RN Independent Contractor

nurserowina · Apr 29, 2004

Hi there

you mentioned that you are compliling some information onto a CD- sign me up.

I am very interested in working for myself. I believe that this should be a trend for nursing- nurses should be able to bill like physicians do, we provide a service, a very important service- we are so needed, where would healthcare be without us?

suzanne4, RN · Apr 29, 2004

I set up my corporations in Michigan, each were about $60 at the time. The paperwork can be done on your own. If you have an "S" corporation, most of the paperwork is done as part of the 'owner's own tax form..............extremely simple to do and actually much easier to do as you can do all of the paperwork yourself, and with many of the others you need to pay someone to do it.................... :balloons:

nurse_robin · Apr 29, 2004

Thanks Wyoming!

I sent you a priate email.

sherryg0 · May 16, 2004

Dear Wyoming:

What group will help me become independent in California or Arizona?

Is there a collection of nurses that are independent connected by membership to any organization?

Thanks for the reply in advance

Evening All - this is the "other half" of Canyon View Nursing. Pat is out for the next week on assignment and I didn't think you should have to wait for information. I started pushing her to go IC in November 2002. She decided to make the leap in January, 2003. We spent four months getting everything set up as she was under a contract to an agency until May anyway, but decided not to do any marketing until November as we run a lawn sprinkler business and the summers are very busy and we did not think we could devote the proper time to a new business start-up during the summer. The last week of Oct., 2003 we started marketing, and she was working her first assignment as an IC by Thanksgiving in which she made more than all of her start-up cost combined. Each month has gotten better and we are now in the process of marketing to four more facilities. Thus far, we have not been real aggressive on the marketing. Maybe it would be called a soft sell marketing strategy.

Band together - there are a ton of IC's in Calif. In addition, many of them are now setting up PPG's (Professional Practice Groups). If I understand it right, the difference between a PPG and an agency is that you have a part ownership in the PPG and thus share in the profits. It is also my understanding that all the participants have to take assignments (share the workload - pull your own weight - nobody making money off the labor of others).

With that said, I'll return my attention back to cpk's post and try to answer some questions. As to helping others, I believe we are communicating with 4-6 right now. I know one pretty much has everything set up and is getting ready to start marketing; the rest are in various stages of start-up. I think most of the people we hear from are serious, but one never really knows. I do remember one that I felt was more curious than serious. We won't hear from one person or another for weeks, and then all the sudden we get an e-mail with questions. So you never quite sure what people are doing. I will check with NAIN to see if I can find any members in the MN area.
Since November, I have been compiling information we have either used or referred to. My goal is to get it all on a cd. I believe that having the information in a usable format on a cd will save tons of time (such as re-typing) as well as expense. For instance, I did not like the contract template which we received from NAIN, so I completely re-typed it. ( I have 15 years paralegal experience) Then I submitted it to Pat's brother who is an attorney. He made suggestions and hopefully, we have a very good and universal contract template that can be adapted with just a little editing time. (We used this template to make a final one year contract with the facility which she is headed to today.) To give you an idea of what is on the cd, so far I have a business plan (I am in the process of adding another one), ideas for business cards, invoices, contracts, etc.. I plan to get all of this on a cd and out for $25. I tried to get NAIN to do this - and sent them a cd with what I had at the time - but they never acted on it. Another IC and member of NAIN encouraged us to "go for it" as it would help everyone and save start-up cost, so I decided to take the ball and run with it. At this time, I have no plans to openly market it. I am doing it for those that are interested to save them time and money. I believe that the easier we can make the process, the more that will be interested in becoming autonomous.

As to some ideas on "how to get started", here are some specifics:

1. Make a commitment. Having a new business is like having a one year old child. It takes a lot of attention and commitment. Having an established business is like having an 8 year old child. You can relax a little, but never very much. But the rewards are well worth it.

2. Becoming an IC means having two jobs; one is nursing - the other is running the business. As I tell Pat, when running the business, take off you nurse's hat and "think like a business person". What is best for the business? When nursing, take off your business hat. Doing your job right as a nurse will sell your business more than anything else. Each job (nursing and running a business) takes different talents and a completely different thought process.

3. Decide on a business name. You will need this for the next step. At this point you should also consider writing a business plan. A business plan will really help in deciding what kind of a business you really want (do you want to specialize in anything - are you willing to travel - if so, how far - I understand that there is one IC that is going State to State with her RV - ain't that a hoot) as well as help you think about how you are going to market your business and the costs of everything. It will also help you see how the costs will come down. For example, are you going to use you personal phone number or pay for an additional business line? Are you going to use you personal cell phone or is the business going to have a separate cell phone? What kind of an advertisement do you want in the yellow pages? How much is it going to cost? Do you have more than one phone book in your area? Which one(s) should you advertise in? Since phone books only come out once a year, they only take new ads certain months for each area. What is the deadline to get your ad in? This will also tell you when you have to pay for it (out of pocket expense). With a business plan in place, you should have a very good idea as to what the actual start-up costs will be. Our actual start-up was just under $2000 spread over 6 ½ months (that included paying dues for NAIN, yellow page advertising in two phone books, LLC registration, etc.) In other words, we set things up and paid one large expenditure one month, some little expenditures the next, etc. Our plan was to do this without borrowing a dime and to have all start-up cost paid for by the time she got her first assignment. A business plan does not cost a lot of money; but it does cost some time and thought.

4. Decide on what type of business you want or need; a corporation? an LLC? a partnership? etc. Setting up a corporation is the most expensive. While most State laws are pretty similar, there is enough differences to warrant the cost of an attorney to see which is right for you and to properly help you set it up. There are some Internet site that help set up corporations, but since we have not used them, I really cannot comment on them. A couple nurses have reported that they are cheaper than an attorney and paperwork is paperwork. The main reason to set up a full corporation is to protect personal assets. If you do not have a lot of personal assets, why go to the expense? It is completely a personal choice and decision. Remember, if you have a full corporation, then you will need to have insurance for both you and the corporation (which of course the corporation pays for), but by doing an LLC, we just have to carry Pats malpractice insurance. Also, having a full corporation means filing two tax forms; one for you personally and one for the corporation. By being an LLC, everything is incorporated into on filing. So like insurance, the cost is cut in half. Remember, if you set up an LLC, you can always convert it to a full corporation. So to save money at initial start-up, you may consider another form such as an LLC to start with. Regardless of what kind of a business form you choose, and who you choose to do it, to do the paperwork, who have to have a name for your business to complete the paperwork. I think I will copy Pat LLC filing and put it on the CD also. Setting up an LLC is generally pretty simple.

5. Once you have chosen what kind of a business entity you want/need, get it set up and get your insurance in place.

6. Start marketing your business. DO NOT market your new business as an IC. Technically, all agencies are IC's (independent contractors). Do you see them make a big deal of the fact that they are IC's? NO. I am an IC in a different field. I never use the words IC or independent contractor when marketing my sprinkler business. Several nurses have reported negative results from facilities when they have made a big deal out of being an IC. Once your business is up and running, you simply work for XYZ company. The fact that you own the company is generally irrelevant. What the facility wants to know is what you are charging - not who owns the company. It is also none of the facilities business as to how many employees you do or do not have. Some summers, I worked 10-12 employees. I got tired of the hassle, paperwork and taxes, so the last eight years, I have not worked any employees. While this means doing less overall work, we have ended up with more money in our pocket with none of the hassle. Some nurse IC's actually hire one or two more nurses, but they are - so far - few and far between. We have a scheduling conflict coming up in March, so now we must decide whether we are going to hire an employee, sub-contract the work to another IC, or just turn it down. (We have one RN that has been bugging us for some hours for her, but she is already booked the days we could really use her - bummer.) The bottom line, market yourself as a business - not as an IC. If you are not a creative person, how about a family member or friend? Consider contracting with someone who works in the advertising department of your newspaper. Maybe you can find someone who is interested in extra money for night or weekend work.

On a general note, we determine our hourly rate based upon several factors such as what agencies are charging. We offer our RN nursing service at the same price which local agencies are charging for LPN's. We have already established a repeat business with one facility because whether they need an RN or LPN, they can get Pat. It is less hassle for them. Another factor used to determine our rate for a particular facility is how good of a place is it to work in. If it has a bad reputation for its treatment of nurses or patients, the price goes up. By offering a better price to the better facilities, we get more calls from the better facilities which Pat prefers to work in. In my sprinkler business, I have a general price, but then have to factor in such things as how big the job is, how many trees, what the water pressure is, etc, etc. In other words, while you should have a basic price structure, that does not mean you have to charge every customer (and that is what a facility become as related to your business) the same price. We choose not to charge any extra for travel or for Pat working in a charge capacity. Also, we offer one facility a $5 an hour discount if they use our service at least 8 hours three days in a row or more. This encourages them to block her schedule rather than having her fill in one day and then have her come back two days later as one facility was doing. So far, this is working really good as every time they have called, except once, they have got the discount; and it has saved Pat a lot of travel time.

As to marketing, remember, we live in a very rural area. The facility that Pat is headed to is 170 miles (one way). The next assignment may be 90 the other direction. Making in person sales calls in not really practical. We have thus used a lot of marketing via flyers. (Remember, successful marketing means repetition - keeping your name in front of potential customers). Because of the DON, we refuse to even market to our one and only local facility. We have also used phone calls directed to DON's, HR and staffing. If you live in a metropolitan area, your marketing may consist of different things. USE YOUR IMAGINATION. We are considering offering a gal, who works as a marketer for a local agency, some additional work on the side. She needs the money so I think she will be interested and she has experience on directly calling these people. I think it will be money well spent. We have not talked to Louise (an IC in southern Calif) recently, but the last time we did, she was handling four full time contracts and turning down work 3-4 times a week. Being in a rural area has some advantages; but being in a metropolitan area has some different advantages.

Lastly, I'd like to mention that the assignment Pat headed out to tonight, also wanted her for three days in March; unfortunately, Pat is already booked for those days. I suggested that she go ahead and call an agency to cover her schedule. Her reply was that if they can't have Pat, she will work it herself. She made it clear that she did not want "just a warm body taking up space". I just loved it. Because of the sprinkler business, we understand customer service. I told her when we started, Let's spoil our customers and their patients; let's let your performance be our advertising. It may be slower, but just as in the sprinkler business, it will pay off.
Sure hope all this gives you some thoughts and ideas. If you have questions, just let us know.

pedsnurze1 · Sep 24, 2007

3 year old post and jam packed with information I've been looking for thanks for leaving it posted

caliotter3 · Sep 29, 2007

Pedsnurze1

Several years ago I saw something concerning independent contracting but have never seen it since. As I recall, it was a group or company that would (for a fee, I'm sure) help a person get set up in this practice. I also saw something similar, on, of all places, the Employment Development Dept. job website. Looked screwy to me at the time.

One of my friends is sort of an independent contractor, I guess. She was asking me about it when the insurance company that was handling the case decided to fire the home health agency. The only thing that seems to be different now, is that her paychecks come from the insurance company rather than from an agency. She had been hoping for a pay raise when the agency middle man was cut out but that did not occur. Good luck with your endeavours.

JeannieT · Aug 30, 2008

Thought I'd bump this up for others interested in IC nursing.

I think this is a fascinating venue.

The more nurses that do this, the more the hospitals will have to respond.

luvincare08 · Oct 29, 2008

Although this has been written quite some time ago. Is the CD available and where can you purchase it?

gold beach gal · Oct 29, 2008

Did you develope the CD you mentioned. I see this is an old post but maybe you are still active. I wuld like to take a foot care course and start my business here on the Pacific Coast. Any links to a good program in Oregon would be greatly appreciated. I will keep looking.

Thanks! Happy to have found this thread and this site.

Gold Beach Gal. :nurse:

NurseNancy888 · Apr 18, 2012

I am an RN working Home Health, single grandparent with custody of my 14yr. old who was diagnosed with JME (Juvenille Myoclonic Epilepsy) after her first seizure in 2009. My agency changed my status from Full-time Case Manager to PRN et lost my benefits. I was sad et bitter at first, my grandaughter blamed her condition which indirectly a factor but I am a big believer that all things happen for a reason :) I quickly changed my negative attitude around and have been making the best of it, and thankful to have a job, count my blessings, etc., etc... My employer keeps me busy when I am needed, PRN.. I spoke with the Board, of Nurses and Board of Pharmacy reps today, neither seem to know process for me to provide services independently like mediset/mediplanners, med education..VS w/assessment, foot care...tasks that medicare or medicaid (d/t recent waivers) do not cover... I would appreciate any feedback that would be helpful.