want to open my own agency

RNewbie · Jun 21, 2012

I would say get an attorney to write up the contract. Pay someone who has an established agency to work as a consultant to help you get started. Make sure you have plenty of nurses lined up but make sure you tell them you don't have a contract yet. You may have to start off with a significantly lower bill rate until you are established.

Esme12, ASN, BSN, RN · Jun 24, 2012

Hi everyone I'm about to open my own agency but don't know how to get hospitals to sign contracts it makes me really scared cause I have never been a marketer and don't know anything about it .... There is one more thing any one knows about the rates I should give the hospitals and r nurses still interested in working as a registry ? I am working as a registry right now but I'm not sure I can find nurses .... I have an office and documents and everything set up and I wanna start in 10,days any tips would help

I think you need to do some more research on running a business and marketing a business. The requirements to running a healthcare business. How to certify you employees, how to do criminal checks, what you are responsible for marketing these nurses to facilities, insurance, malpractice coverage, legal consultation about running a business that provides licenses staff and the liabilities of running that business. Taxes, insurance, liabilities.....do you know anything about running a business? This is a big deal.

Having an office and documents isn't sufficient when negotiating with a hospital to utilize your staff over another well established staff. What research have you done to know what the staffing agency/hospital contracts look like, which is different than staff agency contracts. What are your HR policies? How do you establish compliance with HIPAA/Joint Commission? Are you going to be doing home staff or just facility staffing? Do you know anything about billing and coding?

You should have already done net working with facilities/clients and staff ready to come on board with tentative agreements for contracts. What is your plan when you negotiate with a facility to provide staff and you haven't hired any staff? How do you plan to get staff when you don't have and contracts? How to document competency, CPR, criminal background checks, licensing, compliance....in 10 days.

I mean this in the nicest way.....I think you need more than 10 days. Do a little more research. Best of luck to you.

ticklemern · Jun 27, 2012

Good for you... I have a friend who owned her own agency. When she started she only had one employee - herself! She slowly but surely built her business. At first it was only healthcare (RNs CNAs LPNs) but she eventually went on to staff secretaries and other office personal just to make money. She ended up getting a state contract. Her overhead was so low she always won the bids. She eventually had a multi-million dollar business. She no longer does that. Now has her own business teaching CNAs. I'm sorry I can't tell you how she negotiated her contracts. But I just wanted her story to inspire you. When she started up her business she didn't know what she was doing. She made a lot of mistakes, but never gave up. Eventually it paid off.

Next time I speak with her I'll try to get more specific information on how she got started.

Good luck!

NedRN · Jul 4, 2012

I agree with ticklemern. Start with yourself. It is really not very complicated, but when you don't know what you are doing, it seems so! What you are selling is yourself. How you do that is with your profile. Every agency completes a profile they send to hospitals to market travelers for open positions. It consists of a work history, skills checklist, two written references, and ideally a one page concise summary of the traveler - this includes the proposed start dates and contact info for an interview. All in all, only five well done pages - no manager wants to dig through a 20 page profile.

The best is to start with a travel contract for 13 weeks. You don't have the resources to be a registry, trust me. I don't, and I've had my own agency for 8 years. I would talk directly to a manager you've worked for, or one you can get on the phone and see if they want someone with your skill set (that usually turns into a mini interview. If so, now you can send your profile to HR (as an agency) and use the manager's desire to hire you as leverage with HR. If they agree to do business with you, you can send them a contract after negotiating a bill rate. Usually HR will tell you what they want to pay. It should be a fine rate for your first time, but feel free to negotiate if you want.

Your contract doesn't have to be perfect, and many times the hospital will ask for changes. Once that is signed, you will have to provide a number of other documents. You need professional and general liability, 1/3 is standard. They may ask for proof of workers comp and unemployment (not so many hospitals ask for that, but I'm always ready if they do). That's it for the agency side (no "license" in most states)! For the traveler side, you will need a physical, titers and immunizations, background check, drug screen, and licenses and certifications. Then go to work.

You will invoice weekly from your signed timecard (you need a form for that too). That takes like 5 minutes a week. The hospital, per your contract, will take 30 days to pay.

Obviously, there are lots of fine details. But that is the gist of it, it is really that simple. Just make a mental picture of you, the agency, negotiating for you, the traveler. Get your head around that and you will be fine. A large number of agencies start with a nurse or a tech representing themselves and grow from there. If you want to grow. I occasionally hire a traveler, but for the most part I make much more money just working assignments on my own. Margins on hiring other workers are not so great, and you need a lot of nurses to make it worthwhile just hanging out in an office.

delerben · Jul 16, 2012

5 Ps:

Prior

Preparation

Prevents

Poor

Performance

You're better off waiting and doing due diligence before jumping in and learning on the go IMO.

NedRN · Jul 31, 2012

You are right in general. Especially if you are only interested in working in one metro area and get a bad reputation with local nurses and hospitals. But if you start with just yourself and one hospital, there is not much to go wrong. Worst case, you don't get to do the job but you have learned a lot, including how to talk to the client. Sometimes that is the only way you can really learn. Only so much you can learn from books, especially if you really have the entrepreneurial bent (or bug).

fawnsternurse · Sep 15, 2012

Hi this is a really interesting post. However what about the Hospitals who tell you they only have contracts with certain agency's?

I personally have tried putting AD's in for private duty and never received one response. Not one!

Discouraging to say the least.

NedRN · Jun 3, 2013

Most hospitals (and businesses for that matter) will say upfront that they have enough vendors and don't want another. There are ways around that obviously as hospitals are always taking on new vendors. My personal favorite is a manager who wants you specifically. That usually opens the doors at HR or staffing. The front door is often the worst way to get new business.

By the way, I sent you a private message. Looking at my own inbox, they are easy to miss!

wyogypsy, RN · Jun 7, 2013

I wish you the best - I would have wanted to also work for at least one agency as a recruiter, besides the travel nurse end, before being brave enough to start anything up!