A Noblesville family took on the U.S. nursing shortage in 1999 armed with only $30,000 and a home computer and wound up creating a multimillion-dollar business.
The nursing shortage still lingers, but the family's company, Innovative Placements Inc., takes in more than $8 million in annual revenue by filling employment gaps with traveling nurses.
Twin sisters Retha Clark and Letha Engelman, and Letha's husband, John, place more than 100 nurses in 39 states. They want to add 50 more nurses this year and have 11 employees working at headquarters in a Noblesville office park.
The company recruits nurses and places them, typically for short periods like 13 weeks, in hospitals that have temporary needs, such as those just opening.
The company finds housing for the nurses; pays salary, benefits and Worker's Compensation insurance; and makes sure the nurses meet the qualifications for the hospital that needs them.
In return, Innovative receives roughly $30,000 for each placement. The company pays its nurses anywhere from $28 to $45 an hour, depending on variables like hospital location.
Clark and the Engelmans jumped into this logistical maze with no experience to guide them. John, who worked in medical sales, came up with the idea after hearing nurses complain about pay and recruiter problems.
"It's almost like the nurse was being left behind," he said.
Letha and Retha, who grew up on a farm, always wanted to own their own business, and they decided this was their chance. They started with an ad in the back of a trade journal, a computer in Letha's bedroom, and $30,000 from a silent investor.
Nurses responded to their ad, and the fledgling business owners cold-called hospitals in the areas those nurses wanted to work.
"You have to make the hospital believe you have nurses and the nurses believe you have hospitals when you have neither," Letha said.
It took two weeks to land the first nurse, a surgical technician they placed in West Virginia. Then they had to find temporary housing and furniture for the nurse.
Eventually, they made enough for John to quit his day job and Innovative Placements moved from Letha's bedroom to an office above a garage. Then they graduated to the office-park scene.
Innovative Placements brought in $767,063 in 2000. The company then notched more than $3 million the next year. In 2004, it rang up $8,172,194, according to Clark.
Such growth puts the firm in rare company, according to Greg Woods. The Key Bank business banking vice president has about 50 clients, including Innovative Placements, and less than 10 percent of those companies grow at that rate.
The company prospers as a small fish in a crowded pond. A few years ago, the National Association of Traveling Nurses estimated there were about 255,000 travelers working throughout the United States.
Large companies, like Kansas-based Favorite Nurses, pull in more than $200 million in annual revenue, according to Modern Healthcare magazine.
The key to survival, according to John Engelman, is customer service. His company also tries to keep its nurse-torecruiter ratio lower than that of the bigger players. Innovative Placements pushes to make sure the necessary paperwork arrives at a hospital on time and in order.
How far this growth takes the company remains to be seen. The native Hoosiers have no plans to go public or leave Indiana, even though they do business with only one hospital in the state.
"We just enjoy owning it for ourselves, just for the freedom," Clark said.
The company will have plenty of vacancies to fill. The U.S. Department of Health and Human Services projects a shortage of nearly 150,000 nurses this year.
From left, Retha Clark, John Engelman and wife Letha Engelman operate Innovative Placements Inc., which places nurses in health care facilities in 39 states.