Sorry if there is a thread on this topic already.
I briefly searched and didn't find one.
I'm a recent graduate, freshly licensed LPN living in Miami, FL.
I've been working home health for the past couple months and it's been very much so extremely beyond belief frustrating to the point of having a complete meltdown.
Apparently, Miami-Dade is the U.S. capital for Medicare fraud. No argument there. The number of shut down home health agencies can surely attest to this fact. But for us LPN's and RN's out in the field, doing our jobs, it feels like a nightmare.
Job security: None. Any agency is apparently able to be shutdown at the drop of a dime upon suspicion of fraud. In and of itself this is fine. Unfortunately, agencies here payout 1-2 months after the work you've done in the pay period. And if the agency you work for shuts down. Whatever work you've done up to date that you had not been paid for... ends up being charity work. The agencies claim their assets/funds get frozen and they cannot pay you for what ends up being 1-2 months worth of patient visits. Furthermore, you're expected to keep providing care to the patients until they've been reassigned to another caregiver. This does not feel right. Is it legal for us not to get paid for services already provided? Are we really liable for not continuing to provide care after the fact? I've searched and found no answers on the topic.
Wages: slashed in half. I get paid per skilled nursing visit as much as a Home Health Aid or CNA gets paid per visit. I've been told this is on account of Medicare's new rule/payout system on a per patient basis. My understanding was that this new rule/law has the purpose of eliminating fraud and effectively lowering the cost of home health to Medicare and is to go into effect as of January 2010. I've had my wage reduced by 50% since mid-November. The agencies I work for state Medicare did not pay out in full for my patients and therefore they cannot pay me anymore. Is THIS legit? I hear of other peers working for agencies that still pay the normal LPN-per-visit amount, or a bit less, but for the most part half. Did Medicare adjust their payout since November? Was the law not supposed to take effect until January? How can I find out? Can this be reported? At the same time, agency owners are always apt to remind you that if you're not happy with it you can leave. No doubt, there are so many LPN's in Miami right now ready to take your job, we've all become utterly replaceable at the drop of a hat. You can't corner your agency into showing you the monthly/quarterly statement from patient A because they will literally get rid of you right then and there. Extremely frustrating.
Where can I find this medicare ruling? How can I become informed of the actual changes? All you hear are rumors. Every agency sings you a different tune as to what Medicare pays out, when the change took effect/will take effect, why they can't pay you more per visit... UGH.
I try looking for a job. Most hospitals now do not hire LPN's. And the ones that do... good luck. With so many LPN's in Miami-Dade it's all up to who you know to get a job (most of the time).
Hospice won't hire me because I don't have 1 yr experience with my license.
Nursing homes are booked. On-call shifts but not much else for recent grads.
Home health agencies are closing left and right. Wages cut in half. No answers. Lots of questions. No clear and distinct higher authority to inquire with.
Anybody else going through the same?
Anyone can point me in the right direction with any of my questions? In any direction?
It feels hopeless. I'm stuck working home health. Making less than what I feel I should given my qualifications.
I understand that all this fraud has been going out and Medicare has paid out hundreds of millions to these agencies but... really? Now we all have to pay for it?
Am I just jaded and misinformed?
I am so frustrated.