Home Health agencies paying nurses per visit

Specialties Home Health

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I was wondering how many home health nurses are hearing that agencies are leaning towards paying per visit instead of hourly in order to save money.

I definitely prefer an hourly rate, but all the agencies I've have contacted only pay per visit. I am hearing that even agencies that are currently paying hourly are probably going to switch to per visit.

For the first time in many years, I am considering going back to the hospital because of the inadequate wages in home health.

My agency payes all of us nurses by the hour. I make 25.00/ hour with a 0.43$/mile. I am responsible for up to 3 counties but if I am oncall, I'm responsible for up to 10 counties.

I am wondering: with having to cover 10 counties...how does that work with the 50 mile radius limit that is imposed on most agencies.....in louisiana, our rules say 50 miles because they dont feel you can effectively manage to take care of patients needs if they are more than 50 miles away...not sure what your rules are just curious.

Specializes in Dialysis, Home Care, Med-Surg in 4/07.

Thanks guys for letting me vent.

I can't make it better for you but I do understand. The agency I had worked for previously also gave us no warning that we were going per visit. Everyone was angry about the change though no one quit because we were the last agency in town that had remained salaried. I never spent a minute more in that office than I had to after that. They weren't paying for my office time any longer. I eventually resigned due to a pathetic census. I went from an average of 35-40 visits a week to maybe 15-20. I couldn't pay my bills. I send you best wishes for whatever you decide.

Specializes in OB, M/S, HH, Medical Imaging RN.
I can't make it better for you but I do understand. The agency I had worked for previously also gave us no warning that we were going per visit. Everyone was angry about the change though no one quit because we were the last agency in town that had remained salaried. I never spent a minute more in that office than I had to after that. They weren't paying for my office time any longer. I eventually resigned due to a pathetic census. I went from an average of 35-40 visits a week to maybe 15-20. I couldn't pay my bills. I send you best wishes for whatever you decide.

Thanks for your kind words. I do think soon all agencies will be per visit. Cuts any overtime. They tell you you'll make much more than you did. Um, ok...then why are you changing? for my benefit? No, sorry...stupid is not written on my forehead!! Obviously keeping more money in their pockets.

Specializes in Home Health, Podiatry, Neurology, Case Mgmt.

i love working for my home health agency...i get $20 per visit, plus a work cell phone, and a $400.00 check at the beginning of the month for gas/milage/car maintence (which for me works out to like 45 cents a mile i think) We also can have medical (but i dotn need it since my hubby is in the military) all in all i pretty much make my schedule and my company is good in that i can refuse any patients (which i do if they are farther than 30 miles from my home) and my visits only last about 30 min MAX! so i reallly do end up making like 20 an hour...ohhh and one thing they did start doing is that i f the visit is OVER an hour long, then the company is paying more. for instance i do an IV visit and we have to wait there while it infuses and a half hour after that...well that means i'm there from 2.5 hrs so i get $50 for that visit alone...3 hrs would be $60 ect...also lets say i go for a visit and do a blood draw and ahve to then take that blood to the lab...well from the time i get there until the time i leave from the labe i'm paid more as well just like the lengthier visits. I feel bad for the RN's there though because they are salary and they only usually do the new admits/oasis ect, but they dont get paid for going out there and doing them, not to mention they are then stuck in the office or picking up any visits that cant be seen buy the LVN/LPN's and they seem like they are ALWAYS on call w/ no extra pay! Dont think i woudl do it as an RN but as an LVN it works out GREAT!!!! I maybe do 29-35 visits a week but it only takes me maybe 26-32 HOURS of working time for full time pay, if we went hrly i'd have to look into the hospitals or LTC's to bring home the same amount!

LPN's can always make out. they just had a big shift where I use to work. Past tense. I quit. They hired another nurse with no home care experience and I was in charge of training her. She told me what she starting making an hour (4 dollars an hour more than me) and I had been there 11 years. I was livid. I spoke with my manager about this and she said her hands were tied and that if I didn't like it, I could go elsewhere... which I happily did.

Specializes in OB, M/S, HH, Medical Imaging RN.

I tendered my resignation today with a 2 weeks notice. The owner came up with more bad news yesterday and that was the straw that broke the camels back. Meetings, even mandatory meetings are paid at $30.00 whether it lasts an hour or 3 hours, just the one flat rate. Absolutely no office time will be paid. Sometimes you just have to have office time! No compensation will be made for extended visits. i.e. I had an admit last week and just at the end of the visit the patients nose started to bleed. She had a fractured right arm and leg. What was I going to do just leave her? No.

The owners answer? Sorry you happened to be in the wrong place at the wrong time, no extra pay. I just want to SCREAM !!!!!

Sign me, Unemployed.

Specializes in Lie detection.
I tendered my resignation today with a 2 weeks notice. The owner came up with more bad news yesterday and that was the straw that broke the camels back. Meetings, even mandatory meetings are paid at $30.00 whether it lasts an hour or 3 hours, just the one flat rate. Absolutely no office time will be paid. Sometimes you just have to have office time! No compensation will be made for extended visits. i.e. I had an admit last week and just at the end of the visit the patients nose started to bleed. She had a fractured right arm and leg. What was I going to do just leave her? No.

The owners answer? Sorry you happened to be in the wrong place at the wrong time, no extra pay. I just want to SCREAM !!!!!

Sign me, Unemployed.

See thats BS, if you are case managing then you do need office time. When I did Fee for sevice visits (same as pay per visit), I sa the pt, did the care and that was that. I just worked Saturdays and rarely saw the same pt. twice, never did any case management so my $53 per visit was great.

You could end up spending a LOT of time on a caseload and not get paid for it? No thanks.

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