Two patients one client

Specialties Home Health

Published

I have a rate at an agency for X per hour. I am interviewing with a family to provide care to their TWO toddlers that have the same ailment.

Should my rate be higher from the agency? How do I ask about it without seeming like that's all I care about?

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Two patients is two patients, they will take twice as long, with twice the documentation...... The health insurance will be charged per patient. There is no two for the price of one in the medical world. I would just simply say "you do know that there are two patients in the home" if they act like "oh well" then I would make sure to just double my time in the home. You will have proof with your charting right?

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The agency will want you to do this for the same pay as one patient or maybe a little more. Don't accept this situation. Two patients/pay for two. An agency tried this with me one time. They actually thought there was no reason to pay me for twice the work. They didn't say they were only being reimbursed for one patient!

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Specializes in Complex pedi to LTC/SA & now a manager.

My agency does two patients = two nurses for pediatric private duty. The one "overlap" is if there is a skill (such as replace a dislodged NG tube)that is RN only there can be one LPN & one RN. They can "swap" patients if there is an unscheduled NGT replacement there is a specific P&P for this scenario.

If this is home health (intermittent skilled visits) there is an easy solution. Visit toddler A, complete visit & billing and then visit toddler B complete visit & billing. Just like if you visited two clients in the same assisted living.

However this sounds like private duty (shift work 4,8,10,12 hours working with one patient )) and while some agencies try one nurse, two patients. & bill for each patient separately and say pay nurse a little extra the potential issue is what if toddler A has an emergency& while you care for A, B has their own crisis. Yes in a facility nurses care for more than one patient, however there is more than one nurse working in addition to ancillary staff. (CNAs,RRT, admin) At home you are on your own.

This is why agency A has had a policy of twins , triplets, quads etc that require skilled nursing get 1:1 care, four children = four nurses. Agency B tried one nurse per family and there were a set of multiples that two had a crisis back to back and things did not go well fortunately no one died or suffered permanent injury. But the insurance company was not happy with two hospital admissions not too long post discharge. So now 1 nurse per patient has now been implemented.

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And it is only common sense that you would be interested in the rate of pay at this home.

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Thank you for all of the replies. Especially, the part about nursing in hospital v. private. That was where I was torn. I still have to interview with the family to see if I even match to their needs and vice versa. If it looks promising I will talk to the agency about my concerns.

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