As a certified nursing assistant in California, Marcus has dreamed of building a business that would connect hospitals and long-term care facilities with qualified nurses. Like many aspiring entrepreneurs, he quickly learned that starting a nursing registry isn’t as simple as filing paperwork. He realized that it’s a process shaped by strict state regulations, licensing requirements, and legal entity rules.
His story highlights the critical steps on how to start a nursing registry in California. If you find yourself in a similar situation, keep reading to learn your business entity options and get an overview of the process you’ll have to complete.
What Is a Nursing Registry?
Under California Civil Code §1812.524, a nursing registry is a business that assigns licensed nurses (RNs, LVNs, or practical nurses) to private duty patients under a physician’s supervision.
Here’s the key distinction: the registry acts as a connector—it doesn’t provide direct patient care itself.
Marcus originally thought he could form a limited liability company (LLC) and start placing nurses. But after learning a bit more on how to start a nursing registry in California, he soon learned forming an LLC for this business is not option.
Do You Need to Be a Nurse or Medical Professional to Own a Nursing Registry?
No, you do not have to be a nurse or licensed medical professional to own a nursing registry in California.
However, if you intend to personally provide nursing services through your business, you must form a Professional Corporation (PC) and hold the appropriate nursing license. Owners without medical credentials, like Marcus at the start of his journey, can operate registries through a General Stock Corporation, as long as they follow the compliance rules listed above.
Legal Entity Options in California: The Foundation of Your Nursing Registry Business
When Marcus first approached us about starting his nurse staffing registry, he naturally gravitated toward forming an LLC. But he also wondered whether his business would require a professional corporation instead, given the healthcare nature of his venture.
Does a Nursing Registry Need to be Formed as California Professional Corporation?
California laws have very clear mandates for licensed professionals, like doctors and nurse practitioners, who want to operate under a corporation. The Moscone-Knox Professional Corporation Act states that business entities directly providing professional services must be formed as professional corporations.
Marcus’s situation is quite unique, though. He wanted to start a nursing registry business that will act as a “connector” rather than provide medical services directly. So in this particular situation, a professional corporation wasn’t required.
How To Start a Nursing Registry Business in California: Start With the Best Structure
While LLCs work well for many businesses (especially real estate ventures in California), we generally don’t recommend them for nurse staffing registries. Instead, the optimal structure is a general stock corporation paired with an S corporation tax election.
This combination offers nursing registry owners the best of both worlds:
- Strong liability protection
- Pass-through tax benefits
- Operational flexibility
- Professional credibility when working with healthcare facilities
For most small business owners in the healthcare staffing industry, this structure provides the ideal balance of protection, tax advantages, and growth potential.
Setting Up Your California Nurse Registry: Step-by-Step Guide & Key Requirements
Operating a nurse registry in California requires more than just incorporation. Your business will connect licensed nurses with patients needing private duty care under physician supervision, and these essential compliance requirements ensure legal operation.
1. Local Business Licensing
Obtain a business license from the city or county where your registry operates. Requirements vary by location, so verify specific licensing needs with your local jurisdiction to ensure proper tax and regulatory compliance.
2. Choose and Reserve a Compliant Business Name
State law requires a nurses’ registry to avoid names or advertising that could confuse the public into thinking you are a professional nursing corporation or a licensed home health agency. Using terms that may imply you directly provide medical services can trigger rejection or even compliance issues later.
Here’s the smart, practical move Marcus did and you can consider: reserve your business name with the CA Secretary of State before filing your incorporation papers. This step acts like a “test run” because the SOS will check whether your chosen name is available, distinguishable from other businesses, and not misleading under state rules.
The SOS will hold it for 60 days, giving you time to finalize your incorporation paperwork and ensuring you don’t have to rebrand after the fact.
3. Secure Your $3,000 Surety Bond
Before you can operate legally, you must file a $3,000 surety bond with the California Secretary of State, as required under California Civil Code §1812.525. This bond protects clients from fraud, dishonesty, or failure to provide promised services.
Key bond requirements:
- Minimum 24-month term
- Filed with a $30 fee (original bonds only)
- Must be from a California-authorized surety company
- Required before conducting any business
4. Business Registration and Licensing
Choose your business structure and register with the California Secretary of State if forming a formal entity. You’ll also need to:
- Obtain an Employer Identification Number (EIN) from the IRS.
- File a Fictitious Business Name (DBA) if needed.
5. Ensure Compliant Nurse Contracts and Record-Keeping
As stated in California Civil Code §1812.526, all nurse contracts must include key disclosures such as fee schedules, assignment policies, dispute procedures, and termination rights.
Number contracts consecutively with both parties retaining signed copies. Maintain detailed records of all assignments for one year, including nurse and patient information, services rendered, dates, and fees charged.
6. Fee Transparency and Compliance
Post fee schedules prominently in your registry and keep records for one year. Provide nurses with monthly statements detailing all assignments, earnings, and deductions. Any changes to fee schedules must be posted conspicuously for at least seven days before implementation.
7. Nurse Verification and Documentation
Verify licenses and experience of all nurses before assignments. Document license inspections, expiration dates, and maintain verification records in individual nurse files. This verification process protects both your business and the patients receiving care.
8. Follow Standardized Procedures and Supervision
Ensure that any services involving the practice of medicine (such as injections or wound care) are performed under standardized procedures signed by both a supervising physician and the nurse. This compliance with the Nursing Practice Act is mandatory for medical functions.
9. Patient Disclosure Requirements
Provide written notice to patients clarifying that your business is not a home health agency. It should clearly state that your business is solely a nurses’ registry.
Your disclosure must also include instructions for filing complaints against a licensed nursing personnel, directing them to the local district attorney and the Department of Consumer Affairs with contact details for regulatory authorities.
10. Start Your Nursing Registry Operations
Now that your business is properly bonded, registered, locally licensed, and all internal policies and legal requirements are in place, you can officially begin connecting clients with licensed nurses.
Prohibited Practices to Avoid for Nursing Registries in California
More than just figuring out how to start a nurse registry business in California, maintaining compliance also means avoiding prohibited practices. And for this type of business, state law explicitly forbids:
- Charging nurses registration fees (CA Civil Code §1812.530).
- Dividing fees with physicians, hospitals, or patients (CA Civil Code §1812.531).
- Making false or misleading advertisements with incorrect business contact details and misrepresentation as a home health agency (CA Civil Code §1812.533).
FAQs: How To Start a Nursing Registry Business in California
How much does it cost to start a nursing registry in California?
Specific startup cost may vary based on your chosen business structure, local licensing fees, and insurance. But all registries must file a $3,000 surety bond with the California Secretary of State. So expect to budget several thousand dollars for incorporation, legal compliance, and initial operating costs.
How long does it take to start a nursing registry in California?
The timeline depends on how quickly you complete incorporation, secure your surety bond, and meet compliance requirements. On average, it may take 4–8 weeks from filing paperwork to officially launching operations.
What disclosures are required to patients?
Nursing registries must disclose in writing that they are not a home health agency and provide complaint instructions with contact details of concerned authorities.
What is the difference between a nursing registry and a staffing agency?
A nursing registry specifically connects patients with licensed nurses for private duty care under physician supervision. A staffing agency may place nurses or healthcare workers in hospitals and long-term care facilities, but it is not governed by the same Civil Code requirements as a registry.
Do you need a license to start a nurse registry in California?
No statewide license is required, but you must obtain a local business license and file a $3,000 surety bond with the CA Secretary of State.
Marcus’s Final Lesson: Compliance First, Successful Nursing Registry Will Follow
Marcus learned along the way that figuring out how to start a nursing registry in California isn’t something you can wing. His experience shows that transforming a good idea into a legitimate, thriving business takes more than enthusiasm.
You need a solid plan and a real grasp of California’s specific regulations. Contact Incorporation Attorney today for a consultation, and our team will walk you through building a nursing registry that’s built for long-term success from day one.
Disclaimer: This article provides general legal information and citations to California law. It is not legal advice. For tailored guidance, consult a licensed California attorney.
