Starting as a self-employed home care professional

There is a lot involved in being self-employed. By following this step-by-step guide, you will be on the right track and know what laws and regulations apply to you. Are you considering working with an intermediary agency? Then read more about choosing an intermediary.

When registering self-employed healthcare professionals, confusion sometimes arises about the different types of healthcare professions and the tasks and steps involved. This step-by-step guide is for self-employed professionals in home care in the 'helpende' or 'helpende plus' category. You take care of and support elderly people, people who are sick and/or handicapped. You provide your services in the client's home. That may also be an institution or care home. You perform household work and help with showering, putting on support stockings, and feeding. You also administer medication and eyedrops. 

Step-by-step plan home care zzp'er

Make a business plan in advance so that you can make your plans concrete. Answer at least the following questions: who are you, why do you want to become an entrepreneur, and what qualities do you have to succeed? Also describe your offer and target audience: what care do you provide to whom?

1.  Check your working relationship

Do you have private clients or do you work via a (home) care institution, intermediary agency, or another professional contractor? Your client and you are both responsible for choosing the right working relationship. Make sure you avoid false self-employment and comply with the DBA Act (Employment Relationships Deregulation Act). 

2. Make a financial plan

Make a financial plan to determine whether you can earn enough to live on as a self-employed professional without staff. Determine your hourly rate. Are you paid from a personal budget (PGB)? If so, check with the municipality or insurance company about the care rates for PGB holders. If your rate is much higher, your client will have to pay part of it themselves. You may miss out on orders. Are you paid from a PGB or do you provide Wlz care? Then you will be paid for a maximum of 40 hours per week. Also check under which law the care you provide is paid for. Ask your (future) client or their contact person about this. You may be paid under the Youth Act or the Social Support Act (Wmo).

3. Register at KVK

Register with KVK as an entrepreneur. This will give you an SBI code corresponding to the work you do. For home care, the SBI code is: 88101.

4. Apply for eHerkenning (eRecognition)

You need eHerkenning for your registration with the Healthcare Provider Portal. You can apply here. Please note that this costs money. The amount of the costs differs per type of login and per reliability level. You will receive the eHerkenning within a day to a few days. If you only provide care under the Wmo, you may skip this step.

5. Log in to the Zorgaanbiedersportaal

Register with the Zorgaanbiedersportaal  (Healthcare Provider Portal) as a new healthcare provider so that you are known to the Healthcare and Youth Inspectorate (IGJ). This is mandatory under the Care Providers (Accession) Act (Wtza). Log in to the Zorgaanbiedersportaal (in Dutch) and complete the questionnaire. After submitting your questionnaire, your registration is complete. If you only provide care under the Wmo, skip this step.

6. Comply with the Wkkgz

Make sure you comply with the requirements of the Care Quality, Complaints and Disputes Act (Wkkgz, in Dutch). This means you have to meet certain conditions, such as becoming a member of a trade association, appointing a complaints officer, and setting up a disputes committee. If you only provide care under the Wmo or Youth Act, you do not have to comply with the Wkkgz. But you do have to meet the requirements of the municipality where you provide care. Check with that municipality what these requirements are.

7. Apply for your certificate of good conduct

Apply for a Certificate of Good Conduct (VOG) so you can show it to your clients. In the previous step, you joined a sector organisation, check whether they apply for and reimburse a VOG for you. If not, apply for the certificate yourself here. A certificate of good conduct costs money. Within one to four weeks you will have the certificate.

8. Apply for a quality mark

Apply for a quality mark. This is not required by law, but clients, care offices or the municipality may ask for it. A quality mark is a proof of quality. It shows that you are a professional entrepreneur. And that you work according to the requirements and rules of your profession. Good to know: it costs money to apply for a quality mark. You will receive it within a few weeks. There are two quality marks to choose from:

• KIWA (in Dutch) is a quality mark for self-employed workers in (home) care. The inspection is done by uploading documents and is valid for one year.
• HKZ (in Dutch) stands for Harmonisation Quality Assessment in the Healthcare Sector. The inspection is via an interview and is more extensive than for the KIWA seal of approval. It is also more expensive and valid for longer: 3 years.

9. Apply for an AGB code

Apply for a Algemene Gegevensbeheercode (General Data Management Code, AGB code) so that you can declare the care you provide. You can apply for the AGB code from Vektis (in Dutch). Applying takes about 20 minutes and you will receive the code within 5 working days. Has something changed in your situation or your activities? This may affect the validity of your AGB code. This is because your KVK and Vektis registrations are linked. So check regularly whether both are still in line with your actual situation.

10. Check: do you provide compulsory or involuntary care?

Do you provide compulsory or involuntary care? That means giving your patient care against their will to prevent harmful situations. For the patient himself or for others. Follow the step-by-step guide (in Dutch) of the Care and Coercion Act (Wzd) and register with the location register (in Dutch).

11. Think about your client files

Think about how you want to keep clien t records. You need to keep records of each client's health and counselling. What data should be in the file varies according to treatment and medical profession. Clients should be able to view and manage their records digitally and free of charge.

12. Check whether you are registered for VAT

Check whether you have to file a VAT return. Two weeks after your registration at the Chamber of Commerce, you will receive a letter from the Netherlands Tax Administration. This will state whether you have to submit a quarterly VAT return or whether you are exempt from VAT. It is your responsibility to check whether this is correct. Call the Netherlands Tax Administration if in doubt. Check here which healthcare services are exempt from VAT (in Dutch).
 For example:

• If you provide care through an intermediary agency, you may be registered for VAT. And so you have to charge VAT to your client and submit VAT returns.
• As a self-employed person without an intermediary agency, most of the services you provide are exempt from VAT. You do not then have to file a VAT return.

13. Engage in marketing

Find clients or principals. Making a marketing plan can help. For example, you can find private individuals and care institutions through your own network and through online platforms where supply and demand come together. Or use an intermediary agency if you find it difficult to recruit clients.

14. Arrange general issues for starters

As an entrepreneur, also arrange your general terms and conditions and insurance. This prevents hassle and reduces entrepreneurial risks. It is also a legal requirement to keep your business records. Read more about administration and bookkeeping here.