Hoolahan: Thanks for the promotion! Seriously, never served as DON, only acting administrator during vacation refief over two years for a home care agency. Did serve as Clinical coordinator/QA in my previous home care agency. Currently work in intake/UR in non-profit homecare agency.
My first home care experience in 1985 was working for a 6 month old, privately RN owned company that is still in existence. Working as independent contractor, We did private pay shift nursing, facility staffing, Medicare + insurance cases and served as subcontractor for various IV agencies, so I've seen a lot as I grew with them over 10 years.
DJH: See that you only want to do private pay. Will it be RN only staffing, or have HHA/homemaker's? Different rules for each.
With RN's you can be broker and hire staff as independent contractors. With the HHA's, you will be employer, workman's comp, background checks, overtime, etc., will be big costs, along with no shows, as I have seen about 10% HHA no call, no show for work over the past 15 years.
Owner of first agency had equity line of credit tied to home in order to meet payroll till established cash flow, be careful of this. Consider having 6 months expenses in savings, to protect against losses. In the Phila. area, homecare staffing has almost dried up---how easy to recruit in your area? Thinking you have experience in home care re your post, I offer the following.
Where to start:
1. Contact state board of health re rules/regulations.
2. Contact small business administration re startup, funding and business plan.
3. Look at Medicare and JCAHO web sites re laws and standards, also fraud and abuse rulings. You will be held to their standards, even if not servicing their members as they are national standards
Medicare and Medicaid manuals, bulletins online, and link to healthwatch update re MC laws
here @ http://www.hcfa.gov/pubforms/pubpti.htm.
JCAHO site with links to some standards: http://www.jcaho.org.
4. Visit a college with nursing program major: nursing administration. I'm sure they'd have textbooks/resouces available on home care agency's and maybe they can put you in contact with more resources.
5. Consider joining homecare organization. One group I'm aware of is American Home Care Association,Inc.
Web site http://www.americanhca.org.
They have a large convention, October 22 - 25, 2001 New Orleans, Louisiana.
Convention website including listing of presentations:
Newsletter links from this site-http://www.americanhca.org/execs/nlengine.exe
Most familiar with these publications, all excellent. Eli's is one of the bible's of the industry, expensive subscription but with it. ?? available at college library's with MBA Healthcare programs.
T.M. Marrelli's Home Care Nurse News
Eli's Home Care Week
Home Care Compliance Alert
Other group that my Homecare agency is a member of is National Association of Homecare Agencies:
The have a magazine CARING with other links here:
Check out thie Homecare University that I just found on 7/30/01:
6. Do you have a healthcare council in your area? Here is a link: http://www.pohly.com/assoc4.html.
7. Check out website I found this week from another healthcare consultant, Pam Pohly's "Toolbox for Health Managers & Administrators" @ http://www.pohly.com/admin.html.
Major topics listed here with may further links:
Executive & Health Administration - Wealth of health management resources here
Publications, Journals & News - Industry news, research, who's who
Medical Legal, Governmental & Regulatory Links - Resources for compliance
MIS & Software Links - Systems, software, telemedicine, what's hot
Other Health Administration SuperSites - Other health management websites
Medical & Clinical SuperSites - Clinical links with mostly medical information
Human Resource Tools - HR and personnel resources for health care
Road Warrior & Traveling Tools - Make reservations, check weather, maps & more
Professional Associations - Guide to organizations for health professionals on the net
Hospital Associations - Links to hospital associations, by state
Health Care Compensation & Salary Surveys - Check out what everybody makes
Internet Guide for Mental Health Professionals - Links for behavioral health
Hospitals, Managed Care & Healthcare Companies on the Net - A wealth of links to employers
8. Consider consultant. Know of Tina Marrelli from her Homecare documentation handbook and newsletter, does consultations.
Her website is http://www.marrelli.com
Marrelli and Associates, Inc.
P.O. Box 629
Boca Grande, FL 33921
Phone: (800) 993-6397 (NEWS) or (941) 697-2900
Fax: (941) 697-2901
9. Willing to ask RN colleagues that own homecare agency, if they would be willing to speak to you (know two different agencies) if you desire.
Ten years ago, considered having my own agency. Knowing it would tie up 80% of my time, beeper and cell phone forever tied to me, I decided against it. Email me if desired: NRSKarenRN@aol.com