5-Tips before You Start a Florida Nurse Registry
If you are thinking about applying for a Nurse Registry license , or in the process of obtaining a Nurse Registry license from the Agency for Health Care Administration(AHCA) and want to learn 5 important tips to help with the license application process before you start, then this article is for you.
In a nutshell, the to apply for an AHCA license requires the preparation of an extensive application, payment of varying fees, proof of insurance, background checks, the preparation of a Proof of Financial Ability to Operate form and more. The AHCA website has different rules for each type of healthcare provider. For instance, there are specific forms for a Florida nurse registry and therefore you should go to that website. This is a very brief summary, and you should review the AHCA website for the application process and required forms.
Step 1-Commit to Spend Time
The first step is to begin thinking about your business plan, i.e., sources of revenue, number of RN’s, LPN’s ,Home Health Aides, Homemaker Companions other employees, and costs to operate. This type of information is key to developing and preparing your Proof of Financial Ability to Operate (PFA). Before you start, you should be aware of a very important form, that is part of the AHCA application process known as the Proof of Financial Ability to Operate (PFA) that was mentioned above. I have spoken to applicants who forgot to include the PFA because they did not understand the instructions or incorrectly completed the form. With a little preparation and setting aside the time, you can avoid the misfortune of being rejected by AHCA for failing to include the PFA or to correctly prepare the PFA.
What is a The Proof of Financial Ability to Operate Form ?
At this point, lets spend a little time to become familiar with this form. The Proof of Financial Ability to Operate form is not a simple form, its rather complex and is designed so that the applicant demonstrates to AHCA, among other things, that the Applicant has a well thought out financial plan to deliver nurse registry services and is knowledgeable in their line of business and the projected operations in the Proof of Financial Ability to Operate form is achievable. The Proof of Financial Ability to Operate is effectively a formalized financial screening process to filter out the non-serious applicant or those that may have not the know-how, and/or have the financial resources (‘the financial ability to operate”) to provide nursing services to Florida residents.
Step 2-Fulfill the Requirements
It's important to go to the AHCA Website to become familiar with the entire application process and learn about the application forms, checklists and the PFA, Instructions to the PFA and all the requirements. When you read the instructions for the PFA, take the time to focus on the word “assumptions”, which are the building blocs for your projection included in the PFA. Making valid financial assumptions, and explaining them clearly, can make the difference in being approved or rejected by AHCA. Often, the primary reason for approval or rejection relates to how you explain your knowledge and expertise of the healthcare industry. There are many reasons for rejection, which are not relevant for this discussion and can be avoided by understanding the instructions and correctly completing the application. Even if you have healthcare experience , you should perform your industry and competition research diligently so that your assumptions are consistent with the current Florida market place. These assumptions will be reviewed by AHCA. You must then consider these financial assumptions based your knowledge and research in the preparation of the PFA and communicate or disclose them clearly in your PFA and business plan. If your financial assumptions are challenged, you will have the documented support to respond to any comments received from AHCA. To demonstrate the importance of having understanding and having correct assumptions, AHCA's instructions clearly state “ Schedules 1-6 reflect the anticipated results of future operations. Since these schedules are forward looking, the applicant will have to make certain assumptions about future revenues and expenses. The assumptions an applicant uses are essential in developing a projected set of financial schedules and should be consistent with the applicant's business plan. All assumptions used in the projections should be contained in accompanying notes to the projections.”
Step 3-Decide if You Need Help
After you read the instructions to the PFA and all six related forms, you should evaluate if you are able and capable to prepare the PFA. The next decision to make, is whether you want to self-prepare the Proof of Financial Ability to Operate or use a CPA or accountant or bookkeeper to prepare the Proof of Financial Ability to Operate. That decision is up to you. If you are good at spreadsheets, understand AHCA's instructions and confident that completion of the form is easy, have the time then, to self-prepare the Proof of Financial Ability to Operate is the right choice for you. Most applicants feel the form is too complex for them. I think the analogy is similar to buying bedroom furniture from Ikea. If you feel the same way about complex financial forms, then another suggestion, is to use a bookkeeper or non CPA/accountant to help. A word of caution, make sure the person you hire, has the experience in preparing a Proof of Financial Ability to Operate and knows how to prepare and articulate in writing the assumptions and footnotes.
Step 4-Check Thoroughly
Checking the PFA and following the instructions is so important, so please click here so you can access and read the instructions one more time, or read them now, if you have not read them while preparing the PFA. If you have read the instructions once, now re-review the requirements to make sure you have not missed anything. For this reason, I have highlighted in the instructions, two important areas, that I believe are often misunderstood and should be intelligently handled before you submit the form to AHCA. One pertains to assumptions which was discussed above and the other is Schedule 1: Estimated Provider Costs And Source Of Funds. These instructions are from the Proof of Financial Ability to Operate.
Assumptions-In the assumptions used, the instruction states that Assumptions are key to AHCA’s understanding your projections and Notes which must be attached to the projection so AHCA will understand the assumptions.
Schedule 1: Estimated Provider Costs And Source Of Funds. This schedule computes and shows AHCA the amount of pre-opening costs, contingency and working capital requirements that you will need until you achieve until you reach a levels of positive cashflow. Also, Schedule 1: Estimated Provider Costs And Source Of Funds, requires the applicant to provide independent evidence of sufficient funds for startup, working capital and contingencies. For an explanation of this form and learn about the required funds needed to be approved by AHCA, click here for my video. To save you time, as the video concludes, there is no magic number which AHCA will accept for approval. On the contrary each application from Schedule 1: Estimated Provider Costs And Source Of Funds, summarizes and computes a different amount that is the required information derived from the projections which needed by AHCA for their review, analysis and approval.
Step 5-Complete and Submit
The Proof of Financial Ability to Operate is an important part of your application and it's important for it to be correct. If it's not correct, then you will receive a comment letter from AHCA and have 21 days to correct the Proof of Financial Ability to Operate . If you are unable to correct the Proof of Financial Ability to Operate within the 21 days, then you will have to re-apply and pay certain fees again. Therefore, after you complete all the AHCA required forms, review and re-review it. Assuming you have self prepared the PFA and/or the Application, you many want to have another person who has healthcare experience with filing these forms with AHCA, review your entire application. Its best for you to perform your review the next day, after a good night's sleep and then file. Alternatively, if you are not comfortable completing the PFA you may want to contact an accountant.
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If you need help with the preparation or consulting with the Proof of Financial Ability to Operate, feel free to contact me.