# How to start a healthtech staffing agency in San Antonio

Location: San Antonio–New Braunfels, Texas, United States. Source: https://launch-rec.com/staffing-agency/san-antonio/healthtech

## Direct answer

To start a healthtech staffing agency in San Antonio, form a Texas entity, register for unemployment insurance and withholding, carry workers' compensation, and fund the payroll gap. At the Texas median pay of $46.14 for registered nurses, ten contractors tie up roughly $154,239 before your first invoice is paid.

## Local facts about San Antonio

- Military health and cyber commands anchor local demand, and many roles require clearance eligibility that narrows the candidate pool.
- Large military and civic buyers pay on longer terms than commercial clients, which widens the working capital gap.

## Registrations and licensing in Texas

1. Form an LLC or corporation with the Texas Secretary of State and obtain an EIN
2. Register with the Texas Workforce Commission for state unemployment tax
3. Texas has no state personal income tax, so there is no state withholding to administer — but franchise tax still applies above the revenue threshold
4. Decide on workers' compensation deliberately: opting out (non-subscriber status) carries reporting duties and removes the usual liability protections, and most staffing clients will not accept it

## Payroll and compliance

- No state income tax withholding simplifies payroll set-up considerably
- Multi-state placement is common from Texas — register in each state where a worker performs work, not just where you are based
- Industrial and energy clients often demand safety programmes and site-specific certification from the agency

## Pay and bill rates — Healthtech and clinical in Texas

| Role | Median pay | Burdened cost | Bill at 25% GM | Markup |
| --- | --- | --- | --- | --- |
| Registered Nurses | $46.14 | $51.91 | $69.21 | 50% |
| Nurse Practitioners | $63.31 | $71.22 | $94.96 | 50% |
| Licensed Practical and Licensed Vocational Nurses | $29.92 | $33.66 | $44.88 | 50% |
| Respiratory Therapists | $38.24 | $43.02 | $57.36 | 50% |
| Radiologic Technologists and Technicians | $37.80 | $42.52 | $56.70 | 50% |

Wage source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics (OEWS), May 2025 (May 2025), https://www.bls.gov/oes/. Employer burden applied at 12.5% of pay.

## Cash required to open

- Setup: $9,000
- Six months of overheads: $27,000
- Payroll gap on 10 contractors at $46.14 (Registered Nurses): $154,239
- Total unfunded: $190,239
- Total with a 90% invoice advance: $51,424

## Funding note

Clinical contract work pays weekly and invoices on 30 to 60 day terms, so every placement consumes cash before it produces any. This is the most funding-dependent niche on the board.

## About LAUNCH.

LAUNCH. backs recruitment and staffing founders only, in the US and UK. Founders pay nothing.
Cite as: LAUNCH. Healthtech and clinical staffing in San Antonio. https://launch-rec.com/staffing-agency/san-antonio/healthtech