Self-Employment

Mister Chris, MSN, NP · May 5, 2004

I am looking for any nurses who are self-employed providing services to the elderly. I am especially interested in sharing effective business/marketing strategies with this population.
I have been working as a self employed nurse now for nearly four years and quite successfully. Being self employed is not for the faint hearted. Several establishments will not employ self employed RNs, only agency or 'you are on the books'. The problem they see is one of control!
I enjoy the freedom, being able to tell potential employers when I will be available, how long I am prepared to work etc. You have to sell yourself, have some confidence and be presentable and punctual.
You also have to do your own accounts and deal with the tax man!
It is worth it.

ADON132 · May 10, 2004

I am looking for any nurses who are self-employed providing services to the elderly. I am especially interested in sharing effective business/marketing strategies with this population.

I have been an independent nurse for about 2 years, I just joined NAIN about 2 months ago, they offer ideals and support. I am a MDS Nurse and I go from nursing home to nursing home either as an Interim MDS Nurse or just to relieve someone on vacation or maternity leave or for what ever reason. I really like being independent, that was I can take as much time off as I want to. :balloons:

martysgurl · May 12, 2004

I'm just wondering if the money is just as good when your self employed. I have often thought about doing that. I worked for a month with a company called para-med. They provide home nursing.

A family wanted me to sit in a room with there 80 some year old mom and watch her sleep.. in the dark... for 12 hours lol. Sorry I had to share that. :rotfl:

nightingale, RN · May 12, 2004

thread has been moved by this moderator to the entrepreneural forum

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the entrepreneural nursing forum is an excellent forum for support, problem solving, and discussion about this wonderful world. let's use it to our advantage within the boundaries set forth by this bb, please.

there is so much to be gained when we support one another and share information on this board. personally, i would love to hear how one markets to the elderly population; so, how does one market to the elderly population?

night

Trauma Columnist · May 12, 2004

Me too! I do have to share though that it is easy (too easy sometimes) to dupe the elderly and this is wrong! My father was taken for $1500 while he was in hospice by some creep trying to sell him life insurance!!!!!

ADON132 · May 20, 2004

I sent a letter to all the nursing homes within a 75 mile radius of where I live, saying what I specialized in and that I would like to work on a as needed bases. As they contacted me I made appointments with them and quoted a salary to them, if they accepted than I worte up a contract and we both signed it. Now each of thoses facilities call me and if I am available that I go to work for them. Each time a new job is started I sign a new contract saying what my rate of pay is and the length of time I will work. I set my salary sort of high. I try to figure how much their nurses would get paid if they didn't take the benifits plus $8.00 an hour for any extra expence that I may occur.If I don't add on the $8.00/hour and I have to stay out of town they they pay me so must a day expence for motel and etc. Hope this helps.

nightingale, RN · Sep 12, 2004

I am looking at doing this too; promoting myself directly with the facility. Have any of you had a problem in receiving your payment via invoice. I have heard, though I am not sure I beleive it to be factual, that facilities, particularly Nursing Homes pay past the customary 30 days. My business consultant recommends a discount offering if the submitted bill is paid within 30 days.

WyomingRN · Sep 14, 2004

Each time a new job is started I sign a new contract saying what my rate of pay is and the length of time I will work. I set my salary sort of high. I try to figure how much their nurses would get paid if they didn't take the benifits plus $8.00 an hour for any extra expence that I may occur.If I don't add on the $8.00/hour and I have to stay out of town they they pay me so must a day expence for motel and etc.

First, all of our contracts are for one year. To heck with doing a contract every time one is called. If I did that, I'd be doing 3-4 contracts a week. Once a year is just fine. Several months ago we placed one of our contracts online to help others on another thread on this Forum.

Second, as to what to charge, we looked at what agencies in our area were charging the facilities and subtracted $5. (Agencies in our area charge $65-$90 an hour) Then we based what we actually charge on how good the facility is regarding the care of patients and the treatment of nurses. If they treat nurses and patients good, we subtract another $5; if not, we leave it at $60. If the facility has a poor record/reputation, we may add $5 back to our hourly charge. While we can add out-of-town expenses to our base rate (see contract), remember, you can also waive that anytime you want to.

I will also note that we pay our RNs approximately 75-80% of what we charge the facility. The average pay for an RN in our area is $18-$23. Obviously our pay rate for RNs is double that.

Something else to think about. A nurse we had working for us messed up - pretty badly - and so when we did the invoice, we gave the facility a 50% discount on that shift on the basis that the nurses did not provide the full and proper service. The DON and administrator were ecstatic. They had never heard of anything like that before. What ever you charge, charge appropriately; do not undercut your hourly rate. But remember, you will have a very happy customer if you charge fairly. My goal is to have long term relationship with these facilities. Not just 3-5 shift per year.

Have any of you had a problem in receiving your payment via invoice. I have heard, though I am not sure I beleive it to be factual, that facilities, particularly Nursing Homes pay past the customary 30 days. My business consultant recommends a discount offering if the submitted bill is paid within 30 days.

Good question. Our contracts specify the payment terms and the late payment fee. To see how we stated this, view the contract as noted above. One facility we have a contract with pays thirty days on the dot from the date of the invoice. Another pays 10-14 days following the date of the invoice. They know they have thirty days, but choose to pay quickly. This last week the DON received a call from another agency wanting his payment. She informed him that he would be paid on the 30th day and no sooner. The DON said that their payment of invoices is based on the quality of the service that the individual or company provides to them. I found that interesting. I also found it interesting that she shared this information with me. I am really building great repore with the management of the facilities I have contracts with. It pays to do so. Remember, that they are your customers. By doing such things as providing great patient care and, showing up on time (or 15 minutes early) shows that you care about your customers. I go the extra mile whenever I can to help the facilities out.

For example, this last week at one facility, I showed them how they could save paying me for 20 hours of service. This was the second time I have done this. The DON and administrator are extremely grateful. While it may have cost me 20 hours, I am at the top of the list when they are short. I am always offered first crack at any open shifts. That is two facilities that now have me at the top of their call list. I will easily make up that 20 hours; probably 10 time over. What can you do to genuinely help the facilities you service? How can you improve customer service?

tinkle · Jul 21, 2006

I want to start an elder nail care business. Any suggestions? I don't want anyone to think I am practicing medicine I am not of course. I am an RN with lots of experience in home care and Long term care. I know that this service is really needed in our community. I also know that nail clinics are connected to other health care entities, like podiatrist. Please any advice or help would be appreciated. tinkle

moto2822 · Aug 14, 2006

I'm responding to your message on self employment and it sounds just like what I am working towards. I have been an RN for 7 years with cardiac care and some ICU experience. I am in the beginning phase of forming my agency incorporation. My next stage is drafting my first contract with local hospitals. Would you mind reposting your contract on the forum, I have not seen it? Could you also give me advice on how you approach hospitals and other facillities before contracting with them. Do you call them up first, who do you ask to speak with, or do you just present yourself to HR? I'm a little nervous about this. My other question is this, I plan on expanding the business to neighboring states, would I be required to hold another business licence in those states? Thank you in advance.

nightingale, RN · Aug 14, 2006

moto:

Keep in mind, most of this post is quite old. The Thread started in 1999.

What has become popular is subcontracting your service through an Agency / Vendor who has existing contracts through the facilites and postiitions you are interested in. You are then paid on a 1099. There are several.

Unless you are working for a federal facility in a different state then your home licensed state, you will need a license for each state. Exceptions to this rule are with a home state in a Compact State with other participating Compact States.

Please do take the time to read through the Enptrepreneural Forums with many questions answered that you may want to know about. In particular, the Thread on Business Planning may be of help to you.