Nursing Agency Owner

Nursing Agency Owner

What do I need to know to be an Agency Owner and start a nursing agency?

In any business, two important jobs need to be done successfully. One job is that of the manager of the business aspects and the other job is that of the provider of the services or products. In some business, the jobs are performed by one person. Most nurses have the ability to provide the service; but, do not have the expertise to successfully manage the business without additional education. Success often depends on a team of business advisors.

What is a nursing agency?

A nursing agency or nursing registry is usually the non-official (medical lingo) name for a company providing temporary nursing staff to healthcare facilities. The North American Industry Classification System  (NAICS) lists it as a temporary help service. In the United States, Mexico, and Canada, the NAICS provides an official industry classification system with numeric codes. These codes provide a method to collect data and to identify companies for state and federal regulation and taxation. Proper classification is important to the business’s future. Some states require licensure and some do not.  To keep up-to-date with the medical staffing industry, read the blog at

How much does it cost to start a nursing agency or registry?

Nursing agency startup costs are a minimum of $80,000 up to $100,000. The additional startup cost accounts for hiring an office staff and launching an effective advertising campaign. Those who are successful with the smaller investment tend to be nurses who are willing to do the work themselves, spend a lot of their personal time, and build the agency slowly. A funding base of $200,000 and up is needed to meet payroll while waiting for payment from the facilities. Funding is available from factoring and funding companies. The Internal Revenue Service (IRS) requires that personal and business expenses and equipment be held separately. Personal computers, software, printers, and other equipment and supplies used by the company can be purchased by the company from you. You can loan your company startup funds to purchase these items or rent them to your company. No personal business should be done on company computers or equipment.

Will nursing agencies be around in the future?

The future for this industry is good. This is based on the shortage of nurses and the continuing increased demand for nurses forecasted in the future.

Do I need to be certified?

A healthcare temporary staffing service does not have to be certified to provide staffing to facilities. The Joint Commission offers certification to healthcare temporary staffing services. For more information on the Joint Commission certification process follow this link:

How much can a nursing agency earn?

Earnings are unlimited and are based on the number of employees working in facilities under contract. Agencies quickly move into multi-million dollar earnings. Typically an agency gains the interest of an acquiring agency in one and one-half years and is worth from 1.2 to 3.2 million dollars.

Do I need special education to start a nursing agency?

The owner and operator of a temporary help service does not have to be a nurse or have any special nursing education. Some states require that a registered nurse work for the company either as an employee or consultant. Business 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.

Is a nursing agency usually a DBA, LLC, or corporation?

The legal structure for a temporary help service is usually a corporation affording the most tax deductions and liability protection. The corporation is an independent legal entity separate from its owners. The owner is not liable for the debts or judgments incurred by the corporation, and personal assets are not at risk. Providing your services as a LLC and/or corporation does not relieve you of responsibility for your nursing actions or protect your personal assets from judgements related to your actions as a nurse. You are personally responsible as long as you are a licensed RN.

Is there anything I need to know about working for a nursing agency?

It is usually operated out of a physical office, not a home office. The office is open during normal business hours and someone is on-call 24/7. A temporary staffing service with 10 nurses working regularly is a multi-million dollar business. Business knowledge, persistence, hard work, and diligence are needed to start and grow a multi-million dollar business. Nurses have all these qualities. The bill rate (billed to the hospital) and the pay rate (paid to the nurse) in most areas is between 15 and 30%. Nurses working for temporary help services are usually designated as employees. Some agencies hire independent contractors. The agency, the healthcare facilities, the nurse, or the contract between the nurse and the agency are not the final word on worker status for tax purposes; the IRS has the final word on worker status for tax purposes. You may be responsible for back employee taxes and penalties if the IRS determines that the nurse (worker) is employee status and not independent contractor status.