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Radio ShowNuts and Bolts of an RN Business Patient Care Provider FactsExamples of Independent nursesIndependent contractors provide nursing services to patients in their home. If services are in a healthcare facility, they are under the direction of the facility's nurse. The patient pays for the services. The nursing care must follow the state's nurse practice act. Healthcare facilities and temporary staffing services can get in trouble with the Internal Revenue Service (IRS) if they hire independent contractors. Agency contracts usually have a clause holding the nurse responsible for any back taxes and penalties. Independent homehealth providers contract with the state Medicaid system and become an RN provider. The services are provided to Medicaid patients and money is collected from the state Medicaid program.
Holistic nurses are independent practitioners. The services provided must fall within the position statement issued by the state nurse practice act. Esthetic nurses provide cosmetic treatments ordered by a physician. In most states, the physician does not have to be onsite. EarningsIf you are working alone as a independent contractor, the earnings are limited to the number of hours you can physically work. A forty-hour week yields about a $125,000 to $250,000 annual income depending on your bill rate. Nurse practitioners' bill rates are higher than an RN's. If you have employees, the amount is based on the number of employees and the number of hours they work minus employee expenses and wages. Startup costs and legal structureThe startup cost for an RN consulting service is relatively low. You can use a home office and equipment (computer, printer, etc.) that you already have. As an RN, you are licensed to practice as a nurse; therefore, you are not required to start a sole proprietorship, limited liability company (LLC), or a corporation. Although it is not required, the NNBA recommends that you incorporate your business to protect your personal assets and take advantage of many tax deductions only available to small businesses. The book, Self-Employed RN: Choices, Business Aspects, and Marketing Strategies, contains a complete outline of startup costs. Click here for book details and/or to purchase the book. No business loans or grants are available for startup. You can personally loan your company startup funds. Your company can pay you interest and repay the loan as money is available. Personal computers, software, printers, and other equipment and supplies used by the company can be purchased or leased by your company from you personally. The Internal Revenue Service (IRS) requires that personal and business expenses and equipment be held separately. No personal business should be done on company computers or equipment. Industry futureThe future for this industry is good based on the shortage of nurses and the continuing increased demand for nurses forecasted for the future. EducationBusiness education is needed for nurses to understand the business aspects of being self-employed or a small business owner. The association provides this education customized for nurses. College and community business courses do not understand the nursing community. Advanced nursing courses do not teach self-employment and small business ventures. The NNBA provides this education in various ways to make it convenient and affordable for you.
Business legal structureA corporation affords the most tax deductions, benefits, and liability protection. The owner is not personally liable for the debts or judgments incurred by the corporation. LLC and sole proprietorship are not the best choices. Start by incorporating. Coding system for businessesThe North American Industry Classification System (NAICS) provides the official industry classification system with numeric codes. Proper classification is necessary for tax and regulatory purposes. The wrong code can ruin your business. Little known factsNurses who practice holistic nursing do not need advance degrees or physician collaboration for many services. Self-employment can cause difficulty acquiring loans for cars and mortgages. A home health agency is a complex and heavily regulated business. The profit is low and the expenses are high. Medicare requires money ($50,000) be held in reserve and often Medicare and Medicaid do not pay for several months. The nurses (employees) want pay every two weeks. The business soon runs out of cash and funding must be obtained. Inspections are often delayed for years and the business must continue to provide services and fund the business. Medicaid, Medicare, and insurance carriers will not pay a home health agency that is not inspected. If you have questions about starting an independent practice contact Pat Bemis, RN CEN, president NNBA. Contact by email. Phone (321) 633-4610. |
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