Self Employed CNA?

[Brad_RN_Student_PA]

Hi all...kinda new here, but figured this would be a good place to start to find some answers. I'm currently a CNA, as is my wife. I'm going to RN School, and will graduate in Spring '07 (whew hew!). I went to school for business management prior to nursing, and being an entrepreneur runs in my blood...SO...I am wondering if my wife and I are legally allowed to run a home health agency (starting out, just us doing the care as CNA's, then eventually perhaps employing LPN's and/or RN's.) We live in PA, so I imagine any laws governing this would have to be state-specific. Also, wondering if anyone has advice for getting this off the ground...obviously we will both have to remain at our current jobs until a positive cash flow is created (with the price of gas, not sure if this would even be feasible). And obviously couldnt perform any care beyond our professional scope of limitations. Anyone have any comments/advice/experience on this? Any help greatly appreciated! And a special hello to all RN STUDENTS CLASS OF '07! WHEW HEW!

[CritterLover, BSN, RN]

it really depends on what exactly you have in mind, and whether you are planning on trying to get reimbursed by medicare/medicaid/private insurance.

you could offer the home care services of a cna, certainly. cnas/home health aides work for themselves all the time. this would most likely be private pay.

as for opening a home health agency, i believe first of all you would need to apply for a certificate of need from the state, and get that approved. while you could, of course, be the owner/founder/administrator of the agency, you would have to employ at least an rn as a supervisor, most likely more than one. medicare does not reimburse for the services of an aide in itself; it will reimburse for "skilled care" (read: rn level), and will sometimes give enough money for that skill to cover aide services as well. but that care given by an aide must be supervised by an rn.

i once worked for a small home health agency. there was an administrator, an rn director of nursing, an rn clinical supervisor, and a clerk that were on staff. then there were several "per diem" staff -- staff that were only paid for the visits they made, rather than an hourly rate. probably 1 aide, 2 lps and 5 or 6 rns. that was the smallest agency i've ever worked for, and even it needed several rns to function.

this would be a very complex undertaking, good luck in what you decide to do.