Start a practice with Assisted Living Facilities

Nurse Practitioners who want to get started in business, with low overhead would do well to look at this business model. Listen in:

Comments 23

  1. I have ponder the idea of an assisted living facilty for years. I have a practice in which I provide care for elderly in a nursing home. I think an NP owned and operated assisted living facilty is a great market. Is there any NP’s who have taken this step.

  2. I would like to actually star a house call practice targeting senior cneters, assisted living and nusring homes. Im still in the process getting everthing together . If i do get info i will gladly pass it on. In the meantime good luck!

  3. If you decide to have a practice based on making calls to LTCF, what do you need to do? I know you need an NPI and Medicare Provider number. Do you need to create an LLC? What about physician supervision? I’ve been asked to call on patients in assisted living, but the more I think about it, the more I realized I don’t know how to get started. Any tips would be appreciated.

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    Great questions.

    1. I always recommend you look into creating some sort of a corporate business structure. Which one will depending on what you plan to do, and to some degree state laws. An LLC is one of the easiest. Note that you will need an NPI number for the business itself.

    2. Physician Supervision – It depends on your state law. If you are somewhere that requires this, then yes. In terms of physician involvement for LTC facilities – it is still required, nationally, that there be a physician attending. So even in an autonomous state such as mine (WA), the patient must have an attending physician and that physician must stay involved with the care (visitation rules vary).

    Hope this gets you started. Since you are an NPBO member, be sure and get on our next Q&A call and we can go further into depth with your questions.


  5. Barbara,

    I am planning to start a house call business in the near future & am actually considering assisted living facilities. What is the best way to market to these individuals? Also, considering that Medicare only reimburses NPs 85%, should I be credentialed with other plans in case they have a secondary payer? Is it necessary to have hospital privileges? If not, what do you do if you think a patient needs to be hospitalized? I have a lot of questions regarding this particular niche. Are there resources you can suggest?

    Thank you.

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    Hi Teri,

    1. First, market to the facilities. You’ll find the administrators and nursing directors will do much to help you market to the individuals and their families
    2. Most will have medicare and some sort of secondary. Find out what’s most common. Usually (in my experience) if you are credentialed with MCR, you’ll be fine. However, I’m now seeing where some of the Medicare Advantage Plans want us to credential with them as well.
    3. You’ll still only be allowed 85%, but MCR only sends you 80% of the 85% and the 20% will come from patients or secondary payers.

    Hope this helps.

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  8. Barbara,

    In providing healthcare to seniors in their home, how important will it be for me to have hospital privileges?


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  10. Hi Terry,
    I work in a clinic that would like for me to do visits in a ALF as well as housecalls. My question is should I ask for more money hourly or say nothing? Also I reside in Florida and we are the queen of restrictions here. Can I see patients in a ALF without a physician supervising? They wanted me to fill out forms such as the medical certification for nursing homes/alf form and an resident assessment for alf. Am I authorized to complete these forms??? Please help. Thank you!

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  12. Hello, I have been practicing exclusively as an FNP in SNF, elderly patients homes, and assisted livings and will not be transitioning to assisted livings and home visits only, I am looking to see what a patient panel size would be for this role. A full time SNF panel is around 150 patients, I am assuming that ALF/Home visit would be larger?

  13. Hello, I currently work at VAMC as home-based primary care provider AGNP-C. I would like to start doing house calls, assistive living in private sector to earn extra money to help pay off my student loans. Where do I start? I have a NPI,taxonomy, business name registered. How do I market myself for contracts? I would like to work with medical advantage plans. I am seeking information, resources that I can reference. Do anyone have recommendations.

  14. Hello, My wife and I are both NPs and we just started a house call primary and we are getting into assisted living facilities. Do we need some type of contract or agreement with the owner of the assisted living facility? what is your advice of it. I do not thinks since we will be billing the resident directly but wanted to make sure.

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  16. I need help how to come up with a proposal contract within NP and MD to help seen her patients in an AL F community. How much is Ideal to ask as compensation..

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    Do a bit of market research. You can look up Medicare reimbursements to get an idea of reimbursements and go from there. A great deal will depend on if you are to be an employee or if you are contracting your services.

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  19. Hi Barbara

    I’m an NP with my own practice in Massachusetts working in the LTC and SNF setting. I would like to work in ALF as well for acute visits etc. Does the patient have to switch their PCP to become me or can I just see the patients for their acute issues? Will they need a referral from their PCP to be seen by me OR will I need a collaborative agreement with the MDs?

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    There are many ways to do it. If you wish to do just acute visits, you can see the patient AND send a note to the PCP’s office to let them know you saw there pt and what you did. If patients choose to switch to you for PCP, that is their choice. No collaborative agreement or referral needed.

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