Not a week goes by without someone inquiring about how to open a long-term care related business. Whether it’s because of the state of the economy, fears of downsizing or burgeoning entrepreneurial spirit, the demographics in Florida are certainly in our favor. In case you’ve flirted with a similar idea, here are some points to consider:
- Decide on the type of services you want to offer. Skilled services are those that require a licensed professional, such as a nurse or therapist. Non-skilled services encompass personal care, such as assistance with bathing, grooming, eating, etc. Homemaker/companion services are also non-skilled, but include no “hands-on” care of patients.
- Evaluate the various payors you would like to pursue. Skilled services are medically necessary, so Medicare and third party health insurance are the primary sources of revenue. For non-skilled services, Medicaid, long-term care insurance and self-funding (private pay) are the most common options.
- Based on the services you expect to provide and payors you will pursue, decide on the structure of your business.
- All home health agencies (HHA) (skilled and non-skilled) are licensed by AHCA and require accreditation from one of three organizations. A one-year timeline from getting started, in earnest, to final accreditation isn’t unrealistic.
- Nurse registries (NR) are also licensed by AHCA but do not require accreditation. These can generally be launched in four to six months.
- Homemaker/Companion Services (HCS) are registered with AHCA, do not require accreditation and can open in about 30 days.
- Assess your background and candidates for leadership positions. HHAs require a qualified administrator and alternate, director of nursing (or RN supervisor for non-skilled) and professional advisory committee. NRs need an administrator and alternate, as well as a nurse. For an HCS, there are no special personnel requirements.
- Capital requirements are hard to predict. AHCA reviews financial projections for the first two years of the HHA and NR. The various financial schedules, based on the business’s projected overhead and patient volume, yield the amount of capital required. In addition, Medicare has separate financial requirements based on the costs reported by agencies in the proposed business’s geographic area. For an HCS, AHCA does not have capital requirements.
Obviously, many other issues factor into the decision to start a business, but consider that, according to the US Census Bureau (2010), over 40 million Americans are over the age of 65; the greatest proportion of elderly are found in Florida (17.3% of the population). Each day, more than 10,000 Baby Boomers turn 65 years of age and become prospects for your long-term care related business.