Case Managing

[ksmrnn]

Not sure where to post this.

I currently work for an agency and have for 2 years doing pediatric home health. For the last year I have worked with the same child. The family wants to leave the agency since they have been unable to staff their allocated hours. (Medicaid allows 80hrs/week and agency has only staffed 40-actually 50 since I have worked 10 hours of overtime every week for the past year). They asked the agency if they would case share with independent nurses, which would allow the family to staff the remaining hours that the agency could not. The agency said they don't case share since the situation can get sticky. After being understaffed for a year and overall issues, they want to leave.

I can work as an independent nurse and I have in the past for another child. I have never case managed. I intend to take over the current case that I am working on right now and both case manage and work on the case. This is what the family also wants. We have wonderful doctors and a hospital case manager that will make this okay. Plus the agency is so lazy that majority of the time I am getting the orders and managing the paperwork flow back and forth at the current time.

I signed a Do Not Compete upon hire. I have spoken with my attorney and based on the verbiage and the state statues the Do Not Compete is very weak and would most likely not hold up in the court system. It is a risk I am willing to take for both myself and the family.

My question is.....has anyone done this? Left the agency and "taken" client with? But then worked independently? I want things to go as smoothly as possible, though realizing the hand off of the case is going to be the challenging part.

Again, I am not worried about the Do Not Compete. The agency has failed to fill the hours allotted to the family for over a year. For that reason the state took away 20 hours per week of their time because it was never filled so there was no documentation proving the need for the services. The family is not interested in moving to a different agency since there is only one other and it does not deal with complex pediatric cases.

Thanks in advance.

[caliotter3]

I have been in similar situations. I got the "treatment" from my primary agency when a shared case went back to the originating agency based on me applying there. Heavens, how could I do that to them! Yeah, it was perfectly fine for them to hire the nurses from the originating agency AND PAY THEM MORE THAN ME, when the case was moving in their direction. And they were ok with those nurses working for both agencies. But, boy, when I decided to do the same! I never heard the end of it and my standing with that agency was broken for good. I think you get the picture.

On another case, somewhat the same. Most of the nurses on the case also worked private duty for the client because she, also, had lost so many hours over the years. She went from one agency to another due to staffing issues, and the losing agency did the nastiest things to the nurses and the client as the case went out the door and to the new agency. I was screamed at, yes, screamed at, on the phone by the DON.

Do not let it be known that you "took" the client away from the agency. Never use those words. The client must go to the agency, fire them, tell them off if need be, but leave your name out of it. They have to realize that you have to look out for your interests too and you don't want to burn your bridge with that agency. You never know when you might have to crawl back there, so always be prepared to phrase your departure separately from the departure of that client and the client's case. If they expect you to stay with them when the case leaves, tell them you are not prepared to be unemployed, underemployed, nor are you willing to go to a new case (unless you want to do a shift or two to keep your foot in the door). Expect the worst, but the big joke on that agency is that they drove away the client but they weren't able to take away your livelihood.