Starting An Agency - page 8

I'm exploring the possibility of starting an agency. I've worked agency for several years in an urban area with many hospitals (and agencies). I have a pretty good feel for what hospitals are paying... Read More

  1. by   MsBiz
    I am working as an independent contract but I am not sure how to get started. Does anyone have any advice to point me in the right directions?
  2. by   ICBSN
    Quote from MsBiz
    I am working as an independent contract but I am not sure how to get started. Does anyone have any advice to point me in the right directions?
    Same here I would love to get started...does anyone have any advice?
  3. by   yamiarn2
    Quote from WyomingRN
    Both me and my husband are independent contractors. Technically speaking, all agencies are independent contractors. My husband is a construction contractor. I took his 14 years of experience and applied it to nursing and am now a nursing contractor. Like my husband, sometimes I am the only employee of the business. Like my husband, sometimes I hire a few employees when the need arises.

    As a nursing contractor, I work out of my home; as do many independent contractors including my husband. I started off as the only employee and had very little expense. One month, I paid for my yellow page advertising; the next month I paid for insurance for the LLC so that I could hire employees when the need arose. Cost can be spread out as you earn money. My entire start-up expense is paid in full and within my first two months, I recouped the entire cost working no more than 12 days. We printed up our own advertising flyers right here on the computer as we needed them. We designed and printed my business cards right here on the computer. They both look very professional and cost us a fraction of having others do it (and if want to change something, I'm not stuck with hundreds of cards). I now have a contract with two facilities and am negotiating with another.

    Of course you do have the option of borrowing tons of money, renting a fancy office, buying a new computer instead of making due, ordering 500 business cards all at one time, and hiring a professional marketing agent, etc. You can run your start-up costs up as high as you like.

    As to the question of what to charge, we know that there is no one answer. In preparing to go independent, I simply started asking the DON's and staffing personal at various facilities "how bad is agency zyz ripping you off?" I was surprised at the information they were willing to divulge. The love to moan and complain about how bad the facility was being ripped off. The cheapest rate we have found is $65 for an RN for our area. Every facility we have talked to in the last year has made it a point to tell us about all the extras that agencies add above the basic rate for things like a nurse working as "charge", shift differential, housing costs and travel expenses. In our area, the agencies pass everything on to the facility. So there is room to negotiate and maneuver.

    Check out the information on these threads also:
    Independent Nurses providing medical care?
    PRN vs Independent Contract
    Independent Contracting and Protecting Your License
    RN Independent Contractor

    This information helps you out.

    TERRIFIC HELP - many,many thanks!
  4. by   yamiarn2
    Quote from suzanne4
    You need liability insurance for your agency. You usually will be providing malpractice insurance for your nurses. What about benefits for them? Bill rates are normally never shared with other agencies. They can vary quite a bit. Rate charged will also depend on the quality of your nurses and their dependability. From a business standpoint you are looking at things wrong. Calculate what your costs are and what you will be paying your staff and remember to include mandatory education that may not be reimbursed by the hospital, etc. Do not forget accounting/auditor charges, computer program for billing, advertising, phone service, etc. You need to come up with a workable number that way, do not base your rates on what others are charging. This is how you will make the best deal for yourself. And I am telling you this 100% from experience. I owned my own agency before I moved to the other side of the world. And I can definitely say that the rates we got were higher than many other agencies because the nurses that worked for my agency were quite flexible and could work many different areas. All of us are ACLS and PALS certified. I also have NRP certification. We are all able and qualified to work critical care, including CVICU, PICU, etc, Emergency, and OR.
    All of us have been members of heart teams, etc. Prices charged will depend on what you can offer from your nursing side. Are they willing to take call? Will they work at the last minute? Are they flexible as to what units they will work for the day, and perhaps more than one? I remember one hospital in Michigan where I worked ER on Monday, admitted a patient with chest pain, did his heart the next day in the OR, took care of him the following day in the ICU. I also remember another facility, where I worked 4 hours in PACU, four hours in Endoscopy, and four hours in OR. Experience means more money. You also need to start with hospitals where you have worked and they are familiar with you.
    That is the absolute best way to get started.

    Good luck to you..............................
    p.s. Feel free to send me a PM if you have other specific questions

    Incredibly helpful - thanks
  5. by   yamiarn2
    Quote from sherese
    Right now iam just trying to understand the business and how it runs. i know that I will need lots of money in order to pay the nurses but i also know that there are funding companies that that can help me do this. Can you please tell me something? I want to know after I have recruited some nurses willing to work for me and after I land some accounts in hospitals etc. When a client hospital is looking for a nurse for per diem work how much in advance do they call, usually when do they contact you . do they call you 24 hrs before they need a nurse? what happens if they call and you think you have someone to fill a position but then for some reason they cant make it what is usually done? I want to know a little bit about how the business is ran from the inside so that when I set up my business I can create my own unique selling point that will deal with these types of issues

    Why not work for an agency for a year or two? You will learn the ropes that way. You need a thorough understanding of business practices, various regulations, networks, etc. Another option is to work at the facioity end as a nurse/ancillary staff recruiter if you have the education for the position.

    I recommend you set an apointment with one or tw3o DONs, HR persoannel or the like - take them to lunch - and ask them lots of questions. Be upfront and honest about why you are asking them to lunch. Monolitic hospital staff are too busy but a small community hospital and SNF would probably be a candidate.
  6. by   brissygal
    Don't forget us Aussie Nurses still in Australia who want to work in the USA. Check out the E-3 visa through immigration. Cheaper for the employer. This visa is only for Professional Australian who can work in USA - nursing applies. Most of the recruiting agencies are taking advantage of this visa.

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