The ABCs Of Small Healthcare Business - Employees

Hiring employees is the single biggest step any small business can make. It has been

shown that the complexity of a business scales not with revenue or expenses but with

the number of employees that company has. Of course, it is possible to have a

successful small healthcare business without employees. If you have specialty

experience, being a sole proprietor is a traditional path – think of masseuses,

physicians, optometrists, midwives. In such cases, you are selling only your own time,

knowledge and skill. If you plan to start any kind of 24/7 healthcare operation such as a

medical group home or an adult family home, employees are unavoidable. Even having

a single person in the home available around the clock constitutes more than four full-

time employees. And this is without any vacation, leave or sick time.

A huge raft of government regulations become applicable when a business becomes an

employer. Employees have numerous rights at the federal and state level that the

employer is responsible for ensuring, including making sure your employees are aware

of them. Consider that there are state and federal requirements for providing time off,

overtime, and family leave. Potential employee immigration status can be a significant

issue.

As the employer, you are responsible for collecting and submitting state and federal

employment taxes for your employees. As a result, payroll is a highly regulated process

and can be quite complex. While there is software that can assist with the process, it

has its own typically complicated set-up as well as cost.

Finally, employees come with personnel issues. In healthcare businesses where one is

caring for potentially vulnerable patients, it is especially important to ensure that any

employee issues do not impact patient care. There are numerous requirements in state

law for background security checks, care-giver certifications, and immunizations.

Jumping all these hurdles as a new business is a huge effort, and many simply don’t

make it. However, once past, they are a significant barrier to entry for others.