Starting a nursing agency business requires detailed knowledge of nursing. Decide on the kind of services the agency will offer--whether they will be medical, nonmedical or both--and whether the agency will recruit its own service providers or outsource to recruitment companies. Because of the training and certification required for nursing, universities and medical training institutions offer the best source for nurses. You must develop and maintain a database as well as a working relationship with clients to successfully manage a nursing agency business.

Register the agency. A nursing agency is a business that offers health-care services and therefore should be registered with the Maryland Department of Taxation and Assessments. You will be required to state the type and structure of the business and a certificate will be issued for a private enterprise.

Apply for a license to run the agency from the Maryland state Office of Healthcare Quality and the Department of Health and Mental Hygiene. These will require that the premises to be established meet location and hygiene requirements.

Get a bonding and malpractice insurance license from an insurance company that has health sector packages. This will ensure a smooth practice and will prepare for emergency situations as well as accidents arising, which may require settlements and monetary compensation.

Design contracts for the nurses to be enlisted with the help of a practicing attorney. The contracts should include the conditions of work, pay, benefits, insurance and other requirements on the part of the nurses enlisted. The nurses, for instance, must obtain working licenses from the Maryland Board of Nursing before they can practice within the state.

Set up an office. This is where the coordination, clerical and management duties will be preformed. The premises should comply with local authority guidelines.

Purchase office equipment. Acquire furniture and furnishings according to space and personnel requirements. Purchase equipment like telephones, faxes, computers, printers and copiers that will be used within the office premises.

Prepare job applications for the nurses to be recruited. These should capture the locations for possible employment, educational requirements, terms of engagement and schedules for contract renewal whenever they are applicable.

Advertise in the local community, health institutions and on the Internet. The official Yellow Pages, the local media and direct mail are good places to begin. The kind of marketing you carry out will be determined by your marketing budget. Direct mail is an affordable option while newspaper and TV advertising will mean more expenses.

Recruit nurses. You can engage a consultancy firm that deals with medical personnel or associate recruiters to find, vet and recruit candidates on your behalf. Another option is to place advertisements in the media and carry out interviews. Nurses can then be registered on a full-time residential basis or as part-time caretakers depending on the clientele and budgetary provisions. Universities are a prime choice for graduates eager to get experience and serve the community.