Becoming Independent Nurse Contractor


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by BMOB BMOB (New) New


Specializes in ICU (all), neuro, child rehab. Has 14 years experience.

I am like all of you - wanting to have some control over my schedule AND earn more money! Let's just share thoughts and ideas we glean as we read, surf the net, etc. Too many of these posts are "does anyone have any ideas how to......" with no answers, every one asking for help and no one giving any. Let's put our collective heads together and figure this out ourselves!

I ordered a downloadable package from the Miracles and it was OK. I wrote and asked them some questions and got some replies within just two or three days. But I felt like I wasn't getting the IMPORTANT question answered which is "What do I charge"!!

Personally, I am interested in being an independent contractor for one or two facilities acting just like a staff nurse or agency nurse. I worked for alkmost 5 years with a major hospital and just the last three months have worked for an agency. I LOVE the freedom the agency offers - I set my own schedule!! I can haave weekends with my family and holidays off if I want! I no longer work graveyard! My salary is the same. l Where I work is MUCh more pleasant and enjoyable.

The downside? I get cancelled for several shifts a month and I need the income that 40 hours a week give (at my current salary rate). I have no health insurance and can't afford it when the salary is no different from what I got at a hospital. and THE biggie - I get paid my $25 hour but the agency gets........??? $35? $45? $65? an hour?

I want to form my own mini-agency of one and just under cut the staffing agencies amd what they charge the local facilities. Of course, the million dollar question is "what do they charge" Any ex-staff agency peiple out there?

I have spent hours cruising the net and found a few sites that gave me an idea of charges. One gave ranges by geographic areas and, roughly speaking, the bill rate in 2005 was $50-65 hour for bedside nurses. Travel nursing was a lot more.

TO be an independent contractor you need to determine:

1) your focus. One person agency? Legal consultnat? Asetheician? etc

2) Get an IRS FIN#

3) Go to your local governments and do whatever you need re:business permits and licenses

4) Open an seperate checking account and credit card for your business

5) Decide on a business name and check the web for your own URL/domaine nameSeparate credit card

6) NSO for malpractice insurance

7) Market research - go to HR at local facilities and TALK to them about temp- staffing or talk to other legal consultants etc

8) Get a contract drafted and check it with an attorney

9) Design your letterhead, business caqrds and business flyer

10) NETWORK. Look up networking groups on the internet and attend the meetings.

11) Call on the accounts you wants. Caqll. Set up the appointment and sell your self!

Now, This is some Ideas I have written down the past few weeks as I organized my thoughts and goals.l I woulkd kkoive feedback and suggestions and I hope we can allk benefit from this.l

Go to the web site of National Association of Independent Nurses

Join. I have requested the information pack they offer and will most likely join. members have a discussion forum and I think that will be invaluable..

Good Luck All!!


Specializes in Med surg, Critical Care, LTC. Has 20 years experience.

If your going to borrow money to start your business, you will need a professionally written business plan.

Hello Everyone !

I am very interested in becoming independent as an Interim Nurse Director. Does anyone have any idea what the large employment companies bill the hospitals for Interim Nurses ?

I know the hospital pays all travel, all housing, rental car, but I need to know what the bill rate is .

A couple of years ago, I was paid $ 8000.00 per month by the agency, but I need to know what they were billing the hospital.

Any help would be appreciated.



AuggieRN said:
Hello Everyone !

I am very interested in becoming independent as an Interim Nurse Director. Does anyone have any idea what the large employment companies bill the hospitals for Interim Nurses ?

I know the hospital pays all travel, all housing, rental car, but I need to know what the bill rate is .

A couple of years ago, I was paid $ 8000.00 per month by the agency, but I need to know what they were billing the hospital.

Any help would be appreciated.



I plan on doing the same thing and becoming an independent contractor. Right now I'm doing an LPN-RN bridge so I don't have much time to get it going. One agency I worked for was pulling an assignment up on the computer and I saw what they billed the facility. $360 for an 8 hour shift. I am an LPN and I was to be paid $21/hr for this assignment so $168 for the shift.

I know many contractors in different fields that get paid 25-40% of what their bill rate is. I don't know if that is true in nursing but from the above numbers it looks like it.

My plan right now is to bid myself out to several facilities at about 1.75- 1.85 times what I would be paid as an agency nurse. This will put my bid below what the agencies charge so hopefully I will get called first 🙂

Remember, it is easier to charge less later if you have to, than kick your self and not be able to charge more!

I am also interested in the Independent nurse contractor, I had ordered the package from mericle, but I still have no clue as to how I get started


Specializes in OR, HH.

Hi yamiarn,

I was curious to know how you are doing in your quest to become an Independent RN? I had never heard of this until I was searching allnurses.



Specializes in Critical Care, ER, Tele. Has 7 years experience.

The message above that the "Growth Assessment Report" was linked from 2005 where did you get it and how can I get a more recent one.

Edited by nursejulie22


Specializes in Home Care.

This was a great thread to find. I am an independent nurse consultant in Ohio. It has been a slow start. You need to know in what area you are going to be involved. I worked as the director for a juvenile lock-down and then as the director for a home care agency. I spent many many hours pouring over the regulations for the state and the Nurse Practice Act for the state to see just what I could do without being connected to a doctor or a facility. When I was working for an agency I found that many people in the community and even many hospitals do not know how to research facilities or placement for those who need long term care (either in the home or in a long term care placement). Now I get paid to help families and clients research what their options are based on what they need. I work with the doctor to find out the concerns medically and with the client/pcg to assess safety and comfort issues. I then discuss the best options for care in the least restrictive environment. Sometimes this means also recommending which nursing home/rehab center/ assisted living I think will best meet the needs of my client. It was hard at first but after I spent some time touring the facilities in the area and becoming extremely familiar with the resources in the community (and using the CMS website and insurance websites to see what Medicare and/or insurances pays) it is easier. In the beginning it is alot of research and building files on what is available so that you become the expert. I charge clients based on income and sometime I do it at no cost but it is very rewarding to know that you helped someone find the right fit and remain as independent as possible. Insurances do not pay for this kind of work so you have to really market yourself and you have to be expert or no one will want to pay you.

Good luck. There is good advise at the entrepreneurs section of this site AND you should look at

Ximena2008, RN

Specializes in Home care, Infection Disease. Has 9 years experience.

Hello there Kathi:

would you please guide me on how and with who should I become certified as a wound care specialist. I am comtemplating the idea of IC and wound care has always been something I like. More info would be great. Thanks in advance.


I live in Vermont, and I too am interested in becoming a privat duty independent nurse. Does anyone know how to obtain a billing number for insurances or medicare? Or, better yet, how exactly do you get paid?

Does anyone have sample letters you send out for your bids? How do you approach that? How do you find out what positions are available and what hospitals/facilities are looking for independent contractors?

I have been thinking of doing this too. I am very early in the idea, but I have owned my own business for several years. I have worked as a homebirth midwife and a lactation consultant. I love my job and love my business, but due to sick family members who need care and 5 kids to take care of, I can't be on call 24/7 and rush out to births at a moments notice. I am teaching nursing students in postpartum right now 2 days a week and really like that too, but need more income.

I have an NPI number that I use. RN's can get one, you just go to the website and apply. I have been able to use that for some of my lactation work and even some of the midwifery appointments (and I am a direct entry midwife, not advanced practice). I have a billing company that I hire out and they do the billing for me, they specialize in midwives so they are very good at getting the reimbursements. I didn't realize that I could even get coverage as an RN, but I did!


Has 19 years experience.

You do not have to be a NP to bill medicare. You do have to have your own medicare provider number.

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