Calling all HH Nurses, roll call - page 29

Hi, as a newly appointed moderator, I want to live this forum up a bit. I just resigned my position as a HH supervisor, to go back to the field. I have been a nurse 20 years, 17 in critical care,... Read More

  1. by   eligrace
    I am wanting to start my own HH agency but am a bit lost as to how and what to bill for services, where to begin the insurance nightmare and how to compensate employees. I've never really been concerned with the compensation of care aspect before so now I am a little lost. Any ideas where to start?
  2. by   Dabuggy
    I was working in a NH that was connected to a hospital. Worked the midnight shift and had between 35-40 pt a night. The hospital was sending pt's over because they did not have the room, basic recovery stuff. Because of politics in the NH if there was a problem, I had to call a supervisor in the hospital and seek their advice, then if they let me call the Dr, on call.
    One night a pt presented with a potential MI, had to call the sup, then the Dr. log it into the comp, put new meds into the pt having the MI's MAR. and with the pixis had to wait for another nurse to come and over ride the new meds (ASA & NITRO) so I could give the pt them. Good thing time is not important in this situation. Anyway to protect my license I put in my two week notice and was offered a job in HH.

    I have to drive 53 miles, but it is 17 more than I was driving for one pt. Have to stay at his home for my 8 hrs. Got a 66% raise also. So here I am going for my RN, running sips of water when he needs it, or cath him, and having 3-4 hrs per shift to study. HHHMMMM What does the hospitals/NH do with all the money they get from these pt's. If the insurance co. can pay this kind of money for one pt, makes me wonder.

    Oh, and when I placed my resignation they offered me $5 per/hr to stay.

    So for now while being in school anyway, HH is perfect for me. Yes I miss the co-workers/nurses, but less pt's and more money, less chance of law suites, etc. is best for me at this time. In the future after some experience I may try the med-surge floor.

    Also, when working in the NH there was so much stress. The only stress I have at this time in HH is deciding which day to take off. What a big difference.

    Dabuggy
  3. by   bgogal
    Hello HH!!! BgoGal signing in.

    Been a HH nurse for 11 yrs and tried inpt hospice for 17 months when we relocated. Next month will be returning to my 1st love - HOME HEALTH!!! Wooohoooo !!!

    I'm so stoked coz now they've got this program as long as I get my 30 visits done in 4 days ( 4- 10 hr days) I can be off for 3 so basically get paid for 5 days but work for 4. I'd rather see 7-8 pts per day as long as I'm off for a long weekend. Plus anything over 30 visits would be paid per visit rates. Could come in handy for the holidays.

  4. by   Meems
    anybody here work for a company called Amedisys? Our company was recently bought by them. Want to know what health ins etc they offer...
  5. by   Meems
    the nav system will help tremendously trust me... it will pay for itself in less headaches, and stress with poor directions!
    Last edit by Meems on Aug 6, '07 : Reason: spelling dammit!
  6. by   Yesmakesithappen
    I agree! There have to more home health nurses out there to connect with. I've been in home care for over 20 years and here in CA the local VNA is paying up to $50.00 per hour for per diem work. It's still the focus of my continuing career path but I found we were always short handed because alot of people don't like to do OASIS and deal with PPS productivity issues. I just became a member so looking forward to more HH dialogue.
  7. by   shill
    Hi
    From Med/Surg-Tele to ER now to HHVN and I'm really liking it, alot less stressful...it really is interesting to see what goes on after the Pt is discharged from the hospital and to see why so many Pts return back into the hospital. I've been doing this for 5mos now, and the biggest problem I have so far is finding where the Pt lives.. Yes, I realize that you can always call the Pt, go on mapquest, etc.. but these sources don't have the knowledge at times for roadwork or detours. Maybe Santa will bring me a GPS for Xmas.hohohaha!
    My question is..My experience with Vanco infusion has always been at room temp. for my Pts. I have a Pt that infuses his Vanco, thru his PiccLine at home right from taking out of the Refrig., (He is on his 3rd Picc Line)..am I incorrect in saying/thinking that he should take the Vanco out of the fridg. at least 30mins before infusing it?
    He's not homebound and uses his arms alot(construction).
  8. by   AZHHRN
    In the ideal environment the vanco would be allowed to warm up a little, but we can't always control what our patients do. Infusing right out of the refrigerator may improve his compliance. It is more important that he check the bag or medball for the correct drug and dose as well as for evidence of particulates or discoloration. Out of curiosity, why is he on his 3rd PICC line?

    Good luck, and welcome to Home Care.
  9. by   Josie1010
    Hi everyone!
    I've been reading this thread as well as "a typical day..." and I'm wondering how you manage all of the products that your pts need every day? Does your main office take care of it for you? My agency has us run around and make multiple trips to local stores to take care of DME. What's your experience?
  10. by   AnnemRN
    Quote from Josie1010
    Hi everyone!
    I've been reading this thread as well as "a typical day..." and I'm wondering how you manage all of the products that your pts need every day? Does your main office take care of it for you? My agency has us run around and make multiple trips to local stores to take care of DME. What's your experience?
    My agency contracted with a wound care supplier who would mail the supplies to the patients home after the nurse called in the order. Usually the items would arrive within 1-2 days.
  11. by   Josie1010
    Thanks! The types of products my patients need are beds, wheelchairs, oxygen concentrators, etc. My company takes care of the wound care supplies but when they need ADLs or DME we have issues...any thoughts?
  12. by   AnnemRN
    Quote from Josie1010
    Thanks! The types of products my patients need are beds, wheelchairs, oxygen concentrators, etc. My company takes care of the wound care supplies but when they need ADLs or DME we have issues...any thoughts?
    Aren't there DME companies where you live? Usually, you call the DME co. with the patient information and doctors order, then fax the order to them for billing and delivery. I've never heard of a home health nurse who has to pick up DME.
  13. by   Josie1010
    I live in a pretty rural area so it is kind of a hassle. Does the DME company you work with bill Medicare for the patient or does your agency?


    Thanks again!

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