The nurse registry (NR) business model has evolved a great deal in CCG’s 20 years of business. In our early days, the NR was a faster, cheaper-to-run alternative to the home health agency model, and still allowed for the provision of nursing services. Those clients intended to run their businesses in much the same fashion as an agency, except the workers would all be independent contractors. It was like the best of both worlds: a brand the owner could carefully craft and lower labor costs!
Over time, though, we’ve seen a “hands-off-edness” – if you will – in that the NR really resembles a broker. Gone are the days where the owner could control all aspects of the provision of care (the what and the how), and super-impose its corporate identity on the business model. NRs recruit the client, receive basic information about the client’s needs, explain the registry’s capabilities, and then assign a service provider to the client.
Instead of a linear relationship between the NR & the client and between the NR and the contractor, the relationship now resembles a triangle. The NR performs specific functions (contracting, collecting payment, facilitating information, responding to regulators) and steps out of the performance aspect of the work; that is between the client and the caregiver. Consider the NR a matchmaker, of sorts, who gets invited to the wedding and the anniversary parties, but is not present at the dinner table every night between those milestone occasions.
Without a doubt, the NR model can be a lucrative and successful one, and yes, it is somewhat easier to establish and faster to launch, but a word to the wise: if you’re a type-A personality who loves control, this model is not for you. Control is the most significant factor in determining whether an individual is an employee or independent contractor, and rest assured, the Department of Labor will assure the NR is not shoe-horning employees it controls and mis-classifying them as independent contractors. You will not be involved in the day-to-day aspect of the work but will still be responsible for making sure that the contracted services are provided and all parties are paid.