[msjones]

I am very interested in starting a home health agency. I have worked as a home care nurse in Florida but have recently relocated to Atlanta Georgia. I live in a growing area, but I have noticed that some people live miles away from health care services. Can someone offer an opinion about this venture?

[caliotter3]

I'm just a lil old worker bee in hh but offhand, I would think that the regulatory stuff and initial costs to get up and running would be very daunting. However, the thought is appealing. How about starting small with one "buddy" worker? You could simply place want ads in local media like caregivers do for private duty cases and take it from there. I would say you research first for your compliance needs re: paperwork and interface with agencies, payment sources. It should be doable if you start small. Contract examples and the regs can be found on the internet. The idea I'm trying to convey is that if you don't try to go whole enchilada at once, it might be easier to accomplish. I have seen examples of such. They always have "nurse owned in" their ads, so they had to start somehow. I suggest you look for agencies that have nurse owned/nurse managed in their ads and call them for possible info. Some people are not averse to giving encouragement to others. Good luck if you try this route.

[justcurious99]

I am actually in the process of doing initial due diligence on a few businesses with Home Health Care being one of them. I live in Marietta (West Cobb). If you have any interest in talking or exchanging ideas, send me an email.

Jeff

[Ophelia78]

It is totally possible but incredibly daunting. I am now in the process of leaving the capsizing home health agency started in July by a coworker. Some tips: It will cost much more than you think and will and take far longer to get reimbursed than you will plan for. Please be sure to have a solid business plan first. You will have to treat patients for free at first. To be Medicare certified you have to have discharged 3 patients and have 7 on the rolls. You have to offer at least two skilled services (Nsg, PT, OT, ST, MSW). You will have to have an office separate from your home. The state Medicare surveyor might have a waiting list 2-3 months long- and that's AFTER you've built up your required caseload. No private insurance will even consider you as a provider until you have passed your initial survey and have a Medicare number.

You'll need workers comp and malpractice insurance. You'll need policy and procedure manuals for the business (we got ours from Briggs, but they have to be finetuned, some are vague). You'll need a secure computer (hardware and software firewalls and secure access to meet HIPAA), a Level III shredder, and a hard-drive that supports whatever system the state uses to send OASIS data to them (or invest in software that meets their requirements). You'll need an Oasis manual, your state operations manual, and your local fiscal intermediary manual (all downloadable). And I suggest getting in touch with your state home care association- ours has been incredibly helpful and gives workshops on Homecare 101 for newbies, Oasis, Coding, and Billing.

I would highly suggest having home care experience before starting- there is so much more to it than taking vitals and simple dressing changes.

And last- plan, plan, plan, plan, plan, plan, plan.

Good luck!

[justcurious99]

Interesting points Ophelia.. Thanks for the info. I have started to uncover some of the points and you validated some of my sneaky suspicions. I am starting to lean towards buying an existing if I were to get into the field. Seems like a easier road to hoe.

[NRSKarenRN]

Start ups need to have $250,000 to $500,000 capital if billing insurance companies and medicaid. Medicare requires you to have 10 patients on service before they will certify your agency---you don't get paid for those first clients either. If you are starting private staffing, then can get by with $50,000 to $100,000 startup.

Check out our Home Health forum for more info. I highly recomend that somewone work as Clinical Manager in Medicare certified agency to learn the ropes prior to going out with own shingle.

Good Luck!

[eddy]

Now is a pretty unsure time for considering entrance into the Home Health arena. Budget cuts, increased regulation and reporting, slower reimbursement and other factors are reasons why. Private insurers are following the government's lead and cutting reimbursement rates also. Some of the larger home health companies in the nation are already experiencing some substantial cash flow problems and many are operating at a loss right now due to these issues. It's going to get worse before it gets better. I'd say wait a couple of years for the market to get back to a sustainable and friendly environment for a home health startup. Your business will have a much better chance for survival and profitability. Don't get me wrong. I believe that home health will rebound, but I just think that waiting for the right time is a better plan right now. Good luck!

[msjones]

Thank to all for your comments, it is a little more involved than I thought, so I think I am going to start very small. I am in the process of writing a business plan out with some projections so just pray for success for me as I jump into this venture.

[eddy]

Good luck. Just make sure to proceed cautiously and carefully. Now is one of the most uncertain times in the industry in probably the last decade.

I would suggest you consider private pay rather than medicare/medicaid when starting out.