Interviewing For a Home Health Position

  1. Hi All:

    Well! I have decided to interview for a home health position at the local hospital. I have done about 6 months of home health in another community. I left (mostly) because of the paperwork. I do not immagine it has changed much.

    I truly love the approach of home health or maybe I should say the philosophy. I believe patients do better in a positive home health environment.

    To be honest, the hospital is requiring mandatory overtime and mandatory scheduled call so I will NOT do that. I am not really just picking the lesser of the evils... there is still a part of me that very much would like to be successful in home health. It was a bust before. Not just the paperwork but scheduling was so hit or miss. Lots of busy days or lots of very slow days.

    May I ask for some idea of per diem wages (?), is mileage allowance still common(?), and time approximates on patient visits that are considered customary (intakes and revisits)?

    I will still do my agency hospital work for the experience and the money (not quitting my real day job). I am hoping to work per diem at the local hospital. I anticipate checking it out and maybe go on full time at a later time.

    I am truly having a hard time with the commitment thing to a hospital.

    Thank for your input

    B.
    Last edit by nightingale on Apr 25, '02
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  2. 10 Comments

  3. by   hoolahan
    Hi nightingale,

    I am wondering what is your new avatar? I can't quite figure it out, a flower from your home?

    Anyway, to answer your questions, I have no idea what the rates are in the west. In the east, it's about 22 to 24 per hour, but in the south, it's anywhere from 12 to 16 per hour. No idea what per visit rates are. My agency is the only one around that pays per diems and hourly rate. Per visit rates here go from 30-35 per revisit to 55 or 75 for a new, depending on if it's an IV admit, they get the highest rate (longer visit necessary.)

    How long per visit? Revisits anywhere from 30 to 45 minutes avergae, but it truly depends, sometimes an hour. Medicaid only pays after 3 15 minute billing units, so those visits must be 45 minutes, you make all calls from the home, and do all notes there to meet that 45 min rule of thumb. Medicare revisit must be at least 30.

    New admits? Usually about 90 min in the home, and I saw a figure from VNAA (vis nurse assoc of amer) that quoted the average amount of time spent on a new admit is 3.2 hours, with average time in the home of 45 minutes. I may be able to do 45 minutes if I know the pt, ie frequent flyer, but not a person I have never seen before, that is amazing. So, you can see, if you are getting 55 for a new admit, and you spend 3.2 hours doing the admit, you are only making 17 + per hour. The reality is if you have a new trach or enteral feeding admit, you will likely spend over 3 to 4 hours on this admission. So, you have to give your rates some thought.

    Sad to say, the paperwork is still horrendous. I think that the paperwork will be harder for you as a per diem, as you will not be spending day after day at it, getting it down pat. I worked per diem for a while, but only after I had done some case managing. Whatever you do, if you are only working 1 or 2 days per week, don't agree to case manage, it would be hard for you to follow up, heck, I miss things just being off one day! Be sure they give you a good orientation to the paperwork you need to complete, esp for referrals to other disciplines, and for the managed care companies.

    Good luck. I hope you like it. I still love it, and I prefer to do my paperwok at home. If I get done w my visits by 2:30, I can come home, plop my charts down, start dinner, then do my paperwork later in the eve when kids are doing their homework. At the risk of sounding like a broken record, if you understand the rules of Medicare, and PPS, and learn how to fill out the OASIS correctly the first time, you will decrease your frustration level tremendously.

    Best of luck, and remember we are here for you!!
  4. by   nightingale
    Hoolahan:

    Thank you for the time spent on your input. Lots of info so when I do interview and I start hearing figures; I will know which end is up with a fair offering.

    My new avatar is a porch pot of pansies with snow... lol.. oh yes Wyoming is my home....

    I will interview week after next. I hope I get a good feeling from it all. I so much want to plant somewhere and feel like I have a home (oooppsss almost said nursing home)...

    B.
    Last edit by nightingale on Apr 25, '02
  5. by   juliesosarn
    I don't know exactly where you are. Our agency pays 50 for evals, post-hosp assessments and recerts and RNs get 33-40 for followup visits. IV visits are $5 more (evals and follow-ups). LVNs get 25-30 per visit. We don't pay mileage unless it's an unusual situation (begging a nurse to go farther than she usually goes if we really need coverage -- something like that!) We also have a $5 incentive for each OASIS paperwork turned in earlier than the due date.
  6. by   nightingale
    Thank you Julie for responding.... I "wish: Wyoming had those kind of salaries... we shall see....

    B.
  7. by   NRSKarenRN
    Phila area payment, Agency without IV therapy:

    Admit: $40.00/visit
    Revisit: $35.00/visit
    WE visit: $2.00 more per visit.

    Milleage from office or first patients home: .33 cents/mile to last patients home.

    FT staff are salaried employees. If working
    8 hrs: 1 admit and 6 revisits; only for two or more admits does 1 admit= 2 visits.

    12 Hrs: 2 admits + 8 revisits

    Try it perdiem for revisits.
    You may love it once paperwork understood and workings of managed care understood.
  8. by   nightingale
    Thanks for responding Karen. Gosh, not a big difference for new admit versus revisit. That figure is a surprise.

    I remember one male nurse at my first and only HHC job. He did not do any case management or new admissions. He was happy to do late call for emergency at a very tidy sum. He would easily do 10-12 revisits (a night and sometimes several more) @ 35.00 and often would work for long stretches then take off during slow times and go to fabulous places.


    Is the grass greener? We shall see....
  9. by   nursemicke
    Shands in Gainesville, FL $25 per visit per diem + mileage
  10. by   nightingale
    Thanks Micke! How you doin?

    B.
  11. by   nightingale
    I want to just let y'all know what happened with my interview or lack of interview.

    It has been a couple of months since I talked with that facility and tried to set something up for working in the HH Dept. When I first applied, clerically, the Administrator called me to see if I would interview for a management position for Staff Education of HH and the other 50% of responsibility for Compliance Coordinator (I think I remember that as the title). I thanked her but told her I was not interested in a management position.

    I did make a few appointment to interview for the HH position but the supervisor for that department took a lot of time off (I guess) because my appointments were cancelled and attempts were made to reschedule which were not compatible with my schedule.

    Well, I figured out how to be more successful in getting my needs met with my travels out of town to nurse at facilities. So there I leave it.

    I am at the point now where I would like to see if I can do some sort of "self-contract" with HH Nursing needs.

    Thank you for all your help.

    B.
  12. by   NRSKarenRN
    Look for a HH agency that also does IV infusion---usuallly more flexible.

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