Hey everybody! It's me, Charles Lamson again. In keeping with the new mission of my blog, which I created in my last post How to Create a Mission Statement for Your Blog:
I wanted to share a little more personal stuff I have been going through lately to show how I use these principals merging my day-to-day life with my intense interest in business administration and communications with an emphasis in promotions. |
Those of you who are die-hard fans of The Rant know that I am a disabled gentleman. I broke my neck 31 years ago in a car wreck. I am what they call a partial quad, which basically means I pretty much have full range of motion with my arms but my hands and grip are kind of fucked up. And for the most part, I have limited sensation and paralysis from the chest down. But I can still type halfway decent; decent enough to be a blogger (haha).
So I've lived on my own independently as a disabled guy for like 25 years. To do this I had to sort of start my own little business as a home healthcare provider. And by this, I simply mean I hire and fire my own caregivers and I'm recognized by the IRS as a business in that I have an employer identification number (EIN) and my name is on the paychecks, but all of the administration stuff is outsourced to what they call in the industry a consumer directed services company.
So this makes it easier if you want to hire caregivers in your family, because a lot of times, the caregiver task falls on the family of people with disabilities. So this way, family members can actually get paid for the caregiver tasks they perform with their disabled loved one, or hated one, as the case may be. I fall into the latter category. Aside from my mom, I don't really get along with my family, at all. They're a bunch of assholes. It's a very destructive environment, which they laugh and joke about, but I don't find too god-damn amusing. And I just sort of tolerate my mom, because she still helps me out sometimes and gives me stuff.
So anyway, this leaves me in a position where I have to hire people outside of my gene pool. This can sometimes be a daunting task, as anyone who runs a business knows; the quest for halfway decent employees. So that's where outsourcing the administration stuff (such as hiring, firing, and scheduling) to outside consumer directed services companies comes in. When everything is running smooth, they take care of the hunting for employees, the hiring, the firing, the scheduling, and other administrative tasks.
But when things don't run well on their end, they can leave you high and dry in situations sometimes, like when a caregiver wants a vacation day or has an emergency or sick day and has to take a day (or two) off, or got too drunk the night before (whatever the case may be - you get the idea), and they can't find someone to fill in. Most of these companies aren't very reputable, in my experience. So, often they just do the no-call-no-show thing, leaving you to scramble and think fast and go into hustler mode to get help for the day, calling, friends, family, neighbors, or that one employee who is dependable to a fault, but you don't want to overwork or they might go elsewhere.
So after going through a recent episode of the above mentioned drama. I thought to myself if I'm going to be doing all the scrambling, hustling, and "creative scheduling" to keep my ass covered, I might as well start my own consumer directed services company. I can certainly do a better job of it than most of the people running these companies. They're not brain surgeons.
I have B.A. in Business Administration and a M.A. in Communication with an emphasis in Promotions and a background in small business and I sit here all day long writing about business and communications on my blog pretty much every day for the past three years. And my podcast The Rant with Charles Lamson is also centered on leadership, business administration, and communications with an emphasis in promotions. And living independently as a disabled a disabled person running my own consumer-directed services for 25 years, I certainly have enough experience.
So I figured it was time for me to put some of this textbook knowledge and personal experience to use in this one area of my life. So, as I do in all challenging and uncertain times in my life, I asked Google for guidance. I did this by typing "how to start your own home healthcare business" in the search field and went with the first non-ad link in the search results:
Starting Your Own Home Care Business by Clare Absher RN, BSN (https://www.carepathways.com/articles/starting-a-home-care-agency-business.cfm).
So, I'll be borrowing heavily from this article for the rest of this post. It's a very good, informative bit of writing. I highly recommend it if you're looking to get started in this field. I hope you find the info useful. So here goes...
Home Care Agencies
Home care agencies continue to grow in popularity due to our aging population and preference of many older Americans to be cared for in their homes. Starting a home care business to meet this great demand for in-home care may potentially be a rewarding business enterprise.
Skilled Home Health Agency vs. Non-Medical Home Care Agency
Initially it is very important to understand the distinction between starting a medical skilled home health agency versus a non-medical home care agency. Basically, non-medical home care services include personal care, assistance with daily living activities, meal preparation, housekeeping, and transportation. Such services are often vital for people to remain safe and comfortable in their homes. Private pay rather than third party billing sources are the most common form of payment for non-medical care.
Now in my personal situation, I would need to be a medical skilled home health agency because as the name implies, I will need my agency to administer skilled licensed nursing and rehab therapy services under physician's orders because of my level of disability and to serve my other clients with more advanced levels of disability, as well. Medical home health agencies require extensive licensures, including Medicare and Medicaid certifications.
Today I looked a little more fully into this extensive licensure I would need by calling the Missouri Department of Health and Senior Services at 866-835-3505 and they directed me to a website entitled Missouri Department of Health and Senior Services: Home and Community Based Services Provider Information. I plan to go to the website tomorrow to see what I have to do to get the ball rolling. They also told me to call the Provider and Revalidation Unit at 573-751-3399. I did and I left a detailed message telling them I wish to enroll as a Medicaid provider. The teleprompter told me to allow 3-5 business days for them to respond, which I will do. However, they said via the teleprompter, for a faster response email them at mmac.providerenrollment@dss.mo.gov, which I am going to do right now (Be back in a couple minutes.). So I sent them an email and put "ENROLLMENT AS A MEDICAID PROVIDER" as the subject. This was my message: Hi, So, I just received an auto-reply email from MMAC Provider Enrollment. They said I should receive a response in three days. So there you go. I did all I could on this particular aspect of my little project. So, moving on.
Join a Franchise or Launch Out on Your Own?
The next decision is whether to start a home care business on my own or team up with a home care franchise. There are pros and cons for both, but basically, franchise fees provide a business model along with start-up guidance and ongoing support. Personally, I am going to want to launch out on my own. This route usually has lower start-up costs without entry or re-occurring franchise fees, less hand-holding, but more independence with business strategies. So, when electing the independent option, it is important to write a detailed plan of how you will start, operate, and grow your business. So I have to get that done. It may take awhile, but if you're a regular reader of this blog, you know it's no big deal for me. It's what I do. It's my bread and butter. I am a writer of business plans.
Training and Medical Background
Formal training or a medical background is not required for owning and managing a home care agency. Many healthcare workers find this business endeavor attractive due to their experience, but it is by no means a prerequisite. Strong communication and organization skills with a well-planned business strategy are more fundamental to success, which is good to know since I have a B.A. in Business Administration and a M.A. in Communications with an emphasis in Promotions and I basically sit around writing about well-planned business strategies all day with this blog and talking about them on my podcast. So I definitely have strong communication and organization skills and I'm excellent at creating well-planned business strategies.
Basic Requirements and Advice
Some basic requirements apply to starting a home care business similar to that of most other businesses including the following:
1. Set up Business Entity Set up the business entity that will best fit your needs. (Sole proprietor, Partnership, Limited Liability Company, S Corporation, C Corporation). Consult with an attorney and or CPA or research online on your state government website (www.state.(your state initials).us about appropriate business structure, info regarding payroll, sales tax, workers compensation and business liability insurance. Personally, I still have to do this, but hey, it's on the to-do list.
2. Obtain Employer ID Number
Obtain a Federal Employer Identification Number (EIN) from the IRS (IRS form SS-4) similar to your personal social security number to identify your business with regards to tax liability. I actually already have one of these. So I got that part done.
3. Register with Secretary of State
Register your business with Secretary of State in your state. Decide on a business name and check availability in your state including consideration for a domain name for your website. When approved, have letterhead, business cards, and brochures printed. I have not done this yet, but I plan on waiting to hear back from the Medicaid enrollment people first to see what I have to do meet the various licensing requirements. Then I'll worry about registering with Secretary of State and deciding on a business name and all that. One thing at a time.
4. Check on License Requirements
Check on requirements for city or county business licenses and apply as needed. Again I'll check on that stuff after I talk to Medicaid Enrollment.
5. Prepare Your Finances
Establish a business checking account and credit card account and apply for business loans if required to meet start-up costs. Set up a computerized accounting system. I still have to do this too, but it is on the to-do list, as well.
6. Write or Buy a Policy and Procedures Manual
Write or purchase a policy and procedures manual to address new client admissions, plan of care, scheduling, employee and payroll records, orientation, in-service training, client billing. Duly noted. I will get on that as soon as I have time. Since start-up costs are a factor, and I'm a strong writer, I will probably just write it.
7. Find and Hire Caregivers
Find and hire the best caregivers available as the reputation of your business weighs heavily upon the quality of care delivered. Spend time interviewing prospects and checking references to find the most compassionate and resourceful caregivers. I already have three or four quality employees and an Employer Identification Number from the IRS. I just have to set up my business entity, register with the Secretary of State, get my licensing straightened out, enroll as a Medicaid provider and establish my business checking account to make it all legit.
Post employment ads on relevant job internet sites, at local community colleges with CNA and nursing programs and local newspapers. Should be easy enough. I've done a lot of this in the past, and I have a lot of prospective employee contacts in the industry.
8. Connect with Referral Sources
Determine the best sources for referrals in your area such as connecting with long-term care facilities and hospital discharge social workers. Contact local physicians, senior centers and rehab outpatient centers to reach prospective clients. Again I'm basically just creating this business to cover my own butt. I'm not really even thinking about other clients at this point, but this is definitely very valuable information to know.
9. Build a Website
Hire a website designer to create a professional website with content directed towards internet savvy adult children of seniors who are responsible for securing home care services. Post your agency listing on established elder care websites with strong Internet presence for greatest exposure. Again, it's going to take awhile until I get to that, but its something I plan to do in the not-so-distant future. I am visualizing it right now. It is coming into manifestation by my sheer force of will.
10. Find an Office Space
Find a location where care is affordable to population and without excessive competition. Save your money on costly high traffic commercial office space and instead find a cheaper accessible location for your employees. Done. Since for now I'm basically planning a small-fry operation with me as its only client, I just plan on using my apartment as my office space.
11. Be Creative with Scheduling
Be creative with scheduling to manage an ever changing balance of employees with client needs. Turning away clients is harmful for future referrals but at the same time, risking poor care due to lack of staff is equally damaging to a company's reputation. Again, this is not much of a concern for me because I'm only looking for enough employees to keep my own ass covered and to have the people on payroll that i need to call as back-up on those days when people need vacation time, or call in sick, or just don't show up without calling.
12. Attitude Is Everything!
Be resourceful in managing your day-to-day operations. Be thoughtful, respectful, understanding, and accommodating to your employees and clients. Reflect upon reasons you started your own business in the beginning, and when times are tough, take time to savor the small accomplishments along the way. This is all good stuff to remember. I would add "create a mission statement" to this just to remember why I started doing this to begin with and to keep me on target during the business creation and growth process. 
*SOURCE: https://www.carepathways.com/articles/starting-a-home-care-agency-business.cfm#author, Clare Absher*
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