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I've thought about this idea quite a bit as well. It would be a jackpot to hit the per diem rates in the SF Bay Area.

Are the managers OK with staff stacking their shifts like that and flying back and forth?

The reason per diems exist...is to help staffing issues on the unit, and living in another state it doesn't seem like one would have much flexibility. Can you offer any insight on details?

It depends on the facility. A high need place like SF or Oakland will have need every day. In this manner you give them your dates of availability and they call if need. Depending on where you are at that can basically mean they call on every day you gave them. The guy that does it here says he gives them his schedule 3 months ahead of time and has never had issue getting shifts but he also said it is slower in summer time, he also books his flights 3 months out for cheaper cost too. Like I said the bigger places have lots of need. I am trying to decide if I want to get the per diem here (smaller kaiser hospital) or make the drive to a higher need area like oakland which would be about hour drive for me. There are no good RV spots near there I can move to.

You may be able to write off second home expenses, but pretty sure not travel expenses. It is your personal choice not to live near work, and what you are doing is considered a commute to an open ended job (exactly the same as a permanent job). Commuting expenses are not deductible generally.

You certainly don't have to give up your residency and voting rights and license, and you will continue to pay your home state income taxes. All that has changed is your tax home for tax purposes.

Thanks that is essentially what I wanted to know. Thankfully TN has no state income tax and Im sure I will pay and arm and a leg in CA tax but oh well. I cant make in TN near what I can in CA. I have an appt with my accountant but he is busy with all his regular tax stuff this time of year so I am going to have to wait till that dies down.

What if you get canceled for shifts you've already booked flights months in advance for? When I worked in the hospital, our per diem staff were canceled more than they worked. If I was going to do something like this, I'd want a guarantee of shifts. I once worked with a nurse who worked every other week Fri-Sat-Sun-Mon nights, 8 hrs Fri/Mon and 12 hrs on Sat/Sun. It worked out to 20 hrs/week and once she was done with work on Tuesday morning, she was off for 10 days. I'd also highly recommend if you are going to do this, flying Southwest which doesn't charge change fees and will credit you the full amount you paid to a travel bank that you can use within 12 months if you cancel the flight.