I would like to place a classified ad in my paper, advertising that this nurse will make house visits daily to care for individuals who needs help but does not want to go into a nursing home. I will do everything for them, including shopping, pet care, housework, take them to doctors appts, and nursing stuff. When they pay me, it will have to be out-of-pocket. I wouldn't know how to word my ad, or even how much to charge. Should I charge a hourly or set a monthly rate? Nursing homes are so expensive. When my grandma went to one years ago, they were taking 8k/month out of her bank account....and 2 years later when that was exhausted, she was then able to get Medicare to pay for her care. I would think that someone would rather give their money to a private caregiver and stay at home, than a nursing home (and lose their house, etc).
Another consideration that may pose a problem is taking pt's to MD appt. You need to check with your car insurance agent to make sure you are covered. Another option is to drive that person in their car (if they have one) but check to be sure they have insurance and get it in writing that is is ok. Most insurance will allow someone else to drive a person's car as long as it is only done occasionally. But check with their agent first.
Be familiar with your state nursing regs. Any meds must be prescribed and procedures need an MD order such as an enema for constipation. Don't do anything or give anything that you would need an order for just like in the hospital. And be sure to work only within the scope of your license, whether it be CNA, LVN or RN.
Last edit by Neveranurseagain on Oct 2, '08
"I think it's a really really bad idea. #1 being paid out of pocket is illegal, I'm assuming you won't be reporting it as income to the IRS? #2 you have no one to back you up on anything, you could easily be sued and lose whatever license it is that you have. You can go through an agency to get private duty work, you'll have backing and will pay your fair share of taxes."
Being paid out of pocket is not illegal. I occ. do private duty and report my earnings and get 10-99 from some clients. You are considered self employed, and can deduct your mileage and other expenses. Nurses have been their own employers for years--look under Entrepreneurs in Nursing on allnurses. We are considered Independent Contractors and cut out the middleman. As long as you understand the nurse practice act and work within your license boundries, there should be no problems. And being sued is not that easy, esp. when dealing with an elderly client in a state with a malpractice cap. And when did agencies start backing their nurses? They back up who pays them, not the person they have to shell $$$ out to.
As an RN, I have taken clients who only needed a CNA/HHA and recommended to the family and pt. that is all they need for the level of care provided. And the familys have refused, saying they would feel more comfortable if they were cared for by an RN. Most of the time it was an easy visit or shift, and I got paid to read, talk with the pt. and watch TV with the client and catch them up on current affairs, as well as heard some great history stories!
I think by out of pocket she meant she would only take private pay pts., not bill insurance/Medicaid/Medicare.
I write a note everyday that I see a client in a bound book. I chart wt, meals/snacks, level of activity, meds taken, phone calls to family and MD, any interventions or suggestions/teaching to the pt/family, hygiene, time of arrival/departure and occ will have a family member sign it.
Last edit by Neveranurseagain on Oct 3, '08