CRNA Finance

Feeling Adventurous

Listen up! This is the time to really consider your future and consider starting your business. If you are looking for something in addition to anesthesia or even entertaining a business in anesthesia, this is the time. You all probably know that I am starting a laundromat, and some rental properties. I am always looking to how I can further develop and grow business in the Locum world and outside of it. I use locum anesthesia in order to have these investments. This is, however, the first time I have had to take a business loan. I thought for sure I would be raked over the coals. The contractors for the rehab are making an extensive penny or two from me. I’m still using them because of their reputation and that I know the job will get done. This is sometimes how it works in anesthesia as well. If you have a good reputation and have worked with people before, it bodes well that even with an increased rate, that you will be called over another person. It doesn’t always work that way, but you have a better chance.

I really wasn’t going to write a lot about locums except to say that you can utilize this lifestyle in order to make your entrepreneurial side hustle a real life adventure. I had no idea how I was or … if I was going to get the loans to make this Laundromat work! Here is what has happened so far. I had bids from a great contractor but it would be may before they finished. I had a bid from someone that was not exceptionally or commercially adept, and finally the bid I ultimately took which was based on recommendation and experience in commercial development. I also had the laundry equipment person out to help in design, layout, function, setup of equipment and then the company designed the necessary templates for the construction crews. I talked to a bank which was willing to help but wanted me to be in person and in place all the time so after weeks and weeks I made a switch to another bank. This banker has been awesome. He was proactive in getting the city and state co-loans processed and ultimately approval for all the rehab. The laundry equipment was fully financed by the equipment maker.

I had expected the personal guarantees as I just don’t have millions in assets and it was 100% financed. That said, I expected high interest rates and was thinking that I would be up the creek and paying for it. This is the time to get a mortgage, a business loan or go for a dream. I think it will be harder as time goes forward in the coming years and interest rates are increasing.

This business is less than $2500/month to make an amazing attempt. Yes, there are incidentals, insurance, bills, utilities and the like that will cause some creep but those are operational expenses. Did you think you could have a business with upside potential at $2500/month?

OK, if you don’t want to take on a risk like this. I completely understand. That is where your multi-level marketing companies come in.. Don’t like that?? Then consider your on-line businesses or the many opportunities for growth within anesthesia. You have to take a leap. Listen to the goals Youtube presentation again and make your audacious goals. You can do this!

Are you thinking gees I couldn’t take that risk? It’s not far off from Locum Anesthesia. One day you can have a contract at $160/hour then have a $120/hour assignment. Things change and some day you’ll look for when you can take that vacation and realize that no work = no pay and that you wish you had even a $100 coming in from some investment.

Just a couple thoughts as we are still in the new year…. but tomorrow is Feb 1 and the year will be flying by! Learn, grow, and stay on the journey. You CAN do this!

Investments without large fees

Investing is not one of our best endeavors and many just don’t take the time to learn. With only a few minutes left in the year, here is some information you might not want to miss.  

I was just listening to the ChooseFI podcast and found out a few things to pass along.  First, I recommend listening to them as you journey through life whether you are planning to retire early or not.  

HSAs or Health Savings accounts for any high deductible insurance plan that is define as 1350 for an individual or 2700 for a family.   You can put away 3450 individual or 6900 for a family in an HSA TAX FREE.   Any medical expenses can be taken out TAX FREE at any time / any year!  This of course means you have to keep your receipts for your accountant for years.  After age 65, it acts like a traditional IRA or can be used for medical expenses later in life.  If your plan started dec 1 you could find the entire amount.  Fidelity now has a zero fee HSA management account (funds or investments places in the account may have some fees).  

This is way different than an FSA as those funds don’t fully roll-over year to year.   these funds are for your yearly medical expenses and are typically use or lose.

We are typically interested in low fees and trying to keep our income in our pockets.  Mutual fund investments are just about the most common across the nation and ChooseFI often touts the Vanguard total stock index fund or VTSAX which had a hefty $10k minimum which has now changed to a $3k minimum for getting started.  This opens the fund up to those who are wanting to get started investing at one of the lowest fee mutual funds on the market at an annual fee of just 0.04%! 

Some of you may know these things but the mutual fund information is pretty new.  If you are thinking of setting up the Solo401k it has to be done and funded by the end of the year and if you are looking at a sep IRA it must be done and funded by April 15.   

It’s time to get your investment on! 

LocumCRNA.com and a new investing page?

I’m thinking it might be interesting to go through investments?  We work hard and make a decent income. What do we do with that income, or how do we invest and protect our investments? 

I’m thinking about using my continuous growth in showing what I have been up to on the investment space.  I can show the websites and what I’m working on in that space.  I can go through real estate holdings and what that looks like.  Not to forget sep IRA V’s Solo 401k and stock market investments.  Then businesses and the different types of investments that I look at and consider. 

I wonder if this is something you would want as a page as it only somewhat relates to our site because locums is the way I finance life and the investments?  

When you are booking a hotel for a long term stay.

I put a video up about this topic at locumCRNA.com under videos.  However, I forgot to mention ... 

Don’t forget hotel taxes.  Hotel taxes and fees can be significant.  So add that cost into your calculations.  Also, be sure to ask when those are refunded.  Typically on a long term stay those are refunded or a portion is refunded when you become more of a long-term VS transient guest.  

This is of course if you are not checking out for weekends but might be a good way for you to keep a portion of what your negotiated fees are for housing or if you negotiate an all-inclusive rate you can keep more of your hourly when not having significant taxes and fees taken by the hotel.   

As far as I know the fees and taxes will stay the same for AirBNB and VRBO but those would need to be scrutinized so you have a true idea of the expenses.  

If this is helpful please subscribe to the YouTube channel and if you want to support us ... next time you are purchasing on Amazon click on one of our links in the store and any purchase on Amazon for 24hours will give us a small commission.  Have a great day and let us know how we can provide more content you like at locumCRNAs@gmail.com

Should Locum Professionals be a 1099 Contractor or W-2 Employee 

I've been approached by several W-2 and 1099 Locum CRNAs and many ask what the difference is.  Tom is a wealth of information and his podcast and professional speaking on these topics are highly applicable to our business.  Now for Tom's article for LocumCRNA.com!  Thank you, Tom!

By Tom Wheelwright

Life as a traveling medical professional can be costly if you don’t have the right tax strategy. Locum Professionals, who temporarily take over when others are sick, unavailable or out on maternity leave, tend to be set up as a 1099 contractor. For all Locum Nurses and Physicians, it’s especially important to understand the differences between being taxed a 1099 independent contractor versus a W-2 employee to keep more money in your pockets.

1099 vs W-2

Generally, tax reduction opportunities are much greater with 1099 income versus W-2 income. However, if you're not careful, the 1099 income can be taxed even higher than the W-2 income. 
Traveling physicians should do all they can to make sure they are independent contractors (1099) due to the much greater tax benefits of owning a business (1099) versus being an employee (W-2). For 1099 contractors, travel is 100 percent tax-deductible if you spend more than 50 percent of your day four-plus hours - working while you’re on the road.

New Tax Law Impacts

With the new Tax Cuts and Jobs Act of 2017, this tax question is even more important. After reading the entire new tax plan of over 1,000 pages three times, there are important things to note.  

If you’re set up as sole proprietor or S Corp, you may be able to take a 20% deduction on the net income from your business. Professional service companies, like doctors, lawyers and accountants (though not engineers or architects), business will only get the full 20% deduction if their taxable income is less than $157,500 ($315,000 on a joint return).

Bottom line, a good tax strategy for 1099 or W-2 income should always be developed with a great Tax Advisor to ensure long-term and permanent tax reductions. 

And for more information about the new tax plan impacts, read our newly released Tax-Free Wealth2ndEdition (August 2018).

About The Author: Tom Wheelwright is a Best-Selling Author (Tax-Free Wealth 2ndEdition, 2018), CPA and CEO of WealthAbility, which assists small businesses and entrepreneurs with tax and wealth strategies, and Host of The WealthAbility Show with Tom Wheelwright CPA Podcast. http://wealthability.com

LINK To Tom Wheelwright’s new 2018 book

https://wealthability.com/tfwamazon

 

 

 

Change is inevitable

It’s Thursday and I’m in my last two days of Massachusetts. This is what I’m doing.  I’ve confirmed my credentials for Texas and started the credentialing in Virginia. Virginia is a different group as the previous took 8 months and came back with telling me I would have to resubmit everything and starting over.  I’ll never deal with a group that does that again.  

So, I’m preparing my luggage and work bags.  I’m making sure copies of hotel bills are sent to the agency.  I’m making sure the final hourly bill is sent tomorrow after work.  I’m slowly packing and getting things ready to go.  I’ll be doing homework the next two nights so more time can be spent with family when I get home.   

I sent in my foreign corporation documents by fax and mail to Texas.  This took 4 minutes from searching the foreign corporation and Texas Secretary of State.   

Min the meantime I’ve been in contact with my accountant.  Talking about the change of location.   

I’ve tracked my route to Texas and planned the day of start in Texas so that all is ready and done for a good and quick start.  I have a badge and person that I’m meeting.  Hotel is set and ready to go.  Seems all I need to do is show up and get started. 

Otherwise we are working on the real estate.  We are offering currently on another potential rental, but we are only getting it if it’s at a deal level. The market is turning again to a buyer level in some environments like where I invest, YouTube for Francisco (growing and getting ready to monetize with ads), and getting Elizabeth set for schools and bank accounts (preparing to pay her annually for work). We are finally hunting for what may be our November vacation as we haven’t done a just Francisco and I vacation in a year or two ;).  The journey continues.   

 

Debt reduction as a locum.

I’ve been so fortunate that Francisco is an amazing parent!  Elizabeth has been at home with Francisco 90% of the time and we found a great babysitter through a friend.  Francisco has been knocking it out-of-the-Park with his YouTube channel/ website ConMuchoSabor.com.   

I looked at our debt 7 months ago and was so stressed that we were over $250k in debt not including our home.  I traded my truck for less than half the cost new SUV.  I went to work on locums and raised my rate while telling the place I needed any hours or call I could get.  I’ve been away from the family returning about every 4 weeks for a few days to a week.  We’ve still had time to visit family and a good “working” vacation.  I’m happy to report that our net worth is positive and debt is below 100K.  I’m going to a 2 week on 2 week off lifestyle with intermittent days on my weeks off that will allow us to keep decreasing our debt and allow me more time at home!  Our rental properties have picked up and are now paying for one new property per year and paying thier own expenses.   

I have approximately 3 more weeks away before getting started on my new locum contract!  I’m 12 weeks into my MBA carrying a 3.8 gpa and learning weekly.  I get to pour over financial reports and am doing better each week with my own reports as well!   

I continue to consider business opportunities and think that with time 1,2 or 3 could become something just like the rentals, YouTube or the websites.   

I just wanted to check in and thank you all for the positivity and thank our Locum professionals for keeping us in great standing so we can work, travel, & provide for our families!  We are so blessed!   

 

Flexibility with Travel, Work, & Vacations

The flexibility & vacation time in working locums drew me in and kept me as a locum nurse Anesthetist.  

Work flexibility with a few facilities around the country has allowed the opportunities to do more with my time. 

Recently, my family visited Costa Rica and extended family!  I was able to speak and although I was a little excited, nervous, & even got a little lost in speaking; it was great to see other CRNAs and have them meet the family.   

We moved to Virginia for surrogacy and failed our first attempts.  It was a true and sad failure but due to locums I’ve been able to pay down the debt that occurred for this attempt.   

We’re paying down our debt load and continued to build the real estate venture over the past 6 months.  It’s been amazing to follow a move and family changes over the past 6 months.  I’ve been able to build on relationships and although working a lot... we are still well on our way to continued financial success in our lives.  Although, I know it’s possible to do this in one location with one job, it’s getting done on a condensed schedule.   

Life, flexibility and continue strong work ethic are leading to change as I continue all the things that are important in our family life.   

Finally, school is just about to finish the first 10 week term toward the MBA.  Nothing game-changing but working on a business mindset continues to be a fun opportunity for change despite my whining and complaining :).   

Totally looking forward to the coming weeks and months!  More to come. 

Happy mother’s day

Today is mother’s day and I must say mine has always pushed me to do better.  It doesn’t matter just how much I put in as far as effort, education, level of understanding or time... Mom has always been there pushing my boundaries to improve.  

I think that is missing in today’s generations and I’m hoping I can instill these values into Elizabeth’s core as she grows.  Not to instill negative worth of perception of never quite being good enough.  That isn’t the intent at all.  I see the amount of knowledge, work, time devoted to projects, continuous education, and effort that is put into every aspect of life.  I think the realization is that there is always someone that can do something differently or better in the results column.  I find an appreciation for the neighbor that has the most gorgeous lawn where mine is lucky to be mowed and have a few less weeds than a few other neighbors.  I think each of us have areas where our practice is not as strong as other.  In this area I hope that each of us would take time to learn and grow.  

Likewise, in this community of locums, business minded professionals and those that aren’t are all coming together and we can all learn.  I think our practice, our business skills, negotiation, and our personal lives have to be continually improved upon.   This is all-encompassing and is why you read so much on my personal life.  You read about my finances and how I’m making strides to have this burden significantly reduced by optimizing business, education, and leveraging my hours of work.  You see Francisco and I consider adoption as we want to build a family and seek opportunities to enrich Elizabeth’s life.  You see my real estate and investing strategies that will one day allow for a more diversified risk and likelihood of retirement or at least significantly reduced need for specific hours= specific dollars.  You read about family, conversations, my continued education, insurance and multiple facets as we continue down the road of life.  My hope is that people gain knowledge of life as a locum but also take from the stories the opportunity to enrich other aspects of their lives from family time to vacations. 

I’m continuing my journey by the FI principles of being just 1% better each time and way I can.  I hope it comes through to all out there.   

The busy locum

Another busy week looms in the balance on this Sunday evening.  I am well on my way to paying down the bills as we spoke on in weeks passed.  My Sep IRA through e-trade was set-up and funded.  I’ve traded in the truck for a small SUV that now is less than half the payment and has a better APR with half the balance I was paying.  I’ve also paid off 20k in credit cards.  I still have a long way to go and am paying my dear old Uncle Sam dearly with every paycheck so I can get in the good graces.

Today, I worked at the hospital ... from pediatric code to sepsis and multiple cases in-between it’s been a crazy day.  I was able to get back to my hotel in time to spend some time on homework.  My math class work for the week is complete and now it’s on to business analysis with its’ primary focus being communication this week.  The MBA program is challenging my time management and my brain in ways that I haven’t managed in a while.   

This week is a 60+ hour week and call for the entire next weekend.  I keep my focus on the benefits I see in the long-term as right now I sacrifice time with the family to get us ahead. We are seeking some freedom from the absolute need to work for thought of if things went sideways “what would I do if...” scenarios.   

I’d say in just a few weeks I’ve learned a good amount on every level and look forward to the coming weeks in engaging with colleagues, growing businesses, learning in the structured university education, and then managing life around the critical elements.  

This weekend I spent time on the farm with my favorite veterinarians and did c-sections for sheep.  What an amazing opportunity and so glad I spent a little time with family.   

What an amazing life we lead.  Now it’s off to laundry.  Feel free to e-mail me anytime locumCRNAs@gmail.com