Finances for everything and nothing.

I put my life out there so you can learn from me.  Learn some of the great things and some of the not so great things.  I tell you about my desire to extend my family.  Life is not a solid state and singularly focused.  A financial blog will make it that life has one singular focus of just pay off everything and pay nothing toward anything else... sell everything and know that your life is over. That is not my life.  However...

I have in the past week gone to advocate in Washington DC for our amazing profession!  I have been able to see friends from long ago and meet others that are future colleagues.  I have been able to learn about the political arena in DC and those that work behind the scenes with little to no thanks and with little to no monetary support from our colleagues.  I learned that we are fast attempting to put ourselves out of business by not being active in the community, donating to our own cause and having no interest in helping others understand our profession and differences in providers.  

I have in this time received a decent paycheck to apply to our debt.  So I wanted to update you that the highest interest rate credit card has been paid off!  Thats 22.6% interest that is not being paid!  OK, that means 1/3 of the credit cards are paid off.  I still have a significant amount to go and it'll be weeks before I can make such a significant foray against the debt again as I do have the next check helping to pay taxes, insurance, mortgage, and typical bills.  I would have normally waited on paying down the debt so drastically and saved a bit more just in case I miss something or have a large bill come.  I have a 5K savings backup just in-case and am not going down to my last dollar.  I also put away $9K into my sep IRA for last year which promptly lost 10% of it's value ... freaking stocks.  Also, This week I'm expecting a signed 11 month lease for my college rental home in Kansas.   This will bring rental income up to 2200/month positive cash flow and that will go directly into the improvements of the two newest rentals.  I don't count on the cash flow from the rentals but do make sure they will pay for themselves and the improvements in 5 years.  Granted we did have an unexpected water heater replacement at a property ... that is happening today.  I keep funds in a separate account that is ready for the cost of this expense and won't effect my credit bills or otherwise.... so nice knowing it is covered and not a huge stress.  We also re-bid on the home that needs all plumbing, HVAC, Electric etc... we went from a $14000 bid to a $5500 qualified known quantity bid on doing the bulk of the HVAC and plumbing.  $9000 savings.  I may not have extra money in my pocket but it is keeping it from becoming a sinking ship and money pit.  

This is the current financial picture for this month.  I have given myself until the end of August to get significantly ahead on the finances and save as much as possible for our financial health.  Others are very much ahead of me and to them I would have to say ... AWESOME!  Remember to be active, love family and time home, and enjoy the fruits of your labor!  

I said Finance for everything... because you have to decide what your everything is.  Mine is to not forget family time and what we need for living and someday in building our family.  Nothing, because no matter what you do ... on payday the money goes somewhere and there should be next to nothing left.  REALLY, I mean it.  Your money should go into a trust for your estate, retirement accounts that have an attached succession plan, go into childrens' savings accounts, or pay down the bills so you can set up these accounts.  

Money isn't everything.... but having some available sure helps the world go around.  My ankle is causing me some difficulty and I'm reminded of insurances and disability and all the things that go with this.  I don't think the ankle pain rises to that level but I do know that as life changes and I get older insurance for large things like disability, long-term care, and to cover assets will all be important.  We'll continue to cover things like this as we go.  I hope you like the blog and I know it's all over the place... I'm going to see if I can't get it divided out into sections should someone want to see a specific topic... I have so much to learn.

Start getting involved

Today, I’m supposed to see one of my congressmen at MYA.  While I appreciate the attempt to make it easier for a non-political person such as myself to see our representatives I think it’s less likely to see dramatic changes when I’m going with the idea of three bullet points.  Not one has specific actions.  Not one has to do with the key function that opens the door to the full practice and autonomy that full billing rights does.   

I say this quite possibly out of naivety.  My idea is that if we can bill independently at 100% for all of our services then the right to work autonomously would be a natural progression.  

I see the ASA involved in so many layers of government and see our CRNAs in so few places.  Honestly,  the MYA was much more expensive than I expected and less well attended than I expected.  

I went to the Region 2 update and was impressed to hear about our reactivity to each of the bills in each state.  I heard of 1-5 bills presenting legislation in each state that would better AA, ASA or decrease CRNA practice.  IN EACH STATE!!! I didn’t hear that we presented bills, we sat on these committees and task force set-up by.   I heard the AANA did a first ever state leadership retreat to Vegas though.  Several were happy about this.   

I see that the Cultural Assessment is in full swing and I know people cried for this but the membership slid down a few more points this year.  I guess I don’t understand the cultural piece as this is a business and professional organization that should be fighting for CRNAs based not on culture, ideals, or in an unbiased opinion.  I think the political piece is a large part of what should be our organization but we don’t even raise 3 providers income among 50,000 CRNAs in any given year to work with.   

I offered to put a link on the locumCRNA.com page that would say to support the PAC and was told that it was illegal to do so.  I learned something new.   

I don’t know what is in our future but am quite aware that we need to do better as a professional organization and we all need to be more involved than we are.  Billing rights and autonomy of practice will be paramount principles for independent practice and advancing our profession.  As a locum that enjoys nearly all practice environments I think that this focus and becoming more involved in each states organization can only help us.  But, involvement means action, knowledge, and fricking membership for those that aren’t even a member of our professional organization.   

You have seen my financial information and I’m still a member of our AANA, donate to the PAC monthly, and despite my poor political affiliations I am here trying to learn and grow just to maintain or improve our profession in the future.  I am starting to get some of the knowledge beyond just being a provider, or clinical educator in the OR. 

Please take some time to go to the state meetings or national meetings and start getting involved in what we need to do for ourselves.  Consider a contribution to either the AANA which is tax deductible or to the PAC which is not.  Both advance us as a professional organization just in different ways.   

Just my 2 cents.  

Mid Year Assembly

I am admittedly non political by nature.  It’s very different for me here at the mid-year assembly and I sometimes feel an almost uninvited vibe being here.  Maybe it’s not uninvited but almost disingenuous vibe.  That feeling of people meeting people to say they know them but no uniform familiarity.  I have to say I came here on a whim and not as a planned event to where I would meet with certain people or advance specific agendas.  I am excited that I have seen some people that I knew from years ago.   

I’ve seen some of the very active and vocal people in the profession and learned from the sessions despite my critiques.  I think we all have our roles and I’m still wondering where mine will be in the coming years.  Totally worth trying new things though.   

I feel like I’m trying to grow but I’m still at the kids table.   I look forward to my meetings over the next few days and will totally share with you some pictures of our trip in DC.  It’s a great time to be out and about and I know Francisco and Elizabeth are getting plenty of pictures while here :).

Sunday Day off or Work Day?

It is Sunday, today.  What is your philosophy for Sundays?  Work day or day off?  If you are a locum you could consider it as either.  Even if you are not physically in the hospital.  I am one that is always learning.  It doesn't much matter on the topic but it is important to have down time.  I can honestly say that there are not to many days that go by that I haven't learned something.  Here is my weekend in a nutshell....

This weekend isn't much of an exception to the learning thing.  I try to have each day be a learning thing by reading or listening to podcasts or watching YouTube videos.  I try to share what I learn through different outlets such as this site, my family, Facebook, or other.  I try to share my experience when people message me or call.  

Yesterday, I had someone ask me about setting up a fee structure for a small hospital locum contract that just kicked the group out and the hospital still needed the CRNA to come up for a scheduled time.  I worked about an hour on my presentation for Education Adventures in Costa Rica coming in June.  It's still not where I want it.... but it's coming along.  I learned about backyard gardens for about 2 hours and am going to take people up on the learning they offered!  I listened to three podcasts. I lost $100 at the casino this was a major reminder not waste money and time at casinos.  I discussed two rental home projects that are in process, and the financials. I went for a haircut which was major down time and depressing to see how many were in-line... I think I should own the hair salon but that is a different investment I don't have money or time for.  Elizabeth (my daughter for all unfamilliar) went to the doctor yesterday for a sick visit and needed a nebulizer treatment for what sounds like a chest cold.  I spoke with two agencies about how I can work with them in presenting jobs on-line they might have, being a liaison of sorts for when questions or comments are shared, and discussed some options for feedback that are anonymous and not discussing specifics but will keep them aware of negative (negative are not shared immediately and specific details are not shared) or positive feedback on great recruiters or pay.  I think this is a way that can improve the interaction especially when they know a large forum discusses pay, agencies, independent contracts, hospitals, and the process of being a locum.  I seriously think it scares some. That was my Saturday.  

Today, I will again go to the gym (like I did yesterday) and hope not to see a kid eat treadmill. I have three hours driving that will be broken up by conversations with a small Anesthesia Management Group that is CRNA run.  They are looking for hospitals, surgery centers, endo suites or other to add to their portfolio.  I think we will have a great conversation.  I'll visit some family and see a sheep farm which will be a nice change of pace.  Then it's the drive home and some podcasts.  I'll continue to read two books that I'm in the middle of and prepare for my 60+ hour week coming up.  I'd like to say that I'll be on top of it and plan my garden but I'm not sure that I'll get that far today but I think after returning home I'll be building the garden and getting it ready for planting.  It snowed here last night so I don't think I'm behind yet :).  OK... just my laid back weekend.  I hope yours was awesome.  I know I loved mine :)

Is it difficult to set-up a sep-IRA?

I have been a CRNA for quite some time, as you might be aware.  I have tended to keep my earnings and retirement away from the stock market.  As many would chastise me for not taking advantage of tax sheltering, and even I wish I were a better saver.  

I have always invested in real estate.  For a while it was my own home.  Then it was the start of rental property in Kansas.  I am still invested in Kansas and started on my current home in Virginia.  

I have avoided the stock market though.  I have used an E-Trade account as if it were a casino.  I haven’t been an investor but a speculator.  I have invested over the years in the military Thrift Savings Plan ... 1% for 9 years... you know how little that is.  I forget to take time to learn about those things.  I know I need to shelter my taxable income so I am actually doing this.  

I went for weeks totge website for Vanguard but then they said they couldn’t verify me.  Then I had to fax things for the Solo 401K but... I missed 2017.  So, I decided I would do a simple Sep-IRA if I could.   

I was checking my E*TRADE to make sure my Roth IRA transaction went through and then I had an epiphany.  Why not try to set up just an IRA.  I saw the set-up a retirement account button and so I clicked on it.  Bam, Sep-IRA option right there.  Two minutes later i had $6k coming out of my account to fund a Sep-IRA for 2017.  I have until my taxes are filed toget those dollars cought up. I would prefer a Solo-401k but I didn’t get it set-up in 2017 which means no $$$ can beplaced in it for 2017.  So, i now have a sep and I’m working on saving a tax bracket or two by saving more pre-tax dollars toward retirement as my rentals are post tax.

Is it possible to invest in retirement with real estate?  Yes, but have I done this... no.   

Every year, I will try to be more active in my tax planning and save betterfor my family and child or children (someday).   

Taxes and Investing

Many times our default is to say I don't know anything about taking care of the taxes or the accounting.  Maybe it's time we take on the task of learning as we continue in the understanding of the business of anesthesia.  

I'm not that smart and I don't know either investing or tax code.  But, I am taking control of the time to learn about these things.  I'm investing in my own understanding so that I can utilize the Locum world and combine it in order to provide for the family without providing more than my share to uncle sam, provide educational opportunities to my family, and increase my available time home.  I have to save the taxes in order to fund the financial/investing side.  I currently invest in real estate but hope to someday expand on that into the business, real estate, and stock markets as I learn.  

What are you doing?  I ask this not to sound like I'm doing much but just to be real.  I take the time to learn in each aspect by reading the business books, listening to podcasts, and continuing to ask questions.  

Recommended learning... Consider listening to the Bigger Pockets Podcast on Real Estate.  They have two Tax episodes by Amanda Han... so I would listen to those.  The application is to the 1099 type of income however passive income is different than active... so be careful on the full application.  Business books that I like include things like 4 hour work week (not for the 4 hour part but understanding how to maximize your time), Rise and Grind (the effects of early work and long term benfits), and Motivational books that will inspire increased relationship building.  

That's all I have for today.  

How can I help?

I think some are confused at this point.  I think some of you truly think I'm a recruiter for BlocHealth or National Anesthesia or some other company.  Some think that I'm some fancy dude that is just rolling in bank.  I hate to tell you that this is just so far from the truth.  

I'm a CRNA.  I've been a CRNA since December, 2009.  I have made my way through the locums world since 2011 and have been relatively happy.  I share my experiences and what I've learned along the way.  Yes, I've learned the hard way because honestly half the most out-spoken people just don't know everything and if they say they do... ask yourself if you know everything after being a XYZ of 10-20-30 years.... I'm betting the answer is no.  I prefer to state that I'm no lawyer or accountant but this is my experience, as it's the truth.  I'm not a financial expert or licensed as such so to give counsel... I can't do that.  I can tell you the things I have done or the people I have talked to.  

I can tell you what has and hasn't worked for me.  That's what this site is about, educating you so you don't make the same mistakes I have or collectively understanding where we are and where we go from here.  Giving you options and helping you to be able to figure out decent people to work with.  I can't tell you they are all perfect because part of the information is gathered from our peers to make this a more wholistic site.  I'm trying to give you all the information and not just one perspective.  

So, I'm not a recruiter because I don't call hospitals and get contracts for work.  I don't place CRNAs with hospitals or groups. I ask people to say that I referred them to all the agencies (when this site is instrumental in doing so) when they are going to go the agency route as the referral helps me make this site stronger for you and helps support the number of hours put into this resource. 

How many have looked at the other links at the bottom of the main page?  Anyone see the Store, Financial information that has Accountants and Financial advisers, Mortgage information, and maybe even the Where we go page that has the article by one of our own on RV'ing it across the country?  Take a moment to see all there is to offer.  Jobs come and go from the job board too.  

Any time I discuss with someone I try to make sure I ask.. How can I make this better?  What would help you more?  So, I'll leave you with my E-mail LocumCRNAs@gmail.com  

I did get a request from an undergrad resource wanting to place links to anesthesia schools and feel that first one has to be done with school and should get their practice down before considering locums... so unfortunately, I declined that request.  I'm trying to keep this a clean but solid resource.  so... How can I help?

Cleaning out the office

It has to be done right.  Organization, files, and keeping the house in order.  Just like updating your credentialing, reviewing your licenses to see which ones are coming up for renewal and ensuring the CEUs are all up to date, and finally ensuring the CV has your affiliations, contacts, npi, coi, etc etc etc  all up to date. 

Not an easy task as I continued on the road for a while and returned home to stacks of paperwork.  Yes, my office is a general mess at any given time.  I start to file and realize I don't have files for everything.  I then write out a list for the store so I can get the files and then something happens.  Then Francisco comes in and says hmm... I'll make it neat and clean in here and all my papers are neatly stacked in the same mix of OMG stuff that never was sorted or filed away.  

Long story short... get the files in order.  Just like all those credentialing items you need to have in a file ready to go at a moments notice.  Just like the CV being up to date.  Your office needs to be organized enough that you can tell your partner, child, mom or dad, or maybe even a neighbor... whomever is there to go look for that one thing you need while you are on the road. 

There will be something that is missing, unless you moved your whole life into an RV and sold every possession (ie no storage or other).  Someone will have to look for something you need at some point.  We've all been there.  

This is my week.  I'm off.  I only have a few Pampered Chef things.  I only have an application for school to do.  Francisco flies out for the weekend and mom flies in for the weekend.  This will get done.  I'm excited to get going.  I ordered additional files from Amazon so I wouldn't get sidetracked.  I'm ready for an exciting office day.  

This is also time to review insurance, investments, IRAs, Accounting documents, and those business pieces that keep you going even when your working.

Education

I should have thought of that!  I should have known that but no one taught me! Whaaaa!

What are you doing to educate yourself?  What are you educating yourself on?  you notice it’s not about anyone else but you. It can be aslittle as a $20 audiobook.  You can do some college course. You can start calling your resources.  Call your accountant and ask questions as to what you can do to save on your taxes.  Call your financial person and ask what tax saving instruments can help you.  Have you taken care of your house first?   Are you continually educating yourself?  Listen to your growth and development books, podcast, and be on top of the news or what’s happening around our profession.  

Don’t tell me you never go to your state or national meetings and you can’t find any groups that are autonomous.  Don’t tell me you don’t understand business or negotiation  but never tried to learn.  Take on the task of learning... if you are broke, go to the library or sit at barnes and noble.  

Basically, it comes down to us continually improving our experience,business, communication, & finally staying current in our anesthesia practice. You don’t have to spend hundreds... Just start by taking in your resources and available information.  One point of view doesn’t mean you’re educated. So please, take in multiple points of view. Take on the importance of growing your person. 

Have an amazing day! 

How to Save for Retirement as a Freelancer

By Jeremy L. Stanley, CFP®, AIF®

According to a 2009 study, around 14% of CRNAs worked as freelancers or independent contractors. However, there’s no doubt that number has increased in the last few years as freelancing across numerous industries is on the rise. In fact, according to UpWork, 55 million Americans work as freelancers.

If you’re currently freelancing as a CRNA or would like to make the transition, you likely know of the perks: flexible hours, an independent schedule, the opportunity to travel, and more. However, with the upsides come a few downsides—namely, a lack of access to a company-sponsored retirement account. Luckily, this doesn’t mean you can’t strategically save for retirement. Here are a few ways you can get started.

Break Down Your Paycheck into “Now” and “Later” Accounts

A common mistake freelancers make is neglecting to maintain a sufficient cash flow. Divvy up every paycheck into a few different accounts. For example, you may devote 40% to current expenses, 20% to an emergency fund, 25% to retirement savings (and don’t forget to reserve 15% for taxes).

Choose Retirement Accounts That Make Sense for You

Next, you’ll want to decide where you’ll devote that 25% to retirement savings. Let’s look at a few options freelancers have.

Solo 401(k) or Uni-K

If you’ve established a business, you can open a solo 401(k) or uni(k) plan, which acts like a traditional employer sponsored 401(k). As of 2017, you can save up to $18,000 per year as an employee (or $24,000 if you’re over the age of 50). Your employer, can also contribute up to 25% of your salary on your behalf (up to a total combined contribution of $54,000 or $60,000 if over age 50).

A 401(k) is a great option for CRNAs because, as high income earners, using pre-tax dollars for retirement can put you in a greater position to build and keep more of your wealth. Some 401(k) plans also offer a Roth 401(k) provision. The main difference is that you fund a Roth 401(k) with after-tax dollars instead of pre-tax dollars. One of the biggest benefits of a Roth 401(k) is that you can contribute to a retirement account that provides future qualified tax-free withdrawals regardless of your adjusted gross income. As there aren’t income limitations on Roth 401(k) contributions, they may provide a good option for high income earners like CRNAs who may not qualify for a Roth IRA but would like to generate a tax-free retirement income.

IRAs

Individual retirement plans are another option for freelance CRNAs to use along with their 401(k). Three popular options are the Traditional, Roth, and SEP IRA.

Traditional IRA

A Traditional IRA is similar to a 401(k) in that you can contribute pre-tax dollars to an investment account that grows tax-deferred. For 2017, you can contribute up to $5,500 annually, or if you’re over age 50, a total of $6,500. However, if you’re married and filing jointly with a combined income of $196,000 or higher, you won’t be eligible for a Traditional IRA.

Roth IRA

With a Roth IRA, your contributions are not tax-deductible, like Traditional IRAs and 401(k)s. However, your earnings grow tax-deferred and your qualified withdrawals are tax-exempt (subject to IRS guidelines). Like a Traditional IRA, you can contribute up to $5,500 annually, or if you’re over age 50, a total of $6,500. However, like a Traditional IRA, there are income restrictions for Roth contributions, and many CRNAs won’t be eligible, but if you’re new in your career, you may be able take advantage of a Roth IRA.

If your income surpasses the cutoff amount for a Roth IRA, you may have another option; a backdoor Roth. Consult your Financial Advisor to see if you qualify to contribute to a backdoor Roth.

SEP IRA

A SEP IRA, also known as a Simplified Employee Pension, is a pre-tax IRA similar to a Traditional IRA. As an employer (of yourself), you can make contributions on your own behalf for your retirement. You can set up a SEP IRA and can contribute up to 25% of your self-employment income or $54,000 per year (whichever is the lesser amount). A SEP IRA may be a good option for freelance CRNAs who have a retirement plan they’re already maxing out at work, as this gives them another opportunity to save more for retirement.

Save Aggressively Where and When You Can

Any financial advisor will tell you how important it is to start saving as early you can and as aggressively you can. Channel any bonuses or raises directly to savings. Automate your savings increases of 1% every month or so.

A Few Other Options

There are a few other ways you can maximize your savings for retirement. For one, consider investing for growth, as opposed to what you think you should be investing based on your age. You may want to retire in 10 years, but you don’t need to set a 10-year horizon for your investments because you’ll only need a small portion of your nest egg in the early years. The rest of your money may stay invested for another 20 to 40 years. Invest with an appropriate perspective so you don’t end up cheating yourself out of years (or even decades) of growth.

Additionally, you may consider giving yourself more time to save by pushing out your retirement date. Every additional year that you work is one less year that you will be depending on savings and draining your nest egg.

And lastly, don’t forget to take advantage of tax deductions that are available for the self-employed. Knowing what write-offs you can claim may help you save more on your taxes, which you can then funnel into your retirement savings.

Next Steps to Take

There are a number of options for boosting your retirement savings as a freelance CRNA, but the rules and specifics of each option can be complex and overwhelming. If you encounter questions as you investigate some of these retirement savings options, don’t hesitate to reach out to us. We’d be happy to help you review your options or offer guidance. You can call our office at 855.304.3748 or email inquiry@crnafinancialplanning.com.

About Jeremy Stanley

Jeremy Stanley is the founder of CRNA Financial Planning® as well as CRNA Tax Associates®. He has been providing advice and guidance for Certified Registered Nurse Anesthetists (CRNAs) for over two decades. As a CERTIFIED FINANCIAL PLANNER™, Jeremy has met rigorous certification and professional standards set by the CFP® Board. He is committed to adhering to the principles of integrity, objectivity, competence, fairness, confidentiality, professionalism and diligence when dealing with clients.

Jeremy is also the author of The Wealthy CRNA and A CRNA’s Life After Anesthesia. The Wealthy CRNA features insights into becoming a financially successful CRNA and how to start planning for your financial future, and has been prior approved for up to 4 Class A CE credits by the AANA. A CRNA’s Life After Anesthesia serves as your financial roadmap for a smooth emergence into retirement. It reviews recent changes in the CRNA industry along with the new rules of retirement and the final steps of legacy planning. This book has been prior approved by the AANA for up to 2 Class A CE credits.

The opinions voiced in this material are for general information only and are not intended to provide specific advice or recommendations for any individual. All performance referenced is historical and is no guarantee of future results. All indices are unmanaged and may not be invested into directly.

The Roth IRA offers tax deferral on any earnings in the account. Withdrawals from the account may be tax free, as long as they are considered qualified. Limitations and restrictions may apply. Withdrawals prior to age 59 ½ or prior to the account being opened for 5 years, whichever is later, may result in a 10% IRS penalty tax. Future tax laws can change at any time and may impact the benefits of Roth IRAs. Their tax treatment may change.