Starting a Nursing Agency

You're going to need a lot of contacts at local hospitals and nursing homes.

I am just saying, you know you have to be honest and truthfull as a nurse. You can not sell them good healthcare as a nurse, you have to provide it. I must say, if I were going to open a business, healthcare is where it would be. Good Luck

Moved to Entrepreneurs in Nursing forum...check previous discussions here.

Quite frankly I don't think being a nurse is a requirement to running an agency, but it will certainly give you an advantage once you become one. If you are an entrepreneur and a nurse, both of these will help you in your endeavors. Your eyes will be more open to what a hospital wants as an organization and what a nurse wants as an employee (contracted or perm.).

Pick the brains of nurses who have used agencies for temp.-perm. placement. This is a good start. The hard part is finding someone in HR, specifically a hospital, but they are good resources also. It would be good to have some back office software for tracking time and employee information. Quickbooks does a good job with a variety of tasks, but I think something more specific to nursing would be better about tracking specific jobs/hours worked.

Look for specific business plans that outline the nursing agency process. There are plans that you can view for free, some you have to buy. I don't really have any specific ones right now. I am currently an IC and looking to write a new business plan for a small nurse agency. The one tricky thing I am trying to figure out in my negotiations will be payment. I think being an IC is a good thing in this economy, but sometimes getting paid for the job might take longer than before. Everything I do now is net 30 and all of my smaller clients pay me within a week, but some of these larger institutions tend to drag their feet a bit. Their employees get paid first, but if I can underbid the other agencies by a significant margin then my hope is that they will want to pay me within that 30 day time frame since they will essentially be saving money. It's going to take some selling and a strong contract to back up my assets.

I don't have any books I have read specifically on this, but one book I like right now is Art of the Start by Guy Kawasaki. Nothing to do with the nursing business, but it really helps you cut to the chase on many different levels.

Still....I think it's a great time to start.

Thanks For the links Eddie. I have actually visited Pat's site. Sorry I didn't post that before.

As far as the IRS is concerned, yes, a business owner has to be careful on how this is set up. When I do a contract for someone or client basically hires me, they are hiring my corporation. Essentially they are subcontracting my services. I bill through my corporation and receive payments made out to my corporate name. I then pay myself a reasonable salary, which I pay taxes, FICA, medicare, and unemployment on each check I write to myself (I pay myself monthly). I then pay quarterly estimated taxes to the IRS and to the state of Colorado electronically. It's fairly easy once you get it set up.

I keep corporate records, meeting minutes, etc. so that if the IRS ever audits me, then they can see that I am actually a true corporate entity. Quite frankly I just think they are happy as long as someone is paying the taxes for the work I am doing. It is just like any service that I have provided in other industries. If I am consulting on something, giving billable advice, or just providing some type of service, I send the company a bill. It is up to me to then follow the IRS rules when I pay my employees or myself.

Also, on the agency startup. I have heard of folks starting up for much much less than that. The biggest concern is having enough cash on hand to pay your employees. Even if you are net 30 with a hospital, that of course doesn't mean you'll get your check at the end of the month. There is a possibility that it could turn into a billing nightmare, but once you start getting in some of that revenue you just start building up that "bank" of cash for when it happens again.

I did just talk to a nurse briefly the other day and she actually said that she is an IC and has a couple of contracts in Denver. Once you get your foot in the door then of course it becomes a little easier. She basically does the same thing except she incorporated her own name. She bills, gets a check, deposits it into the company account and then writes a paycheck to herself taking out the necessary taxes, etc. just to keep the "wolves" at bay.

I'm going to read through some of this info. Thanks again.