RN told she will now get LPN wages - page 3

I am an LPN and I take care of a child in his home. The other nurse who works with this child is an RN. Mom said that the agency told the RN that if she wanted to continue with this child that she... Read More

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    I remember that thread. Can't remember if I posted on it or what my opinion at the time was. Naturally opinions change as situations change.

    However for both LVN's and RN's in not good practice for Rn's to be forced to take LVN wages. Not only does it dilute the value of an RN but it does the same for a LVN. If they can pay an RN LVN's wages well Lvn's wont seem much of a bargain and LVn's wages will go down

    Lose Lose
    caliotter3 and ArwenEvenstar like this.

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    Most states require that an RN be in management positions in Home Health Agencies. So an LPN as a nursing supervisor isn't even an option.

    I think most people here are talking about field staff positions. I for one would be angry to find out that I was making less than LPN's working the same private duty case. In our state, although the work load is the same, there are still some things that an LPN can't do, that a RN can. I respect the fact that LPN's are quite able and proficient at what they do but that doesn't take away from the fact that RN's went to school longer and have had more education. I'm sorry if that ticks off some LPN'sl
    ArwenEvenstar likes this.
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    And the main point here is that the agency does get more Medicaid reimbursement for an RN than an LPN so they are choosing to keep that for themselves. That is dirty business!

    ArwenEvenstar and Blackcat99 like this.
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    As an Lvn I would never expect to get paid more than an RN. I mean, RNs do have more education than and LVN. More education should equal more pay.

    My brother in law just recently moved to Arkansas and finished his CNA school. But because he is bilinigual, they are paying him more. He called the other day and told me they were offering him 20/hr!!!!! HEEEELLLLOOO!! I worked so hard for my LVN and my BIL is working as a C.N.A and getting paid more than I am?? I was really upset. Not at him, at the situation. I'm very happy for him, but disappointed in my pay. I was tempted to relocate to arkansas myself!!! Heck, if he's getting paid that as a cna, what would my pay be as a bilingual LVN??

    So i understand the frustration from the RN's.
    ArwenEvenstar, Kyasi, and Blackcat99 like this.
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    Update: The RN was suppose to be leaving this job at the end of October. Mom told me today that the RN has decided to not leave after all. Mom said that the RN has now agreed to stay and that she will accept the LPN wages. Unbelievable!!!!
    systoly likes this.
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    Very believable. The RN decided that the possibility of not being employed outweighed the insult to her self respect.
    nursel56 and Blackcat99 like this.
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    Blackcat directed my attention to this thread. I thought I would share my story, but also, I am specifically looking to how to resolve this issue. I want to make the money that I deserve. I have worked hard regaining my license . . . again. In May of 2009, I retook the NCLEX. After much money was invested, I passed with flying colors. I was ecstatic. I immediately went out to apply for a job to recoup the money I had just invested and to start making money for my family. Like many others here in South Florida, I found that the hospitals refused to hire me. You talk about discouraging. Even some of the hospitals here that promised me a job if I ever wanted to come back had become impersonal due to these companies that are hired to filter through the applications. I have so many glowing recommendations and references as well including people on their board of directors. I have a whistle clean record.

    After a year of pursuing a hospital job and getting turned down over and over, guess what door was opened to me? Home health. At first, I was going to do trach patients. But my forte is babies. So I easily fell into a few cases with those and I have thrived working those clients. I love my job! I love these children and it is encouraging to see them recover so well.

    So naturally, you would think that the agency, seeing how well I am doing, would give me a raise. (not) Within a few months, I got a notification from the agency telling me that Medicaid no longer pays for an RN unless the client has a trach, a GT, or other criteria and that I would have to take a pay cut to LPN status. I love my job. I am good at it. I guess somewhere out there, there is an LPN that can handle a preemie with an O2 NC on various meds weighing 5 pounds and do her job as well as I can. I would like to meet this person if they exist. I have a friend whose son ended up with a hypoxic episode during his home care. These children are not as easy as they look. On several occasions, I have had to act to prevent them from aspiration etc.

    Anywho, I took the pay cut. I had no other choice. I would have loved to have said, "Take your job. I can make more money over here." But you see, there was nothing like that for me. I am making WAY less than $20/hour right now.

    Even as we speak, I can see on one of the hospital web sites that there is a job opening for the nursery at this hospital that holds a monopoly in our area. If I submit an application, I am sure to get a computer letter stating that there are other candidates more qualified. How do you fight something like this? I know I am more qualified than anybody they could possibly have but how do I get them to see that? Do you take someone from the EEOC to the hospital to make them reconsider? Then what? I feel like I would be cutting off my nose to spite my face in that case. How hard would it be for them to find something to fire me over at the end of the day? I want them to welcome me with open arms not feel pressured to hire me. . . or I want the agency I work for to pay me for the work I do. My other question is that after a year of working with the HHA, will the hospital reconsider hiring me?

    If Medicaid is truly paying $35/hour for my services, is it possible to force the agency to compensate me for the work I do? Are they really getting LPN wages for my time? I think one thing to consider is the fact that each case has a case manager that does the paperwork. So that may be where the agency is having to direct some of this money or are they compensated for that as well? Plus, like you said there is office staff, equipment, office rental and many other expenses to running a business. I am sure some of that money goes toward that. Still, I would like to make the kind of money an RN is supposed to make. From what I can see on this board, there are plenty of RNs in home health that are making that kind of money. I am all ears.
    Blackcat99 likes this.
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    I have almost 20 years experience in nursing and my employers think that is good reason to pay me $5 less an hour than I was previously getting, while maintaining employees at $1 an hour more than me that they hired right out of school. I am actively looking elsewhere for employment. I am certain the present employer won't notice I am gone because they don't notice me enough to keep me working at even the low rate.
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    Caliotter3- I am sorry to hear that your employer is treating you so badly. It's bad enough that they give you a low pay rate but they don't even give you enough hours either. I hope you will find a better job soon.
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    Quote from Kyasi
    Below I've copied and pasted a post I made on Medicaid reimbursement a while back. While no company can afford to pay the entire reimbursement they get because there of office overhead, state mandated supervisory and reassessment visits, Start of Cares etc., you can see that there is still plenty to cover that without cutting the employee wages. My agency would never ask a RN to accept LPN wages or a LPN to accept HHA wages. I'd find another agency to work for! Sometimes these things are a sign that it's time for a change. Don't short change yourself!


    I would say the biggest money maker for a Medicaid agency is Prior Authorizations where the per hour reimbursement is $18.34/hr for a HHA, $25.01/hr for a LPN, and $37.36/hr for a RN. I'm sure this varies from state to state. The biggest reimbursement is the 'overhead' where they pay $34.30/day of service. So if the agency is paying roughly $9.50 - $10.00/hr for a HHA, $17.00 - $18.00/hr for a LPN, and $22.00 - $23.00/hr for a RN, you can see the profit.

    So an example would be: let's say we provide a HHA 10h/day, 7 days per week. Reimbursement will be is $1,283.80 + overhead $240.10 = $1,523.90/week. If the average HHA pay is 9.75/hr, the pay out is $614.50/week. Toss in there minimal benefits and a very small travel reimbursement and you can see in a years time that there is a big profit. But then you do have to take into account the nursing staff who does the paperwork to obtain this funding and who do the needed start of care and follow-up visits with the clients. That's what the overhead pays for. But obviously, there is profit or the company would fold.
    Your numbers are spot on for my area.
    Blackcat99 likes this.

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