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Table of Contents About the Author………………………………………………………….3-4 Introduction…………………………………………………………………..5 Research………………………………………………………………………..6 Business Plan……………………………………………………………….7-8 Market Analysis………………………………………………………………9 Capital………………………………………………………………………...10 What is a Staffing Agency….……………………………………………11 Entity and EIN………………………………………………………………12 Insurance/Liability………………………………………………………..13 Pre-Employment Screening…………………………………………14-15 Location…………………………………………………………………....…16 MVPs/Contracting……………………………………………………..17-18 Tracking Hours………………………………………………………………19 Payroll …………………………………………………………………….20-22 5 Do’s…………………………………………………………………………..23 5 Don’ts………………………………………………………………………..24
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About the Author Teberah Alexander (Nurse T); a long-time nurse and entrepreneur renowned for her combination of compassion and inspirational teaching style. Having graduated from Michigan State University in 2003 with a bachelor’s degree in Nursing, Teberah spent the early part of her career-serving patients in Labor and Delivery, Cardiac, ICU and the Long-Term Care Unit. She later established Compassionate Home Care Services (2006); which is dedicated to supporting the ignored health needs of elderly people. Discovering a passion for improving the quality of life for dementia patients, she became a Certified Dementia Practitioner and established Kathelene’s Adult Daycare Center (2013) in memory of her grandmother, Kathelene. Nurse T’s other businesses consist of Excelling Nursing Academy (CNA School 2017), Caregiving Staffing Solutions (2018), and Kathelene’s Senior Village (Independent Senior Apartments; 22,000 sq ft on 6.5 acres 2018). Teberah has built an impressive career and is widely regarded as an expert in nursing and adult social care. She formed Nurses Who Care to help like-minded people become exceptional nurses and forge successful careers in the healthcare industry.
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Teberah is a member of the Michigan State University Alumni& Black Alumni Associations, Michigan State University Association, Michigan Nurses Association, and has served on the board of Michigan State University College of Nursing Alumni Association. She is also a proud member of professional minority nursing sorority Chi Eta Phi Inc. and the loving mother of Amiya Alexander, a graduate of New York University.
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Introduction Let us Get Started: After long days and hours you have decided to step up and turn your hobby into your business. I congratulate you for believing in yourself enough to prevent your business from becoming your expensive hobby. Let us say that your new business is caring for family/friends. You have been taking care of your friends when they were sick without pay: parents, grandparents, patients, neighbors, and many others for a long time, for this service. You do not know if people will pay for your service or staff. You do not know your competition. You do not know how much to charge. You want to start a staffing agency, but you do not know where to start. Nurse T has that Secret Formula to opening your staffing agency!
Let’s Go! My Promise Statement To help my students who are looking for a business opportunity to open a staffing agency so they can have a breakthrough, regain confidence, and to “Work from EVERYWHERE” #WFE.
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Research: Students, you MUST research! You do not want to start a staffing agency without learning the industry first! To begin researching the health care staffing business the best place to start is GOOGLE, https://www.google.com it’s free. Search by the name of your service. The results will tell you what staffing agencies are in the area, what services they provide, and what services your competitors are providing. Now take it a step further, visit Reference USA http://resource.referenceusa.com where you can learn more about your competition and industry. As a patron of the library, you can access Reference USA through your local library. Your valid library card will grant you access through your library’s website. More than 4 million customers use their products and services via their local library branch. The Kaufman Foundation https://www.kauffman.org is one of the best comprehensive websites for entrepreneurial research. They work with entrepreneurs; empower them with tools and resources, and work to break down barriers that stand in the way of starting and growing your business.
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Business Planning: It is time to make a plan! Developing your strategy and creating your business plan is essential to the success of your staffing agency. This plan will help you identify the who, the what, the when, and the where and turn your idea or hobby into your legitimate business. Would it be perfect if someone would just tell you your business idea would stand the chance to excel? It may not be that easy but there are tools, templates and other resources that can help you create your plan. You may not get the direct answer but Enloop www.enloop.com will give you a performance score. Over 305,800 business owners, accountants, entrepreneurs and students use Enloop to write and manage their business plans.
How this works is once you enter your company information Enloop will generate a score with the information you entered and calculate a score to help you improve your plan.
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Do you really know what a business plan really looks like? At BP www.bplans.com they have over 500 free sample business plans for numerous types of businesses.
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Market Analysis Students know your market! What is a market analysis? A market analysis provides information about industries, customers, competitors, and other market variables. You can also determine the relationship between supply and demand for a specific product or service. Based on these insights, you can make more informed decisions about possible marketing strategies. Free business statistics and financial ratios. BizStats www.bizstats.com is the home of free, accurate business statistics, which are well organized and easy to access. Here are two other sites that can be a resource for gathering data www.qualtrics.com and www.tableau.com
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Capital: Students: Do you need help? There are mentors, counseling at no cost to you, and loans supported by the U.S. Small Business Administration (SBA) https://www.sba.gov. What is SCORE? SCORE https://www.score.org has served as America’s premier source of free business mentoring and education for over 50 years. As a resource partner of the SBA, SCORE has helped more than 11 million entrepreneurs through mentoring, workshops and educational resources since 1964. These are a few investment companies who provide capital to small businesses. You must look on the SBA website to see who has funding available. I cannot guarantee you will receive funding. Please be sure to plan to have enough capital to operate for four to six months.
Aldine Capital Fund III, L.P. 444 West Lake Street, Suite 4550 Chicago, IL 60606
Albert L. Brahm 312-346-1004
Anagenesis Capital Partners SBIC Fund, L.P. 575 Fifth Avenue, 14th Floor New York, NY 10017
Melanie Brensinger 646-661-2343
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What is a Health Care Staffing Agency? A staffing agency is a business that provides Nursing, Certified Nursing Assistants, and other medical personnel to facilities who need the services of healthcare professionals. Employed staff of the agency is on temporary contracts to make themselves available for hire by nursing homes, hospitals, assisted living, home care and other providers during busy periods and to cover for staff absences.
With the baby boomers getting older and life expectancy in America increasing, the demand for CNAs in the healthcare system and facilities like hospitals and nursing homes is rapidly growing. A staffing agency is extremely helpful and necessary for these medical facilities to find and hire the quality CNAs or nurses they need, as fast as they need them. Privately owned staffing companies connect nurses/CNAs to their potential jobs and/or health care facilities to their employees.
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Do You Have your Entity Set Up? Be sure you have your entity set up prior to opening your business. Decide with your team if your business should be a corporation or a LLC. Know what the difference is. Employment Identification Number (EIN), also known as a Federal Tax Identification Number, and is used to identify a business entity for tax purposes. For more information, about structuring your business and how to set up your entity you can enroll in “Nurse T’s Business Basics Course” (www.thenurseswhocare.com/courses) to guide you through this process. Once you receive your EIN you can open your business bank account. Always keep your business banking separate from your personal accounts.
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Insurance/Liability: When operating a business and caring for other people, there is always a chance, that something may not go as planned. It is imperative that you have a current insurance policy to protect yourself and your business at all times. It is very important that you are a bonded business (www.cnasurety.com), which means you have purchased a surety. The surety bond protects the third party (facility) that is hiring your business from any losses that will result from any damage, theft, incomplete work, or any other failures of the hired company. Be sure to quote and purchase General Liability Insurance, which will protect you in a lawsuit. You need Workers’ Compensation Insurance to cover lost wages and medical for employees who may injure themselves during work hours.
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Pre-Employment Screening: Background Checks/Drug Screening
Since you will be the connecting, point of CNAs/nurses to facilities and patients you MUST conduct a background check and a drug screening to be sure you are sending accountable staff. Please check your state’s website to register and pay the $100 fee for your staffing agency to conduct your background check. This is the system for Michigan https://miltcpartnership.org/longtermcareportal?r=1. Please check their background prior to hiring and/or allowing staff to attend a shift.
Drug Screening is becoming an integral part of staffing agency’s’ success. This process will enhance your agency’s reputation. This will keep legal issues at bay. Drug screening provides a competitive edge. Offering the most stringent pre-employment drug testing programs enables staffing agencies to reach a level of expertise that exceeds the expectations of their clients. This improves customer loyalty; no company would like to hire staff who are prone to drug
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and alcohol abuse. Your office staff can perform drug screens in your office or you can send your new staff off site.
Companies for Drug Screen Products https://www.confirmbiosciences.com/industries/staffing/ https://www.americanscreeningcorp.com/ https://www.questdiagnostics.com/home/companies/employer/dr ug-screening/testing-reasons/pre-employment/
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Location: What is the right location? Start this in your initial research. Do not sign a lease to fast without knowing what contracts you have in place! With a staffing agency, you can initially start in your home. Do NOT incur unnecessary overhead. This will cost you.
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MVPs/Contracting: What is a MVP? Your MVPs are your “Most Valuable Payors”. You MUST have contracts with multiple nursing homes, hospitals and/or other health care facilities. Nurse T’s online course “Secret Formula to Opening a Staffing Agency” discusses this in detail. It’s time to create a directory, be sure to have your assistant organize a spreadsheet; include columns for the following, payors name, contact name, address, phone, email, fee schedule, contracting requirements along with the length of time it will take to be approved, and leave space for dates follow up calls. Contract/Agreement: is a general agreement between the staffing agency and the health care facility where the agency will be providing temporary or permanent employees to their facility. Be sure to have your attorney draft your contract. What should your staffing agreement include?
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• • • • • • • • • • • • • • • • • •
General Staffing Agreement Exhibit A: Sample Rate Schedule Exhibit B: Sample Benefits Waiver for Assigned Employees Exhibit C: Sample Confidentiality Agreement for Assigned Employees Optional Provisions Reports Time Clock Background Checks/Drug Screening On-Site Coordinator Liability Insurance Late Payment Penalty Nature of Relationship Arbitration Contract Interpretation Choice of Law Assignment of Agreement Holidays Cancellation
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Tracking Hours: Your staff is reporting to various facilities, which means they have a lot of autonomy. You want to invest in a software or app to track your staffs’ hours. Use a time clock system that will track your staffs’ location. The software will allow the staff to clock in and out from their phones; your scheduler can download the weekly reports of their hours. As a backup, in case there is any interruption with technology you should always leave a hard copy time sheet with the facility’s scheduler to have available to your staff. It is also a good idea to provide your staff with a printed copy. The charge nurse is required to sign the time sheet and then turn it into the office immediately, NO exceptions. https://wheniwork.com/ www.easyclocking.com www.fuseworkforce.com
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Why do I Need a Payroll Company? Some businesses opt to handle payroll functions in-house through manual bookkeeping or do-it-yourself payroll apps, while other business owners prefer the expertise of a professional payroll provider. When considering whether to outsource this function, the time and resources required to complete essential payroll tasks often weigh heavily in the decision-making process.
Payroll Time Saved: No matter if you have 1 employee or 100 employees, processing payroll requires time and attention. Your time is valuable; spend time building revenue and servicing clients.
Each pay period, every employee must have his or her hours verified for accuracy, totaled and multiplied by his or her designated pay rate. Next, the appropriate amount of taxes must be calculated and subtracted from the gross pay to determine a net amount. If your employee receives any other deductions, receives
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benefits, child support or retirement plan contributions, additional calculations must be made. Multiply each of these calculations by the number of employees in your business and it is easy to see why calculations alone can take a significant chunk of time out of your week. The physical checks must be printed, signed and distributed. Some employees are likely to have direct deposit, so verify and process those amounts electronically, but employees still need pay stubs. Secure and maintained those records for tax and reporting purposes. After the payroll figures are organized and recorded, there are still additional payroll tax responsibilities each quarter and at the end of each fiscal year. Business owners and/or designated administrators must carefully calculate and complete a quarterly payroll tax packet to prove that the proper amount of payroll tax was withheld. This packet must then be submitted, along with the proper amount of withheld taxes, to the IRS each quarter, which are part of your quarterly reports.
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ADP https://www.adp.com/ is one payroll solution to your business. They offer fast, easy, tax deductions and accurate payroll to save you time and money. Another payroll company is Paychex https://www.paychex.com/ that offer similar services. Complete a consultation with both companies to weigh the pros and cons.
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10 DOS AND DON’TS WHEN OPENING A STAFFING AGENCY 5 Dos 1. Knowledge: Please be sure to do your research and homework before you invest. You do not want to make unnecessary expenses to early. Know your niche. 2. Have a professional contract/agreement drafted by an attorney. Your contract covers you, believe me you will need it. 3. Know who your funding sources or MVPs are. Which facilities have a staffing shortage? Understand the facilities mission and goals. Contract with numerous facilities. 4. In-Service your staff to be sure they are always educated on current health care issues in each facility. Be sure your staff is familiar with their policy and procedures. 5. Have your team of CPAs, Bookkeeper, your business coach, attorney, insurance agent, billing software, payroll, qualified staff and payroll company interviewed in advance. They will help you with your planning and budget.
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5 Don’ts 1. Do not lease or buy a location until you have done your research first! You need to know who your payors are and that you have contracts in place to cover the overhead. 2. Please do not allow coaches or consultants to teach you if they do not own their own successful staffing agency. You need to see that they are operating a successful agency. There are numerous coaches and consultants who are not qualified to educate you so be very cautious. Do not allow the consultants to tell you which contracts they can get for you, this is up to you to sell your own business. Please be sure you understand how you will get profitable contracts. 3. Do not get comfortable with one contract at one facility. Contracts end and administrators change. You MUST have several contracts in place. 4. Do not allow your staff to have a careless attitude because they are agency staff. They must be compliant with each facility’s policies. 5. Do not price your services incorrectly. You want to make sure you price your services high enough that you can make a profit, but low enough that clients will want to work with you. However, if you choose the wrong mark-up, you could end up putting your staffing agency out of business before you even have a real chance at success.
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For More Information Add the Author on Facebook: Teberah Alexander Follow her on Instagram: @excelwithnurset Follow us on Instagram: @fhadultdaycare Follow us on Instagram: @thenurseswhocare Follow us on Instagram: @excellingnursingacademy Like us on Facebook: Kathelene’s Adult Day Center Like us on Facebook: Excelling Nursing Academy Please visit our website: https://www.thenurseswhocare.com/
Thank You,
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