btoddrn

My name is Todd and I am starting a new inpatient detox/rehab facility just south of Pittsburgh. I have done ER/ICU nursing for 13 years along with home health hospice for 3 years. After that, I became a CRNA. I now also do real estate investing. With my experience in nursing, none of it involved inpatient detox. I know the regulations and guidelines, but I'd actually like to talk with a detox nurse before I get started. Mostly about expected patient load and optimal setup of the patient rooms and surrounding area. And if you are near Pittsburgh where the facility will be or near Northern Virginia where I live, all the better. Thanks!

How about if there was somewhere you could go that would help you get set up as an LLC or S-Corp; would help with the contracts; remind you of when your certifications and licenses were about to expire to make sure you stayed compliant; connect you with facilities that take Independent Contractors; and would help you with scheduling at the different facilities? If you had all of this assistance, would it then be worth the extra money?

What would be needed is for you to create an LLC or S corp. Then you would have to pay quarterly taxes instead of annual. When you work for a hospital as an employee, you pay some taxes and they pay some of the taxes. When you work for yourself, you have to pay both of those taxes. However, when you work as an independent contractor (1099 employee), you are then able to write off a lot more when you file your taxes. You will need a good CPA that is experienced in working with independent contractors to make sure you stay on the up and up with the IRS.

I am currently in school for nurse anesthesia. I have been several different places with clinicals and have certainly experienced a lot of variation in "this is the right way to do it." Something I was curious about is how should you handle things when there is a discrepancy between what you (the CRNA) and the anesthesiologist believe is the right way to do something. Especially when it is something you feel is poor practice or patient care. Do you do whatever it is because he/she is the attending and signs as the supervising attending to the case? Do you step back with risk of ruffling feathers and say if that is what you think should be done, then you do it, because it is you that is also signing the chart? Or do you put your foot down and say it really needs to be done this way? If anyone has any experiences and examples, I would really love to hear them. Thanks!

If you were able to work for a hospital as an independent contractor and made more money, do you think it would be worth paying your own malpractice insurance, health insurance, self employment taxes (quarterly) and social security? I am not asking if it is possible. I am simply asking for some feedback to see if you think it would be worth the extra effort if you ended up making more, say a net of about $5-$10/hr more.

That was my thought, but I wanted to make sure I wasn't missing something. However, the quote came from someone who you wouldn't think would be making crazy statements like that. But I guess anyone can put a big title behind their name and start an association.

Thank you so much for that information. Medicare/Medicaid is definitely complex, and I am sure it will be even more complex when the ICD-10 comes out. However, the question that I am really trying to get at is if Medicare/Medicaid would have any issues with patients receiving care from nurses that are independent contractors filling temporary staffing positions versus staff employees. I am dealing with all of the other payroll, tax, business structure questions and concerns. What I am trying to narrow down is the rumor online that Medicare/Medicaid will not reimburse for patients receiving care by nurse independent contractors. That makes no sense to me since CRNAs do it every day. But if anyone can confirm or deny this, it would be greatly appreciated. And if this is the case, I would really like some direction as to where I can get written confirmation. Thanks!!!!!!

I wanted to see if anyone knows for sure if it is true that Medicare/Medicaid won't reimburse hospitals if they are using nurse independent contractors. There are some statements out there on the internet that says just this. However, I am extremely perplexed by this because there are many CRNAs that are independent contractors that take care of medicare patients.

I got in my second time applying after being waitlisted my first time. I took the GRE, got my CCRN, took the two classes listed by VCU online, and took a 400 level physiology class at GMU. It is a fabulous program and they are incredibly supportive versus other programs I have heard of. Good luck!!!

I have an ipad which I love for school. I tried printing out all the slides the first semester and then got an ipad second semester. It is so much more convenient. I don't have to waste paper or pay for ink cartridges. I also kept getting upset because slides were being updated after I would print them out. So now I just download the lectures right before class. It also saves sooo much room. I was concerned about being able to study off of it, but I have had no trouble doing so.

I am looking for someone that worked last year as a 1099 CRNA worker. I am trying to figure out the difference between CRNAs and RNs in working as 1099 workers in the hospital setting. If you know of any reasons why CRNAs can but RNs can't work as 1099 independent contractors for hospitals, I would love to know why. Thanks!

Thanks for the information. From those I have talked with so far, I am finding that the limiting factor deals more with the federal, state and employment tax laws. If anyone can chime in on this, it would be GREATLY appreciated. I have been told that it may not be possible to work in a hospital as an independent contractor because no one would be paying the employee tax that hospitals or agencies currently do for hospital employees or agency nurses respectively. Does anyone know if this is the case and is there a way around this by having the independent contractor pay their business taxes?

Thanks for the thoughts! I'll definitely let you know what comes of it? :)

I was wondering if anyone has any experience in being an independent contractor for a hospital just like an agency nurse but not going through an agency. If so, what tips can you give me and how does the billing work? Thanks!

I did work in the ED there and coincidently, I talked to a nurse yesterday who just worked at Howard last week and quit. I don't know how there tele unit is at all, but I can't imagine it being that much better. All I know for sure about is the ER. And everyone there seems to be extremely miserable going from the charge nurses to nurses to techs and even to the parking garage security officers. Nobody seems to be happy there at all and that makes a huge difference. For me anyway, noone was helpful at all. But again, that was five years ago but things don't seem to have changed from the way the nurse I was talking to yesterday was saying. Howard is a very inner city busy hospital. I don't want to rain on your parade, but my suggestion to you as a new grad would be to look else where. And I wouldn't suggest you believe a lot about what the recruiter says because it is there job to get warm bodies to work there and that is really all they care about and all there job is. They don't get paid if you don't work there. I would just hate for you to hate nursing right off the bat just because you are working in a s*&t hole. Again, sorry, but good luck.