Nursing supervisor of Home Health Agency

caliotter3 · May 23, 2010

The nurses have been the ones committing fraud in the agencies where I have worked. I am glad to hear that at least one agency takes appropriate steps. If it were me, I would get rid of the HHAs that have been doing this even without the evidence. You need no reason, employment at will is sufficient. Just pull them from their cases, then have nothing for them, if you do not want to formally fire them. Agencies do this all the time when they want to fire somebody without going through the trouble of firing them. They seem to get pleasure out of "having no work for you", when the "employee" calls. It is also good to close the case of the client who is engaging in fraud so that you don't have to worry about making frequent sneak attacks to see what other employee they have enticed to lie on their time sheets.

Kyasi · May 23, 2010

It is much more difficult to get rid of these HHA's, at least in my state. (I'm in the midwest) If I don't follow the correct protocol, we end up paying unemployment claims like crazy, even though they sign a 'no guarantee of hours' statement when we hire them. They all know how to work the system and get paid for doing nothing.

Add the Union to the mix here making it even harder to fire/not offer hours to HHA's. I do as much as possible ease my 'trouble-makers' out but have to be very careful in doing so.

K.

caliotter3 · May 23, 2010

At the union agency where I worked, the Director once told me that they had their ways of getting around the union. She stated that they did what they wanted to do without the union finding out and I could see how that would work, especially if the workers being affected had no knowledge or were not the vocal type. There must be some employer tricks in the book that you could use to get rid of poorly performing HHAs. I would diligently look for them. Ridiculous to have to put up with that when there are so many hard-working, honest people out there who need jobs and want to work.

CFitzRN, ADN · May 23, 2010

Oh, it definitely isn't just you experiencing these things! And trust me, I've barely begun to tell you -anything- but I know you know what I mean.

Last week we had a client call and tell us that an entire, full bottle of oxy went missing (and you left it OUT? they just don't think). Later that same day, a client called and told us her fill-in HHA was asking questions about her meds. She was calling from the HHA's car. The HHA was in the pharmacy picking up client's meds and the client decided to call the office and tell us that the HHA was asking lots of questions about her meds (what kind? what for? etc). While we were on the phone with her, she suddenly yells out "THIS IS MY CD! SO IS THIS! SHE HAS A TON OF MY CDs IN HER CAR!!" Come to find out, she was the same HHA who was in the other client's home when the oxy went missing. So we called HHA on her cell phone, told her to take the client home and come straight to the office. She agreed. The plan was to send her to the industrial clinic for a drug test. I said to the other women in the office "Okay, just be prepared. She is going to say that she is taking oxy for a 'back injury', and when we ask her to provide us with her prescription bottle, she will say that she took her last one today and threw the bottle away." Do you know that is exactly what she said, verbatim, when we confronted her? I knew that's exactly what she would say. So when she came up positive for oxy, she was able to provide a very old scrip for it. She says she had held on to the leftover oxy just in case she needed it again sometime, and lo and behold, she had just reinjured her back a couple of days before and was taking the leftover oxy. So we pulled her from those cases and have refused to use her anymore. She keeps calling the office and threatening to sue us if we don't work her. I'm not sure what her options are where that's concerned but we're not union and we don't have to work her...

That was the first big thing to happen recently - it's been like a cascade of events ever since. UGH.

Oh - I was going to tell you this one too: I arrived at another client's home for a sup visit a couple of weeks ago - right in the middle of the supposed "shift". No one was home, and in this particular county, transportation is not allowed. So I wrote up my "attempted visit" sheet and went back the next day. I found the client sitting in a chair outside smoking (of course) while the HHA planted the client's tomatoes. I jokingly said "is this on your plan of care?" and sort of laughed. The HHA stood up, dirty knees and all, and said "if she needs me to plant tomatoes, I'm going to plant tomatoes!". They think they are above any rules or regulations. After I did my visit, I called the SW on the case and she basically said "yeah, I know... they bend the rules all the time." I explained that they weren't even HOME the day before, and the SW said "I know, I see them out and about all the time." I'm sitting there with my jaw on my lap. I said "do you think you might drop her from services and give her slot to someone else who really needs it?" She basically said it was too hard to do that and she wasn't going to try. Well, if the social worker isn't going to do anything, there's not much I can do either.

And trust me when I say, this is just the tip of the iceberg!! :uhoh3:

caliotter3 · May 23, 2010

CFitz

Planting tomatoes sounds kind of nifty to me. At least she was at the patient's house and supposedly was not hopped up on the the patient's oxy!

CFitzRN, ADN · May 24, 2010

CFitz
Planting tomatoes sounds kind of nifty to me. At least she was at the patient's house and supposedly was not hopped up on the the patient's oxy!

True dat!

caliotter3 · May 24, 2010

Actually I could picture myself eating a plate of sliced, yummy, home grown tomatoes, having a nice chat with my patient, with one of the day time TV shows on in the background.

CFitzRN, ADN · May 24, 2010

Okay, yeah, that sounds pretty nice, actually. Hahaha

caliotter3 · May 24, 2010

Sometimes we have to make our own pleasantries in home health! Beats thinking of driving into a gangland neighborhood at 10:45 at night!

Kyasi · May 24, 2010

Our HHA's are there to do personal care only. They can't transport patients, run errands for them, or go anywhere with them. We have a nonskilled/nonmedical department that provides Attendant care and housekeeping services.

'Failure to follow the plan of care' is something I write disciplinary notices for quite often. In fact, I had a HHA that has been causing me many problems and I fired her on Friday for just this thing. She accepted money from the client to buy her some grocery items and didn't buy the items or return the money. She also borrowed money from her and stole some. She denied the latter but admitted she took money to go to the store for her, so that gave me something to nail her on. We suspect that this particular HHA is on drugs herself which explains the theft. Although she denied asking the client for money, she was in the office earlier that week trying to borrow money "for gas" from the office staff.

I have a handful of really great HHA's that I wish I could clone. If I could, my job would be so much easier!

Kyasi

caliotter3 · May 24, 2010

For some reason, the really great employees seem to be too few and too far between.