New to Home Health- Making no money!

  1. I've been working in home health since February and we are paid per visit. First of all, I feel like I have a very small caseload- sometimes, only 2 people a day. My supervisor says that's normal until I build a caseload and do more SOCs so that I have patients in my pipeline. She also says that, since I've never done HH, they want to make sure that I'm comfortable with OASIS and other documentation. We do mostly medicare patients, which she says can be very picky. I can kind of understand that; however, my first check was around $400, my second was around $900. and my latest check was around $600. I can't believe that other HH nurses are making this kind of money. I love, love, love my job. My only wish is that I could do it for more hours in the day, because I can't afford to stay at this job if it if the pay will remain this low.

    Has anyone else had to deal with this ramping up period in home health? Is this normal? How long should I expect it to last?
    •  
  2. Visit shinyhappy1 profile page

    About shinyhappy1, BSN

    Joined: Feb '18; Posts: 22; Likes: 4

    24 Comments

  3. by   shinyhappy1
    Should I consider taking a second part-time HH position to get more patients? Has anyone tried that?
  4. by   OldDude
    Yes, I would recommend you market yourself to as many HH companies as you can, build your caseload, and then go with those that give you the work. You now have training in the field and you would only have to learn the individual company's procedures and computer program. Pay per visit is a win/win arrangement for the employer; if you don't work it doesn't cost them anything; which is OK because that's the nature of the arrangement so it's kinda like day labor...show up at the pole every morning and see who shows up to give you work.


    Good Luck.
  5. by   caliotter3
    If you want consistent pay, then consider extended care home health. Shift work has the advantage of providing a similar paycheck each pay period without all of the driving, wear and tear on your vehicle, and with a fraction of the paperwork and extra work involved.
  6. by   KelRN215
    I would find another agency where you can be full-time/salaried.
  7. by   shinyhappy1
    Thank you for replying!

    I hope I don't sound stupid with this question, but what is extended care home health? A google search didn't answer that question. Also, how would I find a job in that? I couldn't find any job postings utilizing that phrase.
  8. by   shinyhappy1
    You are absolutely right that I lose nothing by not working. If I were independently wealthy, my situation would be ideal! Infortuneatly, at this rate, I cant afford to live so I NEED to work more than I am, but I don't want to be disloyal, either.
  9. by   shinyhappy1
    Supposedly, I am full time and I do get benefits, but that doesn't seem to mean I will make decent money.
  10. by   Have Nurse
    Quote from shinyhappy1
    I've been working in home health since February and we are paid per visit. First of all, I feel like I have a very small caseload- sometimes, only 2 people a day. My supervisor says that's normal until I build a caseload and do more SOCs so that I have patients in my pipeline. She also says that, since I've never done HH, they want to make sure that I'm comfortable with OASIS and other documentation. We do mostly medicare patients, which she says can be very picky. I can kind of understand that; however, my first check was around $400, my second was around $900. and my latest check was around $600. I can't believe that other HH nurses are making this kind of money. I love, love, love my job. My only wish is that I could do it for more hours in the day, because I can't afford to stay at this job if it if the pay will remain this low.

    Has anyone else had to deal with this ramping up period in home health? Is this normal? How long should I expect it to last?
    It's very frustrating and financially it can be a bit scarey when you don't have many in your case load.

    Offer to ride shotgun with another nurse and see if you can do an OASIS with her present. Ask if you can shadow and get to know the clients she is seeing.

    You need to win their trust. You can't do that if you only get a couple of cases a month!

    I'd have a talk with your manager and see if she is willing to help. If they can see that you mean business, they may rise to the occasion.
  11. by   Have Nurse
    Quote from shinyhappy1
    Should I consider taking a second part-time HH position to get more patients? Has anyone tried that?
    Yes. but make sure first that you haven't signed any paperwork that prohibits you from that when you came on board to your present company.

    Some companies don't allow it, as it is a conflict of interest, client stealing, etc. (Believe me, it's been done!) Protect yourself.
  12. by   kbrn2002
    This is why I would never consider home health a viable employment option. I believe all the home health agencies in my area are pay per visit. I know a few nurses that like it as a second income. I also know a few nurses that left it to return to LTC because they had no guaranteed income. If your patient is discharged for any reason, there goes that income along with the patient.
  13. by   KelRN215
    Quote from shinyhappy1
    Supposedly, I am full time and I do get benefits, but that doesn't seem to mean I will make decent money.
    Find an agency where you are a salaried, full time employee. Pay-per-visit has some benefits but I think it benefits the employer more than the employee in the long run.

    I hope I don't sound stupid with this question, but what is extended care home health? A google search didn't answer that question. Also, how would I find a job in that? I couldn't find any job postings utilizing that phrase.
    Try searching for private duty nursing. It's where you work a shift in a patient's home. These patients are typically vent-dependent, have trachs, G-tubes or are on TPN. They have some sort of technology dependence that requires extended nursing care in the home. It pays significantly less than visits in my area (like the agency I used to be a supervisor at, RNs make $28/hr regardless of experience. New grads make over $30 in the hospitals around here) and since these patients are quite ill, they may end up in the hospital frequently and you may end up not working at all for several weeks at a time if they have an extended stay.
  14. by   SaraTayRN
    Hello, I am new to home health as well. I have also been working since February and am in a building up period, but thankfully we have such a high census that I have been just shy of full-time points since I started. I do experience lulls when I have a bunch of discharges, but I just make sure to let the office know that I am at a low patient load and what days I have openings for SOCs. It will take time, but you can really make some great money with the PPV model.

close