Starting An Agency

I think guardian angels missed the point of my question. I did not ask that agencies tell me what they charge. I am asking how to RESEARCH one or several agencies exact rates without calling and pretending to be someone you are not; or assuming the rate based on what they currently pay nurses per hour.

I didn't miss your point. I suggest you do research with facilities.

Agency rates are different because of what insurances are needed to cover employees. Agency's are not the money makers that most think they are. The rates made by agencies are divided to the employee, taxes, liability insurance, bonding insurance, workman's compensation, unemployment compensation, criminal record history checks, physicals, paper supplies, attorney's, accountants, lease payment for building of office, computer and fax equipment, marketing supplies ect.

You are comparing apples to oranges.

An individual contractor doesn't have to pay for the above expenses, and could therefore offer a different rate.

I will do research with facilities. But after reading the post on this forum, I thought people here would be able to answer my question directly. I know that i do not have all these expenses; and that will make me very competitive. However, I am not comparing apples to oranges. Agencies have contracts to send nurses to work and I will have contract to go to work as one nurse, much smaller scale.

I want to reseach what they charge because I want to know what my competition is doing. And that exactly what agencies are to IC nurses.

Each contract is different, not every agency gets paid the same by the same hospital. Depends on how the contract was negotiated. Same thing with Independent Contracts. You may see 5 different I.C.s at the same hospital, they may all have the same rate or they may each be different. Will vary according to what the market will bear in your area, and the expertise of the nurses involved and what priamry area that they will be working at the area. If the nurse is a member of a heart transplant team for a paritcular hospital, chances are that her salary will be more than someone that will be working M/S only on the day shift. Also called supply and demand.

IC nurses are not Agency nurses, there is a difference. I don't believe that you can compare the two. As in Suzanne4 post, we as an agency have a variety of skilled specialists available every shift.

ICnurses ARE agency nurses. (if they are doing it correctly) They are, in fact, staffing companies even if they are the only nurse they furnish. The original poster is trying to pin down some magic number but it does not exist.
Even in the same area rates can vary several dollars an hour. I assume he/she wants this number in order to underbid the other agencies. This is a BIG mistake. First, it is not necessary and if you are a one person operation they will not want to do business with you any way. WANT is the key word! Supply and demand govern any business situation and if they need you they will use you and a few dollars difference won't make a difference. If you stick with it and are persistant you can make an excellent living.

I think there are several points about starting an agency business that have not been explored on this thread as much as perhaps it should be. Namely, competition. I have also wanted to start an agency and think that in most areas there is a need. The nursing shortage has made agencies a popular alternative for staffing. However, even agencies are feeling the crunch with the shortage.

When I was doing my due-diligence and market analysis for my business, I realized I had a number of HCA hospitals in my market region. They have cornered the market in relationship to agencies. For cities and towns that have several HCA facilities in their backyard, you would have to negotiate with their staffing company (All About Staffing) in order to even get some small percentage of market share. They cost cap what they pay agencies that they sub-contract with. And, if you don't sub-contract with them for business, and you have several HCA hospitals in your area, this could spell poor revenue and poor utilization of your business. My one friend was charging $47.00 per hour for an RN and was staffing several HCA hospitals in our area (there were actually 4 of these HCA hospitals within a 20 minute drive of each other). HCA made this policy decision that they would NOT use "outside" agencies for their hospitals and if the agency wanted the business, they would sign with All About Staffing. My friend had to do this and her RN rate went from $47.00 per hour (remember ... this is billable) to $30.00 per hour billable. This impacted the rates she was able to pay her nurses (went from $35.00 per hour to $22.00 per hour). Naturally, she ended up losing some of her RNs. She finally decided to bite the bullett and reduce her overall business revenue and end her contracts with All About Staffing.

If, however, you have reviewed your competition and feel that you could develop decent market share, then starting a nursing agency is a great business to have. I have several friends that have been successful in other demographics with nursing agencies. Some of them have even branched off to home health and I have one friend that even wrote and was awarded a CON for a Medicare home care agency. Of course, I have no interest in a Medicare Home Health company, but the sky is really endless with this type of business if you do your homework, develop a reasonable and logical business plan and grow your business slowly.

I commend all those who want to start a business like this and hope that those of you who are starting and are successful, will come back to this thread and let us all know how you are doing with it.

Both me and my husband are independent contractors. Technically speaking, all agencies are independent contractors. My husband is a construction contractor. I took his 14 years of experience and applied it to nursing and am now a nursing contractor. Like my husband, sometimes I am the only employee of the business. Like my husband, sometimes I hire a few employees when the need arises.

As a nursing contractor, I work out of my home; as do many independent contractors including my husband. I started off as the only employee and had very little expense. One month, I paid for my yellow page advertising; the next month I paid for insurance for the LLC so that I could hire employees when the need arose. Cost can be spread out as you earn money. My entire start-up expense is paid in full and within my first two months, I recouped the entire cost working no more than 12 days. We printed up our own advertising flyers right here on the computer as we needed them. We designed and printed my business cards right here on the computer. They both look very professional and cost us a fraction of having others do it (and if want to change something, I'm not stuck with hundreds of cards). I now have a contract with two facilities and am negotiating with another.

Of course you do have the option of borrowing tons of money, renting a fancy office, buying a new computer instead of making due, ordering 500 business cards all at one time, and hiring a professional marketing agent, etc. You can run your start-up costs up as high as you like.

As to the question of what to charge, we know that there is no one answer. In preparing to go independent, I simply started asking the DON's and staffing personal at various facilities "how bad is agency zyz ripping you off?" I was surprised at the information they were willing to divulge. The love to moan and complain about how bad the facility was being ripped off. The cheapest rate we have found is $65 for an RN for our area. Every facility we have talked to in the last year has made it a point to tell us about all the extras that agencies add above the basic rate for things like a nurse working as "charge", shift differential, housing costs and travel expenses. In our area, the agencies pass everything on to the facility. So there is room to negotiate and maneuver.

Check out the information on these threads also:
Independent Nurses providing medical care?
PRN vs Independent Contract
Independent Contracting and Protecting Your License
RN Independent Contractor

This information helps you out.

We have a staffing agency and home health care. We are doing very well. We have been in business for a year and a half. I am pleased with the response.

We staff 9 facilities at this time.

Hi, My name is Sheryl Pastores, an LVN my first time to join this forum aand I am currently doing some research in how to start a nursing registry. Do you have some helpful advise that you can give me? Thanks.

Sheryl