How to Start a Home Healthcare Service: 12 Steps to a Medical Business

The demand for home healthcare in Vietnam is rapidly increasing, especially in major cities, as the population ages and chronic diseases become more prevalent. According to statistics from the Ministry of Health, Vietnam has over 7 million elderly people who require regular care, while the hospital system is constantly overloaded. This is why many people are looking for how to start a nursing service to both generate stable income and provide practical value to the community.

In many countries, private nursing services have achieved large revenues after only 1–2 years of operation by supplying nurses to hospitals or caring for patients at home. In Vietnam, this model is opening up potential business opportunities for those with nursing certifications, or simply those who want to start a business in the healthcare sector. This article will help you understand how to start a nursing service from scratch, what to prepare, how to begin, and how to get it right from the start.

Step 1: Preparing Qualifications to Start a Nursing Service

Complete a recognized nursing training program

• Enroll in a hospital, college, or university nursing program with a valid training license.

• The program must meet Ministry of Health standards to qualify for a nursing practice certificate.

• This is a foundational step to help you understand professional procedures, ethical conduct, and patient care standards.

Having a nursing certificate facilitates business operations

• Although it's not mandatory to be a nurse to open a nursing service, having a degree helps you:

  • Deeply understand customer needs (patients, families).

  • Effectively and professionally manage your team of nurses.

  • Increase personal and business credibility when working with hospitals and healthcare partners.

Check local legal requirements before business registration

• Some localities require the head of the service to have a certain medical professional qualification.

• It may be necessary to meet assessment criteria such as practice conditions, ethical standards, or a suitability check when applying for a license.

• It is advisable to work early with the local health department or a legal consultancy to avoid omissions in the application.

Practical advice for newcomers

• If you don't have a nursing degree, consider partnering with a certified head nurse to meet legal and operational requirements.

• Concurrently, invest in short courses on nursing service management and home healthcare to enhance operational capabilities.

Step 2: Understanding Legal Regulations When Starting a Nursing Service

Thoroughly research medical and safety regulations applicable to nursing services

• Consult medical laws and healthcare safety regulations directly related to the operation of nursing services in the locality where you registered your business.

• Focus on core content such as: operating conditions, permitted scope of services, responsibilities to patients, and obligations to employees.

Clearly define the legal obligations of the nursing service provider

• Check requirements for:

  • Professional practice license and business license for nursing services

  • Recruitment and management standards for nurses

  • Regulations on safety, patient information confidentiality, and professional risk management

• This is the basis for you to operate lawfully, avoiding penalties or suspension of operations.

Contact the licensing authority or medical regulatory body for accurate information updates

• These regulations are often publicly available at licensing authorities, health departments, or professional registration management units.

• It is advisable to inquire directly or consult the latest documents to ensure the information is always correct and updated, as regulations may change over time.

Practical experience for new nursing service providers

• Before submitting your registration application, create a legal checklist based on current regulations.

• If unsure, you should consult a lawyer or medical consultancy to avoid errors from the outset.

Step 3: Develop a Business Plan for Nursing Services

Develop a business plan from the outset

• Create a clear business plan, focusing on a home nursing service model or nursing staff supply.

• This plan serves as a basis for you to control cash flow, assess risks, and work with partners and investors if needed.

Determine initial startup costs

• List all necessary expenses, including:

  • Business registration fees, medical license application fees

  • Costs for basic equipment, uniforms, care tools

  • Office costs, management software (if applicable)

Estimate initial personnel and salary costs

• Calculate nurses' salaries, management staff, and insurance/allowance costs.

• Prepare sufficient budget to sustain operations for the first 3–6 months, when revenue is not yet stable.

Analyze the market and target customers

• Clearly identify target customers: elderly individuals, home care patients, families needing to hire nurses.

• Research common nursing service prices in the area to build an appropriate pricing structure.

Develop an operational strategy for nursing services

• Establish procedures for recruiting, training, and scheduling nurses.

• Define clear guidelines for client intake, care provision, incident handling, and service quality assessment.

Calculate taxes and financial obligations

• Estimate payable taxes such as business license tax, corporate income tax, or flat tax (depending on the model).

• Ensure compliance with accounting regulations to avoid legal risks.

Develop a marketing and promotion plan for services

• Identify effective customer outreach channels: website, social media, referrals from hospitals, clinics.

• Allocate an appropriate advertising budget, prioritizing channels that reach individuals looking for how to start a nursing service and hire home nurses.

Review the plan with a financial expert

• It is advisable to have an accountant or financial expert review the entire business plan.

• This helps to identify omissions and discrepancies early and make timely adjustments before actual implementation.

Step 4: Prepare Capital When Starting a Nursing Service

Determine initial investment capital sources

• Raise capital through business loans from banks or capital contributions from individual investors.

• For nursing service models, startup costs are often not excessive, mainly focusing on personnel, legal aspects, and operations.

Estimate reserve budget for cash flow

• It is necessary to prepare sufficient cash to pay nurses on time, even if clients make late payments.

• In reality, many families or service hirers may delay payments by 15–30 days, causing cash flow pressure if there is no reserve fund.

Calculate capital needs accurately reflecting operational reality

• In addition to startup costs, a budget should be reserved to maintain operations for at least the first 2–3 months.

• This reserve helps the nursing service operate stably, without interruption due to a lack of working capital.

Practical advice for new nursing service providers

• Prioritize capital sources with stable interest rates and flexible repayment periods to reduce initial financial pressure.

• If raising capital from individual investors, clearly define contribution ratios, benefits, and responsibilities to avoid future disputes.

Step 5: Obtain an Operating License for Nursing Services

Submit an application for a private nursing service license

• Prepare and submit the application to the provincial/city medical regulatory authority where you intend to operate.

• This license allows you to provide private nursing care services for patients at home or under contract.

Register a separate license to supply professional nursing staff

• In addition to the main license, you need to apply for an additional license to provide specialized nursing staff or care staff (CNA) as required by local regulations.

• This license usually comes with requirements for:

  • Personnel qualifications and certifications

  • Professional management, assignment, and supervision procedures

  • Commitment to ensuring safety and quality of care

Carefully check document requirements before submitting

• Some localities require additional:

  • Professional qualification profile of the person in charge

  • List of prospective personnel

  • Operating procedures and risk control

• Thorough preparation from the start helps shorten review times and avoid multiple resubmissions.

Practical experience when applying for a nursing service license

• It is advisable to contact the Department of Health or the one-stop service counter directly for accurate guidance on current regulations.

• If you are unfamiliar with the procedures, you can seek assistance from medical legal consulting firms to ensure your application is correct and complete.

Step 6: Choose a location and office model for your nursing service

Choose a convenient office location for contact

• Prioritize a location that is easy to find and contact for both clients and nurses.

• It is not necessary to have a large or expensive central location if the model does not involve frequent client visits.

Consider an online or virtual office model

• In the digital age, you can fully operate a nursing service with a virtual office.

• Using online work tools helps efficiently manage records, schedules, and personnel remotely, significantly reducing rental costs.

Prioritize communication systems over physical location

• The most important factor when starting a nursing service is fast and stable contact capability, including:

  • Operator or hotline phone

  • Stable internet for client and nurse management

  • Messaging tools, email for timely responses

• In practice, quick response capability is more important than having an office close to clients.

Practical experience for new nursing service providers

• In the initial phase, it is advisable to prioritize cost optimization by using a small office or working remotely.

• As the number of clients and nurses grows, you can expand to a physical office to enhance brand credibility.

Step 7: Prepare contracts and find initial clients

Draft legally compliant client and personnel contracts

• It is advisable to hire a local lawyer to draft contracts to ensure full compliance with current labor laws and medical regulations.

• The contract should clarify:

  • Scope of nursing services provided

  • Rights and obligations of clients

  • Responsibilities, shifts, salary, and insurance for nurses

• This helps limit legal risks and disputes later on when the nursing service opens.

Find initial clients from local healthcare facilities

• In the initial phase, you can cooperate with:

  • Hospitals

  • Nursing homes

  • Private healthcare facilities

• These facilities often have a high demand for Certified Nursing Assistants (CNAs) compared to nursing agencies, which is very suitable for starting and generating stable cash flow.

Recruit nurses and CNAs through local channels

• Promote recruitment on:

  • Local magazines, newspapers

  • Hospital bulletin boards, medical centers

  • Medical industry communities in the area

• This helps you quickly access a suitable workforce that meets actual needs.

Optimize operations with flexible human resource management services

• You can use staff engagement and coordination services to assign shifts and connect nurses with shifts.

• This solution helps reduce the cost of hiring dedicated coordination staff, which is especially effective when the scale is still small.

Prioritize response speed when working with hospitals and nursing homes

• Healthcare facilities highly value the ability to provide staff quickly.

• Clear processes and early responses help you gain a competitive advantage from the outset.

Read each contract term carefully before signing

• Ensure you understand all terms, especially those related to liability, payment, and contract termination.

• This helps avoid legal risks and protects your interests once the nursing service is operating stably.

Step 8: Purchase liability insurance for nursing services

Secure liability insurance from the outset

• Nursing services must have professional liability insurance to protect the business from risks arising during patient care.

• Insurance helps minimize financial losses in the event of claims, occupational accidents, or disputes related to nursing expertise.

Clearly define appropriate coverage and insurance levels

• Carefully check if the insurance covers:

  • Business liability

  • Nurses' liability when working for the agency

  • Common risks in home or facility care

• The insurance level must be appropriate for the scale and type of nursing service you provide.

Understand the type of liability insurance being applied

• It is especially important to note if the insurance is calculated by:

  • Claims-made basis: insurance pays for incidents that occur during the effective period of the contract.

  • Occurrence basis: insurance only pays when a claim is reported during the effective period of the insurance contract.

• Misunderstanding the type of insurance can result in non-payment of claims, even if premiums have been fully paid.

Understand incident reporting obligations according to the insurance contract

• When an incident occurs, it must be reported within the timeframe and procedures specified in the contract.

• Delays or incomplete reporting can lead to the insurance provider refusing to pay.

Practical experience for new nursing service providers

• It is advisable to discuss directly with the insurance provider or legal advisor to have each term clearly explained.

• Do not choose the cheapest insurance package if the scope of protection does not cover the actual risks of the nursing service.

Step 9: Implement payroll software for nursing services

Use payroll software suitable for the specific nature of the nursing industry

• It is advisable to choose payroll software that allows weekly or shift-based payments, suitable for the flexible working nature of nurses and CNAs.

• The software needs to support clear management of working hours, shifts, allowances, and deductions to avoid payment errors.

Prioritize Software-as-a-Service (SaaS) solutions

• You can use online payroll software services (SaaS) with low monthly fees.

• The advantages of this model include:

  • No need for complex initial system investment

  • Easy scalability as the number of personnel increases

  • Remote management, suitable for flexible nursing service models

Carefully consider outsourcing payroll services

• If using a third-party payroll service provider, ensure they:

  • Are closely integrated with the human resource management system

  • Are aware of shift information, feedback, and quality of care

• Incorrect or delayed payments can easily cause dissatisfaction among staff, directly affecting service quality.

Link pay to service quality feedback and control

• In practice, customers often complain quickly about costs when they feel the quality of care is not commensurate.

• Therefore, the compensation system should be linked to:

  • Recording customer complaints

  • Evaluating care quality

  • Timely corrective action if issues arise

Practical experience for nursing service providers

• Prioritize transparency and accuracy in payroll to retain nursing staff.

• A clear and timely payroll system helps build internal credibility and creates a sustainable operating foundation for nursing services.

Step 10: Recruit and screen nurses before hiring

Thoroughly interview nursing and CNA candidates

• Conduct in-person or online interviews to assess:

  • Professional skills and practical experience

  • Work attitude, ability to communicate with patients and families

  • Suitability for your nursing service model

• Prioritize candidates who understand the specifics of home care and can work flexible shifts.

Conduct background checks before signing contracts

• Perform personal background verification for prospective candidates.

• This helps mitigate risks related to professional ethics, patient safety, and the reputation of nursing services.

Verify valid certificates and licenses to practice

• Carefully check:

  • Whether the nursing or CNA certificate is still valid

  • Whether the issuing authority is legally compliant

• Do not hire personnel with expired licenses or unclear records, even if there is an urgent need.

Review candidates' unusual work history

• Pay special attention to cases of:

  • Frequent job changes within a short period

  • Abrupt resignation without clear reasons

• In reality, some staff leave to avoid internal discipline or legal issues, which poses a significant risk to nursing services.

Practical experience for nursing service owners

• Always have a standard recruitment process; do not skip screening steps even if you need staff urgently.

• Personnel are the core factor determining the quality of care, so it's better to recruit slowly but correctly than quickly with risks.

Step 11: Promote nursing services to clients

Directly approach clients at local healthcare facilities

• Place service brochures at:

  • Hospitals

  • Clinics

  • Family doctor's offices

• These locations concentrate the right target audience who are looking to hire nurses or home medical care, helping to increase actual conversion rates.

Collaborate with doctors and medical staff

• Actively introduce nursing services to doctors, head nurses, or patient advisory departments.

• Once trust is established, they can refer clients to you after patients are discharged or require long-term care.

Promote on appropriate media channels

• Use local newspapers, health magazines, or community media channels to increase visibility.

• Advertising content should focus on:

  • The practical benefits of nursing services

  • Suitable target audience (elderly, patients requiring home care)

  • Clear, easy-to-call contact information

Combine online channels to expand reach

• In parallel with offline advertising, you should build a website or social media page to showcase your services.

• This helps customers easily look up information, evaluate credibility, and contact you quickly when needed.

Practical experience in marketing nursing services

• Prioritize outreach channels that match needs, avoiding budget dispersion.

• Regular presence at hospitals and clinics yields more long-term effectiveness than short-term advertising.

Step 12: Work with clients and implement nursing services

Meet clients directly to accurately determine care needs

• Discuss in detail with clients or their family members to understand:

  • Current health status

  • Required level of care (hourly, by shift, 24/7)

  • Specific preferences regarding the nurse's skills, gender, or experience

• This step helps avoid misunderstandings of needs and reduces complaints during the provision of nursing services.

Select the right nurse for each patient

• Based on actual needs, arrange nurses with:

  • Expertise suitable for the pathology

  • Similar care experience

  • Appropriate attitude and communication skills for the patient's family

• Matching the right person to the right shift largely determines customer satisfaction.

Clearly define the nurse's duties according to the treatment protocol

• Specify the nursing tasks to be performed, based on the doctor's treatment plan.

• Clarifying the scope of work helps nurses perform their duties correctly and avoid responsibilities beyond the agreement.

Finalize agreement and sign service contract

• Once all details are agreed upon, proceed to sign a nursing service contract with the client.

• The contract should clearly state the duration, costs, responsibilities, and contingency plans for changes.

Dispatch nurses to the correct clients

• After signing the contract, dispatch nurses to the correct address at the agreed-upon time.

• Closely monitor during the initial days to make timely adjustments if any issues arise.

Join industry associations and stay updated on legal regulations

Join professional associations or organizations in the field of nursing

• Participate in medical, nursing, or healthcare industry associations to expand your network with organizations in the same field.

• Practical benefits of joining include:

  • Connecting with other nursing services to learn operational experience

  • Accessing a source of quality nurses and CNAs looking for stable work environments

  • Early access to cooperation opportunities, projects, or new staffing needs from hospitals and healthcare facilities

Closely monitor changes in medical and safety laws

• Proactively update on new regulations regarding medical, care safety, and labor that may directly affect nursing services.

• These changes often relate to:

  • Practice conditions and licenses

  • Safety standards for patients and staff

  • Reporting obligations, inspections, and legal compliance

Use associations as a reliable channel for information updates

• Many associations regularly share announcements, guidelines, and early warnings about policy changes.

• This is a source of practical, industry-specific information that helps you adjust operations promptly without being caught off guard.

Practical experience for nursing service owners

• View participating in associations and staying updated on laws as a long-term activity, not just for show.

• A nursing service that complies well with regulations and has good industry connections will easily build credibility, attract staff, and achieve sustainable development.

References

1. https://www.nursinglicensure.org/articles/rn-licensing.html
2. https://nursesbusiness.com/nursing-agency-owner/
3. https://www.rqia.org.uk/RQIA/media/RQIA/Resources/Standards/Nursing-Agencies-Standards-Jul-08.pdf
4. https://www.profitableventure.com/starting-a-nursing-agency-business/
5. https://www.prnfunding.com/starting-a-nursing-staffing-company
6. https://smallbusiness.chron.com/startup-costs-associated-starting-private-duty-nursing-agency-1845.html
7. https://minoritynurse.com/the-basics-of-starting-a-nursing-recruitment-agency/
8. https://law.justia.com/codes/california/2009/hsc/1743-1743.37.html

Translator: Sidney Bailey Hoang.