Part Three: How much staff do I need to get started?

In Part Three of this five-part series, we’re discussing staffing needs for the various Florida business models.

For a non-skilled home health agency, Florida requires an administrator, alternate administrator and registered nurse that meet specific requirements.  Because one individual can occupy two positions, this requires a minimum of two individuals.  For skilled agencies, the registered nurse assumes the position of Director of Nursing which places the clinical oversight and responsibility squarely on that person’s shoulders.  For a nurse registry a qualified Administrator and an RN who shall be available to patients 24 hours per day, are required. This could be the same individual.

If you’re not clinically oriented and/or don’t meet the state’s criteria for these positions, you will need to retain the appropriate individuals. After securing capital, that’s probably the biggest challenge.  The key personnel will probably not do very much in the initial stages, learn the policies and operational aspects of the agency and be available and ready for survey.  So paying these key people is the issue in a fledgling organization with no revenue but specific requirements.

Several models have been pursued, from a nominal monthly stipend to hourly wages.  Obviously, the preparation time before survey can range from three months to a year, depending on the business model and regulatory body workloads, so this can represent a significant overhead expense to your new business.  We find that this is the one “make or break” issue to a new client’s licensure success so do your homework and inquire with friends and colleagues to find the right mix of clinical and business acumen at a reasonable price.

Securing direct care personnel is slightly easier.  Your accountant should advise you on whether these staff members are better classified as employees or independent contractors.

Check out AHCA’s handy chart of provider types and staffing requirements.

We’ll see you tomorrow for Part Four of the series regarding capital requirements.

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