Why are there NO posts to this forum? - page 2

I would love to see some input into this forum... Is it up and running? :) B.... Read More

  1. by   SICU Queen
    This is what scares me so much about starting a business. I just don't know the what/when/why/how things... I would LOVe to start my own business, and in fact have gotten together with some friends to begin working on a business plan, but it's all very overwhelming, and is taking a lot of time. It will be worth it though, to be my own boss...
  2. by   nursemicke
    Hi all,
    You can do what I am doing without all those complications. That is why I don't want employees, too complicated. I am starting my own patient advocate and private homecare business. Very simple to do. Queen I emailed you but ran out of space to write more. TRN, couldn't email you according to profile.
    Last edit by nursemicke on Feb 26, '03
  3. by   LoisJean
    Hi. It's been awhile since I've been active on this site and so was very pleased to see this new forum. Hopefully, now, I will not feel so much like the little fish swimming alone in the big nursing bowl of life.

    I have posted several times regarding my independant status as a home health care nurse. I have also responded to private emails from nurses who were interested in such a venture. Still, it seemed that what I shared with them was received more as a story of fiction than a true and very real matter of fact.

    I began my independent practice nearly 8 years ago. I winged it on my own for 6 of those years and then took on a nursing partner because I could no longer keep up with the amount of referrals I was getting.

    I consider my business a success now. We will soon be signing on another nurse to help us out with our expanding territory. All of the goals I started out with have materialized and now new goals are shaping up and are spreading their wings to fly.

    The personal rewards have been phenomenal; the monetary rewards have been more than I could have imagined 8 years ago. The work has been hard, and at times, so have been my lessons. Yet, I believe that we, as nurses, sell ourselves so very short when we deny ourselves to one of the absolute rights which our country affords us...that is the right to free enterprise. We are people with talent, knowledge, expertise and an understanding of what the work ethic is. Most of us know what fair employment OUGHT to be and what nursing care NEEDS to be in whatever setting we see ourselves.

    It's my hope that more nurses will peruse this forum and think of ways in which they might serve others while at the same time considering their rightful place as a free and independent agent within a proud and worthy profession.

    Lois Regan, LPN
  4. by   nightingale
    LoisJean:

    Thank you for posting. It is wonderful to hear of your success. It gives me such joy to know of another nurse who is so successful. I love reading this line, that is worth repeating:

    (Quote)
    Yet, I believe that we, as nurses, sell ourselves so very short when we deny ourselves to one of the absolute rights which our country affords us...that is the right to free enterprise. We are people with talent, knowledge, expertise and an understanding of what the work ethic is. Most of us know what fair employment OUGHT to be and what nursing care NEEDS to be in whatever setting we see ourselves.

    It's my hope that more nurses will peruse this forum and think of ways in which they might serve others while at the same time considering their rightful place as a free and independent agent within a proud and worthy profession.

    LoisJean, do you also do medicare? I am interested in how you bill etc.

    Look forward to hearing more of your input.

    Bonnie
  5. by   nursemicke
    Thank you for posting Lois. Everyone needs to hear of success stories for encouragement. Hope you will keep coming back to encourage others. They are at the "I think I can" stage and you are at the "I know I can" stage because you have succeed.
  6. by   LoisJean
    Thanks for the responses.

    I do not bill Medicare. Medicare will not pay for my services because it does not recognize them as 'skilled'. Services to Medicaid receipients are billed to the referring State agency and they submit those bills for payment for which we receive a monthl check. Very simple.
    All other clients pay an out of pocket fee for service and payment is made at the time of service.

    What I have learned over these past years as a self-employed nurse is to 'keep it simple'.

    I am not a graduate of business school, (altho I did take several college courses in order to get a more solid footing on the ins and outs of the various types of businesses). I keep my priorities straight: SELF
    Service-Economy-Loyalty-Fairness.
    My business is maintained on the 'gentleman's agreement'....I will provide a service and if that service is acceptable the receipient will pay an agreed upon price for the service provided.

    Most of the time, when I am trying to put some kind of complicated gizmo together, I always end up with a few nuts and bolts left over and I have no idea where they are supposed to go. I have learned that when the instructions say, "Assembles in Miinutes", it is usually a lie.

    For me, starting my own in-home care business was easy. It is the putting of the parts together that takes time. I did not wait for a full set of instructions to come before I started to put it together....I started out one day to work on my own and the pieces fell into place as they were meant to.

    I understand quite well the pros and cons of C-Corporations; S-Corporations; Non-profit; General Partnerships; LLCs (a sort of S-Corp hybred)--enough to know that by the time most of these have been digested the info can cause a nasty constipation.

    I kept it simple in the beginning and I keep it simple now. From Sole Proprietorship to a General Partnership. From one to two.

    Soon we will contract another nurse to help us out. Here is what we require of this person which is what I required of myself and my partner:
    1. Current license to practice in our State
    2. Full malpractice/liability coverage
    3. At least two years Med/Surg or LTC experience
    4. Current/valid DBA
    5. Valid drivers license
    6. At least PLPD auto insurance coverage
    7. Current TB Test

    There's more but it's not necessary to this posting. My self-employment is not predicated on how much about business I know--it is predicated on how much I am willing to learn as I go and how much I am willing to change in order to keep my priorities straight.

    Keep it simple

    Lois
  7. by   nursemicke
    Lois,
    "the info can cause nasty constipation" LOL
    Great advice! Keep it simple is best when starting a business. You can always get complicated later. Just as you were a success before taking on a partner. A nurse starting a medicaid/private peds business wants to know how to bill medicaid. Do you have to go through an agency?
  8. by   LoisJean
    Well....here's how it is with us: A person is referred to our State Agency which is a Community Based Waiver Program. The initial visit is made by a nurse and a social worker. The person's evaluation is based on need; if they qualify for the Waiver then the appropriate Community Services are called in based on the assessments made.

    This Agency provides us with a form to fill out on each client to be submitted at the end of each billing date....we submit ours monthly. We then send in the forms on all clients seen that month and they process them then send us a check.

    We keep our nursing notes on file along with any other pertinent info which is sent to us from the Agency like work orders, re-assessments and so on.

    We were recently audited by the State and passed in very good standing. That was a wonderful day for us.

    Where is this nurse receiving the referrals from? If it is a State agency and she is contracted with them to provide services then it seems the referring agency ought to be handling her billing. If she is receiving her referrals from a physician then she may have to do her own billing. I know that things can differ from State to State. Perhaps, if she is truly in a quandry, she might check with her State Medicaid office. Hope this was of some help.


    Peace,
    Lois
  9. by   TRN
    CAN SOMEONE EXPLAIN WHAT A C-CORP AND S CORP IS? I DON'T KNOW IF I'LL EVER BE ABLE TO START MY DREAM OF MY OWN BUSINESS B/C I JUST DON'T UNDERSTAND THESE TYPES OF THINGS! WHERE DOES ONE BEGIN?
  10. by   nightingale
    Dave? How about explaining this one?

    Thanks...
  11. by   Brian
    Here are a few S and C corps pages I found doing a quick search on google:

    "S" vs "C"-Corporations (California)
    http://www.ccsfo.com/basics/scorp.htm

    S-Corp
    http://www.tannedfeet.com/s-corp.htm

    Each state may have different laws, you might want to contact your states Department of Commerce or the Secretary of State and ask them to send you some publications on starting your own business, more than likely, they have booklets.

    For example, Here is MN Secratary of states website:
    http://www.sos.state.mn.us/prodpubs.html

    Good Luck all!
    Hope this helps
    Last edit by brian on Jun 12, '02
  12. by   nightingale
    I just did a search for Wyoming and found a frequently asked question page on the "Home Page of the Wyoming Secretary of State".

    The info regarding filing, tax fees, etc. varies so much from state to state.

    Thank you Brian for your input. Are you a C-Corp or an S-Corp?

    B.
  13. by   tinkle
    I have no interest in starting an agency as I did that years ago. But I do however want to do elder nail care in our community. I think there is a need for it and it would be something I could do and set my own schedule to work around my family. However I mentioned it to another RN who said but wouldn't someone think you are practicing without a license. I do have my RN and this is not something I would need an MD for. But it made me start thinking and made me worry. Any body have some ideas or thoughts to help me out. It is very scary. I don't want to be a podiatrist, I just want to help the elderly and work around my family. HELP< if you can. tinkle

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