Becoming a Consultant

T

ired of working for someone? Interested in traveling? Your skills may be just what other facilities need. If you have been doing the Minimum Data Set (MDS) for years, you might have the right stuff to start your own business and help some facilities that do not have an MDS coordinator and/or train others to get the job done. If you are burned out working long hours for someone else, you can become a consultant and work on your terms. After all, MDS coordinators are in short supply.
       But there are many factors to consider before starting off on your own. Explore all aspects of consulting and starting your own business. Read everything you can. Consult other consultants. Find the best lawyers and financial advisers to help you get started. You will need the best persons to guide you through starting a business.
       In Getting Started in Consulting, Alan Weiss, PhD, lists two conditions of consulting:
1. You intend to build a self-sustaining business in consulting, one that is profitable, creates a personal identity, and can support your lifestyle and goals, no matter how much or how little you are actively engaged in it.
2. You intend to consult on the side as opportunities present itself, and the resultant income is simply gravy on top of the predominant income derived from your other pursuits.
       So, set and define your goals, and judge your success on meeting them. You also need to know where you want to be in five years. Having the same amount of money coming in when you quit your previous job may be one goal. Outline your business and marketing plans, and set up an office. Not sure if you are really entrepreneurial material? Among the key traits are the ability to market yourself, confidence, drive, determination, integrity, experience, common sense, creativity, and flexibility.

Getting Started

       One of the first things to do is to get certified if you are not already. Being certified increases your credibility. The American Association of Nurse Assessment Coordinators (AANAC) has a three-tiered career ladder to increase your credibility as a consultant. After becoming certified, you can obtain an advanced certification and then become a Master Teacher. The first tier is a certification that requires the completion of seven core courses and three electives and the passing of written exams to become Resident Assessment Coordinator-Certified (RAC-C). AANAC holds online classes, or one can attend a three-day seminar.
       The next level is advanced certification, which includes the completion of a proctored exam through AANAC. The organization cites advanced certification as an excellent credential for consulting or for supporting others on the process of using the Resident Assessment Instrument (RAI)/MDS.
       Finally, the highest level is Master Teacher. It requires at least three years of experience with the RAI/MDS process along with a current RAC-C certification, demonstrated public speaking experience, and the completion of a proctored oral exam through AANAC. (For more information, call AANAC at 800-768-1880 or visit www.aanac.org.)
       Next, determine how you will market yourself. Word of mouth is highly valuable and effective. Indeed, networking is the most important aspect of being a consultant. Attendance at state conventions and national AANAC conferences can help you make contacts, let facilities know you are available, and let you network with and learn from other entrepreneurs.
       Make sure you have at least one year’s salary in the bank when you start up. There are start-up fees, which include office equipment, bills for utilities, insurance, and website development. Although you can set your hours, be flexible. You may need to work on the weekend in order to fulfill the requirements of the new job.
       The MDS work may or may not be in the vicinity of where you live. Jobs may take you all over the country. You have to be willing to travel in order to take on assignments. Also, see what the market demands. You can fax your resume to different facilities and even offer your services to a facility at which you once worked. Let others know that you are available to fill in during vacations or illnesses. Remember, though, that you will need a current license for each state in which you wish to work.

Expert Advice

       In preparing this article, I spoke to several persons from around the country who have become consultants and/or independent MDS coordinators. All got started after years and years of experience with the MDS and/or in Director of Nursing (DON), legal nurse consultant, or administrator roles. That variety of settings gave them different perspectives on for-profit companies and hospital-based units. Some work directly with the MDS, and some are involved in teaching and/or public speaking. Two of them still worked on MDSs for a company. Two of them said that they focused on training staff on Medicare and Prospective Payment System (PPS) regulations for facilities whose management was committed to educate staff members in order to capture a higher reimbursement rate.
       The consultants worked as few as 40 hours a week and as many as 60-75, whether that was direct work in facilities or marketing or research. But they worked on their own time and enjoyed that flexibility. The job is not Monday through Friday—they all said they do some sort of work on Saturday and Sunday. All said that they would recommend being a consultant and that it was financially rewarding. They also love traveling and meeting new people when conducting educational seminars. They all had supportive families and friends who encouraged them to strike out on their own and continue being independent, and two have obtained the title of Master Teacher through AANAC and now give the class.
       One consultant, however, spoke of the roller coaster of emotions. Moving to a consultant role can be a scary move, and a key is to learn from the mistakes. Among other advice from the consultants:
• Plan for downtime
• Return phone calls promptly within 90 minutes, and respond to e-mail as you read it
• Manage your time
• Be comfortable with who you are
• Find the market value for your expertise and time.
       For every project, one has to interview the client and determine clear goals for the product to be delivered. Sometimes the goal would be teaching the staff how to determine the optimum Assessment Reference Date (ARD) for the five-day admission assessment, while other times it would be teaching them how to do accurate and timely MDSs.
       Several of the consultants I spoke to like working for a company on a short-term basis, whether is it doing MDSs, conducting mock surveys, or doing an MDS audit. But remember that filling the shoes of an MDS coordinator is difficult. Almost anyone can operate a computer, but completing the MDS accurately requires a sound body of knowledge. Facilities want a consultant who can get the highest reimbursement for Medicare residents and those in case-mix states. That will make you marketable.
       You can base your operations out of your home to decrease cost and increase flexibility. You can start small and then grow if you want. You might remain a one-person operation, but you can also employ someone to assist you. Each person’s operation evolves differently.

Conclusion

       All told, consulting is not for everyone. There are disadvantages. It can be lonely at times, especially when you are not working. You are not around a group of persons consistently. It may not generate sufficient income, and you may incur new debt. And, it may be difficult to sell yourself over and over again. You may end up working longer hours because of work that needs to be done. An idea may strike you at 3 am and you will be at the computer typing away. You still might find some inflexibility when you have to work for a client, either in your home town or in another city. There might be travel inconveniences.
       But it can also be fun. Being self-employed means having more control over your life. You can be flexible with days and hours on your terms. It can be an entirely different experience to work with another company or provide seminars. And with the current demand for consultants, it might just be your time.

       Author’s note: Many thanks to the consultants, particularly Mary Harder (Tucson, Ariz), Ron Orth (Milwaukee, Wis), Rena Shephard (San Diego, Calif), and Becky Weisenhauer (Bloomville, Ohio), for their assistance in the preparation of this article.