary by role and staffing agreement, so facilities should define those terms clearly before choosing this model.
Contract staffing can apply across therapy disciplines. For example, a facility with a defined short-term OT coverage need may evaluate temporary occupational therapy staffing while it addresses the underlying vacancy or staffing requirement.
Full-time usually refers to an employee’s work schedule, while permanent or direct-hire placement describes a longer-term hiring objective.
A facility with an ongoing position may focus on permanent recruiting instead of relying on temporary staffing. This distinction matters because schedule, assignment duration, and employment arrangement are related, but they are not always the same thing.
The best staffing model depends on the workforce problem the facility needs to address. Instead of asking which option is always best, decision-makers should compare how long the need will last, whether the schedule is predictable, and whether the organization ultimately needs a permanent team member.
| Factor | Per Diem | Contract | Permanent / Full-Time Hire |
| Typical staffing need | Intermittent or variable coverage | Defined temporary need | Ongoing permanent vacancy |
| Duration | Variable or as needed | Defined or agreed period | Ongoing |
| Schedule predictability | Often variable | Usually more defined | Generally established by employer |
| Facility objective | Address specific coverage gaps | Add temporary staffing capacity | Add a long-term team member |
| Key question | Which shifts need coverage? | How long is additional staffing needed? | Is this an ongoing position? |
These are general decision patterns, not universal employment definitions. Actual staffing arrangements depend on the employer, agreement, clinician role, facility requirements, and applicable rules.
Per diem therapy staffing may fit a facility with intermittent, changing, or shift-specific staffing needs rather than one clearly defined long-term vacancy. It gives healthcare facilities a flexible option to evaluate when the amount or timing of required coverage changes.
A facility might consider per diem staffing for:
This model can apply across different therapy disciplines. Depending on the facility’s staffing needs, those roles could include physical therapists, occupational therapists, speech-language pathologists (SLPs), respiratory therapists, or therapy assistants.
Facility decision-makers should still consider how predictable the need is and whether it is likely to continue. If the same role requires regular coverage for a defined period, contract staffing may be a better model to explore.
Per diem staffing should not be treated as an automatic way to lower costs, guarantee coverage, or improve patient outcomes. Those results depend on many factors beyond the staffing model itself.
Contract therapy staffing may make more sense when a facility expects a temporary staffing need to continue for a more defined period or schedule. Instead of filling individual shifts as they arise, the facility is planning for temporary workforce support with clearer boundaries.
A facility might evaluate contract staffing when it has:
The appropriate contract length, hours, schedule, and role requirements depend on the specific situation. Defining these details early can help the facility determine whether contract staffing can meet the needs of the open job or position.
Flagstar Rehab supports facilities with a range of temporary and permanent allied health staffing needs. Facilities can learn more about its broader therapy staffing and recruiting services.
A permanent hire may be the better starting point when an organization has an ongoing therapy position that belongs in its long-term workforce. The main question is whether the facility needs temporary coverage or intends to keep the role as part of its regular team.
Facility decision-makers can consider:
Permanent hiring should not automatically be viewed as more cost-effective, more clinically effective, or more reliable than temporary staffing. Each staffing model is designed to address different types of workforce needs, so the decision should start with the role, schedule, duration, and hiring objective.
Hospitals, skilled nursing facilities, outpatient clinics, schools, and other organizations may need different staffing models depending on the therapy role and facility setting.
For example, a facility could need physical therapy staffing for an ongoing position, an occupational therapist for a defined temporary assignment, a speech-language pathologist for a specific coverage period, or a respiratory therapist for variable shifts.
The discipline itself does not determine the staffing model. Physical therapists, occupational therapists, speech-language pathologists, respiratory therapists, and other clinicians may work under different staffing arrangements depending on the facility’s workforce needs.
This distinction also prevents physical therapy, occupational therapy, speech-language services, or respiratory care from being confused with staffing services. Licensed clinicians provide those clinical services while Flagstar Rehab recruits and places therapy professionals.
For respiratory therapist staffing, facilities can use the same workforce framework. An intermittent RT schedule gap may lead a facility to evaluate per diem coverage, while a temporary need expected to continue for a defined period may point toward contract staffing. An ongoing respiratory therapist vacancy may call for permanent recruiting.
The staffing model is only one part of the decision. A facility should also define the work schedule, facility setting, required qualifications, relevant experience, and professional requirements for the role. Facilities exploring this discipline can learn more about Flagstar Rehab’s respiratory therapist staffing services.
Choosing a per diem, contract, or permanent staffing approach does not replace the professional qualifications that apply to a respiratory therapist role.
The National Board for Respiratory Care administers respiratory care credentials, including the Certified Respiratory Therapist (CRT) and Registered Respiratory Therapist (RRT) credentials. The NBRC states that CRT and/or RRT credentials are used as the basis for licensure in states that regulate respiratory care. Facilities should still verify current state-specific licensing requirements with the applicable licensing authority.
The facility determines the requirements for the position and oversees care delivery according to its policies and applicable professional standards. Licensed respiratory therapists and other clinicians provide clinical care to patients. Flagstar Rehab recruits and places those clinicians; it does not evaluate, diagnose, or treat patients.
Before selecting a staffing model, define the workforce need as clearly as possible. Clear role requirements can support the quality of the staffing decision by helping the facility distinguish between isolated coverage gaps, a temporary staffing requirement, and an ongoing vacancy.
Consider documenting:
For healthcare organizations dealing with staffing shortages, this step can also improve communication between the internal hiring team and a therapy staffing partner. The goal is to make the staffing need clear before deciding which model to use.
A facility can narrow its options by starting with three questions:
If the main issue is changing shift coverage, per diem therapy staffing may be worth evaluating. If the need is temporary but clearly defined, contract staffing may fit better. If the organization needs an ongoing team member, permanent recruiting may deserve priority.
These are starting points rather than fixed rules. Facility setting, clinician qualifications, candidate availability, location, and applicable requirements can also affect the final decision.
One common staffing mismatch happens when a facility chooses a model before clearly defining the workforce problem. For example, a facility may start by asking for per diem coverage when the need is actually a predictable multi-week vacancy. In that case, contract staffing may be easier to plan around.
The reverse can also happen. A facility may consider a longer contract when the real need is only a few uncovered shifts. Before choosing per diem, contract, or permanent staffing, decision-makers should first clarify the schedule, expected duration, number of openings, required qualifications, and whether the role is temporary or ongoing.
Yes. Facilities may have different staffing needs at the same time, so one model does not always need to address every opening.
For example, a healthcare organization could explore per diem coverage for variable shifts while using contract staffing for a separate temporary vacancy and recruiting for another ongoing role. A skilled nursing facility might also have different staffing needs for physical therapists, occupational therapists, or speech-language pathologists based on schedules and open positions.
The right combination depends on the facility’s actual workforce requirements. A mixed approach should not be used simply for variety or flexibility; each staffing model should address a defined need.
Per diem, contract, and permanent staffing serve different workforce needs. Per diem therapy staffing can fit variable or intermittent coverage, contract staffing can fit a defined temporary requirement, and permanent hiring can fit an ongoing vacancy. Facilities should compare the schedule, hours, duration, qualifications, location, and long-term purpose of the role before choosing a model.
Flagstar Rehab is a therapy staffing and recruiting agency that connects healthcare and educational facilities with therapy professionals. If your organization is addressing staffing shortages, managing an open role, or deciding which staffing model fits your team, contact Flagstar Rehab about therapy staffing support to discuss the position, schedule, expected duration, and workforce requirements.
No. Per diem generally refers to work scheduled on an as-needed basis, while part-time usually refers to a recurring schedule below an employer’s full-time workload. Exact schedules and employment terms can vary by employer and position.
Potentially. Contract can describe the type or duration of an engagement, while full-time can describe the work schedule. Actual hours and terms depend on the specific position and staffing agreement.
Not necessarily. Per diem describes a work or scheduling arrangement and does not by itself determine whether someone is an employee or independent contractor. The IRS explains that worker classification depends on the facts of the working relationship, including behavioral control, financial control, and the relationship between the parties.
Potentially, depending on the facility’s staffing needs and the available staffing arrangement. Skilled nursing facilities may evaluate per diem, contract, or permanent staffing based on factors such as open shifts, schedule consistency, role requirements, and how long the position needs coverage.
The staffing arrangement does not remove applicable licensing, credential, or facility requirements. Requirements can vary by state, location, and position, so facilities and clinicians should verify what applies to the specific role.
Facilities should generally be ready to describe the therapy discipline, number of openings, schedule, expected hours, duration, facility setting, location, qualification requirements, and whether the need is temporary or ongoing. Clear information helps a staffing partner understand the workforce need and discuss appropriate staffing options.