Deborah MacDonald couldn't sell her house on Grosse Ile -- so she bought three more.

"You just can't get back the money that you put into these homes anymore," the 43-year-old Grosse Ile resident says.

But instead of cutting the price and taking a loss, MacDonald invested more money in the home. Using money from the nurse staffing business she founded, MacDonald brought the home up to state specs so she could open Serenity Springs, an assisted living facility for the elderly.

"I had always wanted to start a home for the aged," she says. "Since the house wouldn't sell, I just thought, 'Why don't you go and start it now?' "

Since then, she's set up three other homes and is buying a fifth.

"It makes my day to know that they're happy, healthy and safe," MacDonald says. "I don't only make them feel good, they make me feel good."

Where she came from: After earning her associate's degree in nursing in 1982, MacDonald worked in a neural intensive care unit in Philadelphia, then joined the Army as a nurse. She had gone to Germany in high school, when her sister joined the service, and it was a bit of a family tradition.

"That was the way back then how you got out of Detroit," MacDonald says.

Instead of heading back to Germany, MacDonald mostly saw Fort Carson in Colorado Springs, Colo., spending half of the year drilling to handle battlefield injuries.

What changed: MacDonald was in and out of the service for a total of nine years, mustering out as a sergeant first class in 1993.

She headed back to Detroit and worked for a number of nurse staffing agencies, which send nurses to hospitals, nursing homes and other facilities on a temporary basis.

MacDonald had done some of that work on weekends while in the Army, and had thought she would like to run her own staffing firm.

In 1999, she started laying the groundwork for Tri-County Nurses Plus in Trenton.

Eventually, she built the business from billing $50,000 in its first year to $3.8 million now, with a roster of 450 nurses.

Moment of truth: The growth of the business took MacDonald away from hands-on nursing, so once she saw the opportunity that her unsold house presented, she jumped back in. Her vision was to create facilities that could offer more than just basic care for older patients suffering from everything from terminal illnesses to Alzheimer's disease.

Instead of just meeting state minimums for care, she's raised the standard to include offering transportation, providing nursing care around the clock and regular visits from doctors and putting no more than six residents in each home.

"We do the maximum instead of the minimum," MacDonald says. "I want them to feel like they're living rich, but not have to pay the rich price."

Stumbling blocks: Since her new venture required state licenses, dealing with the red tape has been time-consuming, MacDonald says. That's included everything from building access to ramps to installing special doorknobs.

"It's all things that can be handled, but it's tedious," MacDonald says. "Then they give you a six-month temporary license and come back out."

Another effort has been marketing the business. Although her first home filled up right away, thanks to word of mouth, it took longer to establish contacts with doctors and hospitals to get more referrals, MacDonald says.

Another issue has been hiring and training the right staff.

"I am solely responsible for every resident in there," MacDonald says. "When I hire somebody new I probably go back there 10 times a day so I can know everything is OK."

Words of wisdom: One factor in her success, MacDonald says, is that the health care sector is growing. "I'm lucky because health care is always going to be needed," she says.

At the same time, anyone going into this kind of hands-on business is going to be needed a lot. MacDonald doesn't take a lot of time off, and estimates she's had maybe two four-day weekends since the business started. Still, that kind of hard work is the key to success, she says.

"The big thing in starting a small business, what makes the difference is if you just keep up the hard work, it will work," she says. "Eventually, it will work."

And a little luck helps, too.

"I always seem to be in the right place at the right time," MacDonald says. "There are a lot of people who tried to start nursing agencies and failed, but I got lucky."

You can reach Brian O'Connor at (313) 222-2145 or boconnor@detnews.com.