Why are there NO posts to this forum?

dmagee · Jan 17, 2002

It is not hard if you have the right team of professionals working behind you. That has been a major issue over the past two years for me. I found and used certain screening questions with these professionals. If they say no to a corporation because of double taxation it is time to find a new one. If they say no to a C-Corp because of a nurse having to be a professional service corporation, it is time to move onto the next cpa or lawyer. If they say you shouldn't be in business for yourself because it cost too much in taxes etc. then it is time to move to the next one. I cannot tell you how excited I am to have finally found a team of professionals that can handle it all for one flat fee. Not the $250hr lawyer or the $75hr CPA. I just spoke to a nurse yesterday who was excited about the land she just bought for investment purposes. I asked her who's name that land was under. She said her name. I proceeded to remind her that if she made a med error that killed someone at work tonight and got sued she could kiss her land good bye. It is important that we find professionals that will show us how to protect our assets and keep more of our own money. The goal here is to ritire from nursing early and there is no reason this cannot happen with the money that is being made. It just isn't going to happen being an employee.

David

SICU Queen · Mar 12, 2002

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... :)

nursemicke · Mar 12, 2002

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.

LoisJean · Jun 1, 2002

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

nightingale, RN · Jun 1, 2002

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

nursemicke · Jun 1, 2002

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.

LoisJean · Jun 6, 2002

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

nursemicke · Jun 8, 2002

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?

LoisJean · Jun 8, 2002

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

TRN · Jun 12, 2002

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?

nightingale, RN · Jun 12, 2002

Dave? How about explaining this one?

Thanks...

Brian, ASN, RN · Jun 12, 2002

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