Never depend on one supplier or one compounder — and build the second relationship before you need it, because account setup, licensing checks, and prescriber verification take weeks you won't have mid-crisis.
Know your stocking model — company-stocked, company-supplied, or tech-ordered — and pick it deliberately, because it shapes your costs, your control, and even how regulators view your workers.
Watch the shortage lists — the FDA and ASHP both publish them, free, and the operators who check them restock before the operators who don't.
This is an operations guide — most of it is drawn from running supply for a real IV operation, and it's labeled as experience where it is experience. Where regulation enters (compounding, worker classification), we link the compliance guides rather than re-litigate them here.
The week the truck doesn't come
Every operator learns this lesson eventually; the only question is whether you learn it from a guide or from a refrigerator with three bags left. We've had shipments stall behind weather on the other side of the country — supplies we genuinely needed, sitting in a distribution center because a storm closed roads two states away. If your whole operation flows through one account with one supplier, their bad week is your bad week, at whatever scale their bad week happens to be.
And this industry has already seen the worst-case version. In September 2017, Hurricane Maria knocked out power across Puerto Rico — where Baxter, the country's dominant IV bag producer, ran three manufacturing plants. The result was a nationwide saline shortage that lasted months: hospitals rationed IV fluids, pushed drugs to syringes and pills where they could, and scrambled for empty bags to compound into. The shortage was serious enough that 29 senators and 63 representatives formally pressed the FDA on it in the middle of the deadliest flu season in years, and the FDA resorted to importing saline from Ireland and Australia, fast-tracking new manufacturers, and extending expiration dates on existing stock to stretch supply.
Sit with what that means for a small operator: the hospitals — with group purchasing organizations, allocation priority, and pharmacists on staff — were struggling. A drip business with one distributor account is last in line behind all of them. Bags of saline are boring until the day the entire country wants them at once.
Two free tools come out of that story. The FDA's drug shortage database and the ASHP shortage list both track what's constrained right now, updated continuously. Checking them monthly — or before you build a new menu item around a specific product — costs nothing and moves you to the front of the "saw it coming" line.
Don't marry one supplier. Don't marry one compounder either.
The redundancy rule sounds obvious and almost nobody follows it, because redundancy feels like paying twice for one problem. Here's the part that makes it non-optional in this industry: you cannot spin up a backup supplier during the crisis. These aren't Amazon sellers. A medical distributor or a compounding pharmacy has to verify your licensure, your medical director or prescriber, your state's requirements, and sometimes your resale or facility credentials before the account is live — a process measured in weeks. And when a real shortage hits, you won't be the only operator scrambling to open new accounts: every company that leaned on the same failed supplier is suddenly in the same application queue, and verification teams don't get faster under a flood of paperwork. Late to that line can mean weeks behind operators who never had to stand in it. The same is true, harder, for 503A and 503B compounders, who are themselves licensed state by state. If your compounder has a production problem in June, the account you open in June helps you in July. The account you opened last year helps you in June.
The practical version:
- Two supply accounts, both active. Not one real and one dormant — dormant accounts go stale, contacts leave, terms change. Route a small share of routine orders through the secondary so it stays warm.
- Two compounding relationships if premixed bags are part of your model — and mind that your two compounders don't share the same single point of failure (same region, same wholesale source for the base product).
- Know each one's allocation policy. During shortages, distributors allocate — usually by purchase history. A secondary account with real history gets an allocation; a brand-new account gets an apology.
(If premixed-versus-mix-your-own is an open question in your operation, that's a compounding-compliance decision before it's a supply decision — our hood and compounding guide walks the three lanes.)
The supplier landscape
Operators in this space generally stitch supply together from a few categories — named here as landscape, not endorsement, and every one of them structures accounts, minimums, and licensing requirements differently:
- Broadline medical distributors — McKesson and its peers: the wide-catalog wholesalers for fluids, consumables (catheters, extension sets, gauze, tape), and general medical supply. Account setup runs through licensure verification, and product access can vary by state and account type.
- EMS and field-medicine suppliers — Bound Tree and similar: built for medicine practiced out of a bag and a vehicle, which describes mobile IV better than most retail medical channels do.
- 503A and 503B compounding pharmacies — Olympia, Empower, and the broader compounding world: patient-specific preparations (503A) or batch-produced product under manufacturing controls (503B), including premixed cocktails and the injectables on your menu. These are pharmacy relationships with prescriber requirements, not catalog checkouts.
The homework is the same for all of them: ask what an account requires in your state, what their minimums are, how they handle staff or sub-accounts (next section), and what their shortage-allocation policy looks like. The answers differ more than you'd expect between companies that look interchangeable from the outside.
Stocking your techs: the three models
Once supply arrives, it has to get into the hands of the people hanging bags — and how you do that is a genuine business-model decision, not an afterthought. Three models cover most of the industry:
1. Company-stocked, drawn per visit. The company holds inventory; techs draw what each call needs, and the cost is accounted per-draw — either absorbed into the service economics or deducted from the tech's cut, depending on how your compensation is built. Most control, most visibility, most logistics: someone has to manage the stockroom, the par levels, and the restock runs.
2. Company-supplied at company cost. The company simply keeps its techs stocked — kits go out, techs work, the company eats supply as a line item. Operators in some markets run this way because it's simple and it keeps quality and sourcing fully in the company's hands; whether the economics work depends on your pricing and your market.
3. Techs order their own through your accounts. Some suppliers and compounders support sub-accounts or authorized orderers, letting individual techs order against the company's relationship (and its medical director's authority). This shifts logistics off the company — and it's the model people usually have in mind when they say "they're 1099, have them handle their own supplies."
Who controls supply sourcing is one of the facts regulators look at when weighing whether a worker is genuinely an independent contractor — and that cuts across all three models, not just the last one. Plenty of operators run a company stockroom and company-supplied kits (models 1 and 2) while classifying everyone as 1099 — a combination worth a hard look, because company-controlled supply is the kind of fact that reads as employment. And model 3 gets recommended in operator groups as the 1099 fix — "have them order their own" — but a tech ordering through your accounts under your medical director's authority hasn't become an independent business; they've just clicked the buttons themselves. State rules differ, and both state agencies and the IRS weigh control factors like these. We're not re-arguing classification here — our employee-vs-contractor guide covers it properly — just pick your stocking model and your classification position together, ideally with counsel, because regulators will read them together whether you did or not.
Shipping realities
Three logistics facts that surprise new operators:
- Licensing gates delivery. Some products ship only to verified addresses tied to your licensure — which is the system working as intended, not an obstacle to engineer around.
- Residential delivery varies by supplier and product. Home-based mobile operators run into "we don't ship to residential" more than any other single snag. We've heard of operators using carrier options like hold-for-pickup and UPS Access Points to receive shipments — whether anything like that works for your account, your products, and your carrier is a question for your supplier before you build a workflow on it, not after. The honest answer is that every supplier's policy is different and the only reliable move is asking yours directly.
- Minimums and lead times compound. A supplier with a $500 minimum and a nine-day lead time is a different planning problem than one with no minimum and two days — and during a shortage, everyone's lead times move. Know your numbers per supplier, and let the slower one carry the predictable stock while the faster one covers surprises.
Inventory discipline, the light version
You don't need warehouse software; you need three habits:
- Par levels with expiry awareness. Know the floor quantity per item that triggers a reorder — and for anything dated (premixed bags carry beyond-use dates; plenty of consumables carry expiration dates), rotate stock and size orders so product is used, not discarded. Over-ordering dated product is just shortage with extra steps.
- A weekly count that takes ten minutes. Whoever holds stock counts it on a schedule. Every operator who's been burned by "I thought we had a case left" adopts this habit immediately afterward; adopting it beforehand is cheaper.
- Respect the vehicle. For mobile: supplies live in hot cars, cold cars, and jostled totes. Temperature-sensitive product needs a plan (coolers, per-shift loading, no overnight stock in vehicles in July), and your techs need to know which items that covers. Your supplier and compounder will tell you the storage requirements — the operational discipline of honoring them in a Ford Transit in August is on you.
What to ask your suppliers (and compounders)
The operations twin of our ask-an-attorney lists — bring this to every supply relationship, existing or prospective:
- What does an account require in my state, and how long does setup actually take?
- Do you support staff sub-accounts or authorized orderers under my account and my medical director?
- What are your minimums, your standard lead times to my area, and how do those change during a shortage?
- What's your allocation policy when a product is constrained — and what does my purchase history need to look like to matter in it?
- What are your residential-delivery and hold-for-pickup policies for my product mix?
- For compounders: which states are you licensed to ship into, and what happens to my supply if your facility has a production interruption?
Infuse Pro doesn't manage your inventory — supply lives with your suppliers and your stockroom. What it does is keep the demand side visible: your bookings, your services per location, and your visit volume are the numbers your par levels and reorder timing should be built on. The operators who handle shortages best are the ones who know exactly what next week's calendar needs before the truck does or doesn't come.
The quick version
- Redundancy before the crisis: two supplier accounts and two compounding relationships, all warm — backup accounts can't be created mid-shortage, and when one supplier fails, everyone who relied on them hits the same application queue at once
- The 2017 saline crisis is the proof: one hurricane over one island shorted the entire country's IV fluid supply for months — hospitals rationed; small operators queue behind hospitals
- Watch the FDA and ASHP shortage lists — free, current, and the difference between restocking early and explaining cancellations
- Pick your stocking model deliberately — company-stocked per-draw, company-supplied, or tech-ordered — and pick it alongside your worker-classification position, because supply control is classification evidence under every model; see the classification guide
- Ask, don't assume, on shipping: licensing-gated delivery, residential restrictions, minimums, and allocation policies differ by supplier — the ask-your-supplier list above exists for that conversation
Run an IV operation you can stand behind
Booking, dispatch, HIPAA charting at the point of care, and payment — connected in one platform, so the visit you run is the visit you can document.
See how it works →