RN told she will now get LPN wages - page 4

by Blackcat99

6,645 Views | 39 Comments

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 would now only get LPN wages.... Read More


  1. 0
    Quote from systoly
    Your numbers are spot on for my area.
    I would be thrilled, at this point, with $22-23/hour.
  2. 2
    Quote from Luv2care0907
    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.
    I was very surprised to return to nursing and find things drastically different from what I expected they would be, too. The market is just so horrible now for everyone. New grads have the worst of it, but it certainly isn't confined to them. It's as if any time elapsed before you want to re-enter the workforce, even if you had lots of acute care experience prior to taking time away, they treat you as a nurse with no experience.

    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.
    You are going to find that raises in home health are few and far between right now. I am at this point thankful my pay has not been cut as I'm pretty sure new hires are making quite a bit less than I am at the moment, but I don't talk about my wages with anyone. I'm an LVN and I take care of trach/vent patients. Lots of babies have trachs and vents, too. Is your agency large enough that you could ask to be paid the RN rate for those?

    As an RN you may also be able to transition into a case manager role in the same company. Or do "visits" in home health that are paid per visit instead of an hourly rate.

    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.
    I've worked in peds ICU stepdown and in the NICU - only mention so you won't have to keep looking.

    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'm not familiar with the EEOC regulations regarding the hiring process. Do they get involved in the issue of qualifications for individual jobs? I always thought you had to prove they had an established pattern of only hiring one ethnicity or age group or physical attribute - things like that. It's incredibly frustrating to see so many obviously qualified people unable to get a foot in the door! What a waste of talent! I only hope the situation starts to improve very soon. I hope you finally make it into the job of your dreams. In the meantime - it sounds like you've really bonded with the super little tykes and found a niche you love. That in itself is such a good thing as we're bombarded so much with stories from nurses who don't seem to like anything about the job anywhere. I hope everything will work out for you!
    elizabethgrad09 and Blackcat99 like this.
  3. 1
    Quote from nursel56
    Lots of babies have trachs and vents, too. Is your agency large enough that you could ask to be paid the RN rate for those?

    As an RN you may also be able to transition into a case manager role in the same company. Or do "visits" in home health that are paid per visit instead of an hourly rate.
    Thank you for your kind reply. Actually, Medicaid does pay RN wages for clients with IVs and trachs. I am not being critical at all here. I appreciate that you are experienced and are well versed on those things. However, the older school LPNs can handle the tougher situations. I doubt a new grad LPN is the same. Yet, no doubt because of folks such as yourself who are great nurses and others like you, Medicaid states that an LPN is all that is necessary for home care. I would like to see an LPN do what I do or even what you are saying you do.

    I may be able later on to be a case manager. Yes.
    Blackcat99 likes this.
  4. 1
    You're right. I probably wouldn't be hired as an LVN at the places I've worked at in the past, say from 1975-85, and I feel fortunate indeed that I was able to work in those specialty units. If I was starting today I would probably go for the RN right away because of the broader choice (assuming the job market ever picks up anyway!)
    Blackcat99 likes this.
  5. 1
    Interesting... I am the Nursing Supervisor of a Medicaid only agency in the Midwest and I have seen none of this. We provide care to children with Prior Authorizations and Medicaid Waivers for Respite Care. RN's are reimbursed with RN rates and LPN's with LPN rates. No criteria exists in my state regarding trachs, vents, etc. Is this something others are seeing also?

    Kyasi
    Blackcat99 likes this.
  6. 1
    Quote from Kyasi
    Interesting... I am the Nursing Supervisor of a Medicaid only agency in the Midwest and I have seen none of this. We provide care to children with Prior Authorizations and Medicaid Waivers for Respite Care. RN's are reimbursed with RN rates and LPN's with LPN rates. No criteria exists in my state regarding trachs, vents, etc. Is this something others are seeing also?

    Kyasi
    This is one of the reasons that I have been posting here. I want to hear if this is a truth. I want to hear what is happening to other people. For example, do other RNs have this same experience? Does Medicaid work from state to state differently? Is that a possible reason?
    Blackcat99 likes this.
  7. 1
    I hope that this isn't a trend because I have quite a few top notch RN's working on cases that are not what could be considered 'high tech'. It would not benefit the agency choose to use LPN's only because they are reimbursed accordingly. The reimbursement rate is higher for RN's but so is the pay rate I have to pay them. So in the end, it shakes out the same.

    Kyasi
    Blackcat99 likes this.
  8. 1
    I am an LPN who gets reimbursed thru Medicaid - & the case I have does NOT pay for an RN - so I can only assume if an RN wanted the case they'd get LPN pay. The case is comparatively easy.
    Blackcat99 likes this.
  9. 1
    Quote from Lisa1203
    I am an LPN who gets reimbursed thru Medicaid - & the case I have does NOT pay for an RN - so I can only assume if an RN wanted the case they'd get LPN pay. The case is comparatively easy.
    Agencies who pay RNs more than they pay their LPNs to work the same case, make up the difference from their operating revenue. Not unheard of.
    Blackcat99 likes this.
  10. 1
    i am a private duty rn in wisconsin working for medicaid/badgercare. for the last year, we have been hearing rumors of budget cuts. they already cut out the few hundred bucks extra a month for the case coordinator.

    we are able to work no more than 12 hours/day, 60 hours a week. there has been talk that if you are an rn, you will be paid the standard $30+/hour rate for up to 8 hours but if you work a 12 hour shift, your pay will go down to $20+ (lpn wages) for the final 4 hours of the shift. i certainly hope that this doesn't come true but its been rumored for about a year now. its bad enuf they took away coordinator reimbursement. that's alot of paperwork!!

    us rns do get the same standard pay rate for vent as well as non-vent patients.

    does anyone know where to look online to find out what's really going on and the truth behind what budget cuts are in store for us? again, i live in wisconsin.
    Blackcat99 likes this.


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