RN who has an idea to do CNA skills only, for nurses pay. - page 2

by IowafemaleRN 9,873 Views | 21 Comments

This might sound crazy. I have been a nurse for 6 years and some days just feel burn't out. Sometimes I wish I could just be a CNA again, but still get my RN salary. I've had the idea to start an independent non-medical home... Read More


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    If agencies in your area are charging $40.00 and hour, who says you can't do aide work as an RN. You will be your own agency, working under your RN license, just not taking care of very sick individuals. Just make sure you are ready to with withold taxes including employer taxes and pay for health/liability insurance. So your $40.00 an hour may be alot less than that amount at the end of the year.
    TriciaJ and KelRN215 like this.
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    Home health aides in my area make just a bit more than minimum wage. I know there's some overhead involved there but nowhere near that much money goes to pay the HHA or CNA.
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    Why would she have to give up her RN license in nj you need an RN LICENSE to have A home health care company even for home health aides. I'm an RN AND I've been doing this for over 20 years . It's forums like this that inspired me to do my own consulting so I could assist nurses and non nurses in opening their businesses as to not get into trouble. I see alot of loaded questions . Please seek expert advice before opening because you definitely don't want trouble with your BONs or the Feds at state or federal level with compliance and billing .
    There are slot of smaller laws that people misconstrue that gets them innocently in trouble.
    Good luck fellow entrepreneur s!!
    Last edit by JustBeachyNurse on Feb 18, '13 : Reason: tos
    toomuchbaloney and TriciaJ like this.
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    It's my understanding that in most states, RNs cannot practice independently. RNs must practice under an MD/Medical Director of some kind. The concept is that RNs carry out and implement plans of care and doctor's orders. Check with your BON, but I'm fairly sure you need at least a consulting MD to issue orders.
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    Quote from mclennan
    It's my understanding that in most states, RNs cannot practice independently. RNs must practice under an MD/Medical Director of some kind. The concept is that RNs carry out and implement plans of care and doctor's orders. Check with your BON, but I'm fairly sure you need at least a consulting MD to issue orders.

    Not so, any nurse can practice nursing independently. There are a lot of things that registered nurses assess and prescribe independently of any physician input, and I'm not talking about just ANPs. RNs are not obligated to "practice under" physicians; even in facilities, our chain of command is within nursing. In fact, physicians cannot evaluate nurses in nursing practice as they are not nurses. They can evaluate how nurses implement the parts of the medical plans of care we are legally bound to implement, but cannot eval, modify or critique nursing plans of care. You can look it up.

    That said, though, there are regs about how RNs can open an independent nursing practice suce as the OP is interested in.
    toomuchbaloney, TriciaJ, nursel56, and 3 others like this.
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    Even though it feels like it sometimes, we aren't indentured servants to doctors and CEOs. My state BON (NC) says that as long as I practice within my license scope it doesn't matter where I work, independently as the CEO of my own biz, or as a servant/worker-bee on a "unit".

    My plan has been to do what WhatamIdoing's doing (hows that for sentence structure). Solo. There is most definitely a huge market for this because our competition (non-medical home care industry) is price gouging for the same services and they're done by people with no education or knowledge about healthcare. If the product you're selling is better than the rest and it's priced correctly... well, that's capitalism.

    Don't be turned off from doing your own thing. It's not that way at all. The most important thing you have to do is have a knock-out business plan. I've found VAST amounts of free info via my local Chamber of Commerce and the SBA, SCORE, others. Clinicians are notoriously not as adept at the business side of running a biz, but whizzes at all things clinical!

    If I had to hire help for my loved one @ 20.00/hour, do you think I'd want a CNA or a RN for that price? Hell yeah, I'd hire the RN. The public just needs to be educated about what they're paying for. I have more experience dealing with the so-called non-medical home care industry than I'd ever want. The helpers/CNA/HHA get min wage -- if their lucky -- but the agency gets 18-25/hr. Eliminate the middle person and you're getting 20.00/hr.

    So go for it. You're right on!
    TriciaJ likes this.
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    Quote from IowafemaleRN
    I thought I could get the same pay, because if you call around to non-medical home health agencies they charge around $40.00 an hour just for an aide to come out. I agree with you ELKPARK though theres no way getting around the legal aspect of standard of care for highest level of education. Therefore this would not be realistic. I've thought about doing home health case management. Not sure how stressful that would be. I'm deffinitely not lazy, but feel very stressed some days working in the busy hospital. Thanks for your guys feedback!
    Just because that's what they charge doesn't mean that's what they're reimbursed at. For example, my agency charges $120 for a skilled nurse visit. Medicaid reimburses us about $90 and some private insurance companies, the reimbursement is even less. You need to have contracts with every insurance company you intend to bill. Or are you planning on doing all private pay? The market for that is significantly less and after you pay small business taxes and buy your own health insurance, you're not going to be making as much at the end of the day as it seems.

    Have you thought of just moving into Home Health as a nurse? I am WAY less stressed now than I was working in the hospital- I have better hours, I sleep through the night every night and my patients are home, where they are happier by the very nature of being in their own environment and they are, for the most part, stable.
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    I know it's been awhile since you posted but wanted to see if this worked out? I am just now starting my own venture too! Pm me if you'd like!
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    I'd love to read any updates on how this is going.
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    I too am in NJ and have just opened a HHA. I am interested in your consulting. I am in the process of reviewing the P & P. I am unsure of how to become medicaid and medicare certified. It's a huge learning process.


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