Long post, but I want real feedback, not cheerleading. Skip to the bottom if you just want the questions.
I'm seriously considering launching a healthcare staffing agency focused on SNFs, mental health/behavioral health facilities, rehab centers, and assisted living — with hospitals as a long-term goal once I've built the infrastructure to compete at that level.
What I think I have going for me:
- I have a surprisingly wide network of SNFs, mental health facilities, ALFs, and rehab centers in my area that are either owned, operated, or administered by people who know me or my family. Not close relationships in every case — but they know my name, my face, and they'd take my call. In a relationship-driven industry, I think that's a real head start.
- I'm a strong problem solver. When something breaks, I figure it out — I don't freeze.
- I have decent sales and communication skills. I can walk into a room and have a real conversation, not just pitch.
- I'm fairly tech-savvy — I understand systems, software, and automating things that should be automated.
- I genuinely believe I have the drive to build something from scratch. I'm not afraid of the grind.
What I'm actually scared of:
My biggest fear isn't getting clients. It's the supply side — specifically, not having enough nurses and CNAs credentialed and ready to fill a shift within 2 hours of a request. I know that in this industry, letting a facility down even two or three times early on can permanently damage the relationship and tank your reputation before you've even really started. The big agencies can absorb that. I can't.
I also know I don't know what I don't know. I've done a lot of research but I haven't done this before.
My actual questions for people who've been in this industry — as owners, recruiters, DONs, or clinicians:**
Is my network advantage as real as I think it is, or does "knowing someone" mean almost nothing until you've actually proven your fill rate?
How many credentialed, bench-ready clinicians did you actually need before you felt confident taking your first facility order?
What was the thing that almost killed your agency in the first 6 months that no business plan prepared you for?
For DONs or facility admins reading this — what makes you give a new, small agency a chance over an established one? What makes you cut them off?
Is the 2-hour fill expectation realistic for a brand new agency, or is that a standard I'm setting for myself that will just lead to early failures?
What do you wish someone had told you before you started?
I want to be grilled. If you see a flaw in my thinking, tell me. If you've watched agencies like the one I'm describing crash and burn, tell me why. I'd rather hear the hard truth now than learn it by failing a DON who trusted me.
Thanks in advance.