Renerian....you are cracking me up this morning!
I am probably not the greatest person to ask for help with this, but I need you to answer a few questions.
For the Medicaid case manager, is this for skilled or un-skilled nursing?? In other words are you a PCA Supervisor? If so, please see the long response I gave someone in home health. I wouldn't be so thrilled with that b/c the call-outs can be a nightmare.
However, in NJ, we have Medicaid case-workers, who are usually MSW's but can be a nurse, who arrange the transportation, arrange for home care to start, arrange for the PCA but not be the direct supervisor. Much different role. So, I am not exactly sure what your role is as a Medicaid case manager in this instance.
I will say that the work from home sounds great! They wil buy your phone line and internet, even better, get them to get you a cell phone and a fax too!
Deducting expenses? I don't see a problem with that, more deductions for you, but a long time in coming. If they reimburse expenses, you get reimbursed monthly, so insist on monthly reimbursement, esp if the pay sucks.
If I were you? I would try the Medicaid job. That job would be harder to come by again, whereas, the nursing home will probably always have a vacancy. Write the nursing home a lovely thank you note, saying how difficult of a choice it was for you, thank them for thier time and consideration, but you had to go with the other offer for "personal reasons." Be sure to say that you would hope to be considered in the future if your personal situation should change. Don't make them feel like their offer wasn't as good, but make it seem like the other one fit your life better, that way if you hate the Mediciad job, you can go in and say, I should have gone with this position, and I hope you will give me another chance.
But, frankly, if you want to leave your job at the door every day, the nursing home is probably the better one to take, plus, better pay, less hours. But, what about the working conditions? On-call? OT?
Good luck with your decision. It is a tough call.