HHRG's

  1. We are required to fill out a HHRG when doing admission and planning for visits. I don't like the extra paperwork but it does help in planning. However, our agency says that one SN visit costs $185 and one PT visit costs $225. On paper we lose money on many patients.

    I understand that office overhead, support staff, etc. etc. is figured into that number but seeing how I get $20 per visit and $65 for an admission the $185 per visit seems AWFULLY high.

    Do any of you also figure out the HHRG's when doing an admission and are your visit amounts in line with ours?

    Thanks,
    Ann
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  2. 5 Comments

  3. by   NRSKarenRN
    Hi Ann:

    Your agency costs are in line. Our largest agency based in Philadelphia charges $200.00 acrooss the board for SN, PT with MSW @ $225.00/visit.

    Your pay is too low for a revisit! We pay $37.00 revisit and only $43.00 for an admit---so your admit costs really covers the agrivation of completing that OASIS paperwork while urs does not.. Your revisit cost is below the norm, especially if you need to do recert, transfer to hospital or reassessment post hospitalization visit OASIS.
    Most agencies pay at least $25.00/revisit. Your higher admit cost might be just to entice perdiems into accepting these cases.
    If you work for a for-profit agency, you can ususally "negotiate" your rate. Many agencies make ~$1,000 profit on each Medicare case which helps balance all the Managed Care and free charity care cases. So hone your negotiating skills and ask for more money!
  4. by   Traveler
    I am the only one in the office now who gets paid per visit and I know that it is low especially since I get no benefits, but the people are nice, they care about the patients and it's very flexible so it does work out. If it takes more than 30 mins to get to a patient's house I make an hourly rate for the extra time which is only $15/hour. So, if it takes me 45 mins to travel I get 15 mins of hourly pay.

    Our coverage area is also really really large. I live at the southern end of our area and when I'm on call if I have to go to the furthest point north in our area it takes me 2 hours. It's just because the population is so spread out and rural that it is this way.

    They are really low on the mileage also. We get .26/mile. On average I will see about 5 or 6 a day with about 100 miles on twisty turny country roads.

    The $200 across the board you mentioned is for Philly which should be much much higher than ours in the middle of nowhere in SE Tennessee. It's very rare that on paper we see $1,000 profit for a Medicare patient and our reimb. rates for Medicare just got decreased as I'm sure they have everywhere.

    Our agency pay is very very low but the people I work with are wonderful which is why everyone hasn't left. The hourly nurses could easily make $10 more an hour at a hospital with lots less paperwork. But, it seems like home health attracts a really different type of nurse who has a hard time making it in a facility.

    I know I love what I do (most days) and I love the freedom of being out and not trapped in a facility and meeting all different kinds of people and really feeling like you can take the time and make a difference.

    Ann
  5. by   renerian
    WE had an office person where I worked that figured that out and advised us accordingly especially if the visit projections were out of line. This person was a nurse hired just to do that as well as sign off on plans of care that were designed by the visit nurse.
    Your mileage reimbursement is very low.

    renerian
  6. by   Traveler
    That's good that you had someone to do that. I suppose they like us to kind of make the projections because we have been in the home and know more about what the patient needs. I'm bad to try to get them too many visits though so we do talk about it if there is going to be a big loss.

    I was working in marketing for a wholesale grocery dist. while in nursing school 15 years ago and I made 32 cents a mile THEN.

    Go figure.

    Ann
  7. by   renerian
    We did decide the visit frequency but if it went over the reimbursement the person would call us and we would work together to tweek the plan of care.

    renerian

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