- Independent contractors provide nursing services to patients typically in their home
or in the hospital under the direction of the hospital nurse. The patient pays for the services. The care you provide must
follow your state's nurse practice act. A private duty nurse is an independent contractor. Healthcare facilities do not hire
independent contractors because nurses as staff members do not meet the IRS requirements for independent contracting. The
IRS has the last word, not your agency, you, or the facility.
- An independent homehealth provider contracts with the state Medicaid system and becomes
an RN provider. The services are provided to Medicaid patients and money is collected from the state Medicaid Program.
- Nurse Agency The company 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 holistic nurse is an independent practitioner. The services provided must fall
within the position statement issued by the state nurse practice act.
- A nurse practitioner can diagnose and treat; but a medical collaborator is needed
in all states. Higher education is required in the form of a masters. Requirements are different in different states.
- An esthetic nurse provides cosmetic treatments ordered by a physician. In most states,
the physician does not have to be onsite.
- A homehealth 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 homehealth agency that is not inspected.
Industry future
The future for this industry is good based on the shortage of nurses and the continuing increased demand
for nurses forecasted in the future.
Earnings
If 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. If you have employees, the amount is based on the number of employees
and the number of hours they work.
Education required
The owner and operator of a private practice does not have to be a nurse or have any special education.
If nursing service is provided, the nurse can be an employee of the corporation.
