How to Open Up a Nursing Agency

Updated February 21, 2017

Currently, America is entering a stage of "greying." As the largest segment of the country's population begins to age, the need for increased health care, particularly in the field of nursing, where there is already a shortage of qualified workers. Nursing agency start-ups are one way to take advantage of the current situation. In addition to treating the elderly, nursing staffing agencies help provide immediate fill-ins for hospitals as well as hospice home health care agencies. Some nursing staffing agencies are even available for private hiring by individuals who require regular visits from nurses to be able to remain in their homes.

Become familiar with basic business principles of managing, accounting, sales and marketing if you are not already. This can be done by attending courses at a local community college or workshops offered by the small business administration. It is not necessary to be a nurse in order to own a nursing agency, but experience having worked for such an agency in the past is also an asset in beginning a start-up.

Develop a business plan. If enrolled in business classes, this may be a classroom assignment. Otherwise, watch for business plan writing workshops to be held in your area.

As a part of the business plan, write a strong vision statement. Be sure to describe the specific type of agencies or organisations that the staffing agency will target as potential clients.

Describe the business owner's prior experience within the business plan. Highlight any achievements or accomplishments the owner has had in running a business and any prior work experience as a nurse or in a health-care related field.

Write a vivid description of the business. The most important feature of this part of the business plan is defining the niche market for the business. Will it be the only nursing staffing agency in town? Will it cater to a specific type of hospital or facility? Figure out who the services will be sold to and hone in on that in the description.

Include an economic assessment in the business plan. Use the target market or markets identified in Step 5 and provide demographic information to illustrate a need for the staffing agency. For instance, if the business will be geared toward serving the elderly, include statistics for the number of elderly people in the area as well as how many nursing homes or assisted livings there are within a certain distance from the company's location.

Make decisions concerning how much the service will cost and estimate the first year's expenses. Provide a detailed financial statement for what money is needed and how it will be used. For this step, the help of an accountant may be necessary.

Select the structure for the business. This will determine how taxes are paid and who holds liability for the company. Most nursing start-ups are begun as corporations in as they make the owner harmless in terms of loss and provide certain tax advantages. An accountant can help make this decision and once the decision is made, an attorney can help draw up the papers for the particular business type.

Make a decision concerning how many employees will be hired and draft potential first year salaries. Typical nursing staff agencies have ten nurses to cover business hours and a rotating 24-hour on-call shift.

Select where the nursing agency's office will be located. This building will serve as the home base of the company. Its phone, computer and fax systems will be held here and employee meetings and trainings may be as well.

If your state or area has a local union for nurses, decide whether the business will make use of union employees. If so, contact the union to inquire about minimum requirements for salary and benefits as well as any additional steps that must be taken to hire union nurses.

Visit the local government offices in the community to see what zoning or business permits are needed to operate a nursing agency in their particular town. Some towns may require special zoning for businesses related to health care.

Acquire information about what additional state level licensing will be needed. In some states, health care agencies are highly regulated, requiring adherence to a certain set of standards such as privacy or cleanliness. Some states even require surprise visits from the state's health department or monthly inspections. A good starting point would be to call the state representative's office for the area where the business will be located.

Register for a federal EIN.

Obtain the necessary insurance for a nursing agency. This will include business property insurance for the office facilities, liability in case of error on the part of the nurses and workman's compensation for the employees at a minimum. If the business is providing vehicles for the nurses to commute from job to job, fleet auto insurance will also be necessary.

Determine an exact location for the business. Ideally, the office space will have enough room for the reception area, an office for the owner and any other administrative employees and space for a meeting or conference room. Obtain lease or sales information once a space has been selected.

Evaluate start-up capital. Typically, £195,000 is needed for the first year of business with a nursing agency start-up.

Search for grant opportunities for nursing agency start-ups or for health care in general and apply for loans at local banks to make up for the difference between cash savings and investments and the cost of starting up. Also take this time while meeting with banks to open a business current account.

Decide how the staffing agency will accept payment. If working with private patients, it might be necessary to accept credit cards for payment and purchase check fraud prevention terminals. If dealing mainly with institutions, it may be necessary to directly debit for services as some large hospitals prefer to pay electronically.

Hire staff by advertising positions in local newspapers, through nursing schools, and online. Conduct interviews. Be sure to contact all references before making a final decision.

Purchase any necessary supplies such as office supplies, a computer and printer, a copy machine, a fax machine, a telephone, and office furnishings.

Determine what type of medical equipment will be needed. If working in hospitals or personal care facilities, the supplies may be provided by the institution; however, if the work will be done privately in homes, there will be a need to purchase stethoscopes, sphygmomanometer, thermometers, syringes, bandages, and dressings. Also make a decision whether the business will provide uniforms for the nurses or ask them to pay for their own. Order uniforms if necessary.

Begin traditional marketing methods. Have signs, business cards and brochures printed. Be sure to target the brochures to desired clientele and describe what makes the nursing agency unique from others in the area.

Begin Internet marketing and networking. Build a website or pay someone to design one. Locate elderly care professional websites for your area that you can be a part of to gain business. Attend local networking events whenever possible.

Celebrate your opening day.


Including benefits, such as group health care to employees is an excellent way to attract and retain talented people. It is also a good idea to obtain a disability policy on the owner in case they would be disabled, resulting in a temporary slow down or closure of the business.


Resist the temptation to make employees independent contractors. There can be serious and costly consequences of such a set-up.

Things You'll Need

  • Business plan
  • Accountant
  • Attorney
  • Articles of incorporation
  • Local and state licensing
  • Federal EIN
  • Phone
  • Business insurance policies
  • Building or lease for a building
  • Start-up capital
  • Business current account
  • Office supplies
  • Printer
  • Copy machine
  • Fax machine
  • Telephone
  • Office furnishings
  • Signs
  • Business cards
  • Brochures
  • Website
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About the Author

Faith Davies has been writing professionally since 1996, contributing to various websites. She holds an LAH insurance license in the state of Pennsylvania and has experience as a bank branch manager and lending officer. Davies graduated cum laude from the University of Pittsburgh with a Bachelor of Arts in art history.