Are nurses required to do HHA visits in your agency?

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We have new administration in our agency and they are making the nurses pick up the overflow from the HHA's. Does any other agency do this? I question whether they can make us assume the role of another discipline. I have worked for this agency for 3 years and have never had to do this.

Yes, I have been exploring other options I'm just one of those people who get comfortable in a place and don't leave even though I know I should. I always think, it COULD be worse... I at least have a job.

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Yes, I have been exploring other options I'm just one of those people who get comfortable in a place and don't leave even though I know I should. I always think, it COULD be worse... I at least have a job.

Could you please remove the name in the post? I changed my username because I was dumb enough to use my real name!

OMGosh! Will fix now.
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Specializes in Home Health, Case Management, OR.

Since I come from a very small agency, I completed both the RN and HHA visits for my pts. I was paid my RN rate for both. We now have grown enough that we have hired an aide. :-) My pts liked that it was me that helped them bathe as they knew me and it was one less person to have to lose modesty to.

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Did you ever have problems keeping the jobs separate? According to our agency both jobs can not be performed in the same day. I used to shower a lady in the AM then give her PM insulin, but they said that was against "Medicare" rules. I guess it could be different for different insurance agencies.

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"When you are working as a HHA, you are not working "below your license." Part of your training as a nurse is to assist patients with ADLs and personal care needs definitely within your scope of practice. Instead of feeling insulted, try looking at what you get out of it. How they pay you is another story. You are required to act to the level of your training and education. They should be paying you for what you know, not what you do."

I am in agreement with Karen. Every one of use have been trained in Nursing 101 how to bathe a patient and yes it is well within our scope of practice to do so. When I was in the role of Supervisor, I went out to provide personal care to patients because of a lack of staffing and enjoyed every minute of. I didn't think of it as being beneath me to do so. (The patients were impressed the Supervisor came to see them and even chuckled when I ended my visit with more powder on me than on them! They couldn't wait to tell their nurse about it.)

Nursing is a broad spectrum profession.....we wear many hats.....and that of a HHA at times is one of them. Agencies should pay their staff according to their position for any care given. Agencies who pay their nurses an aide's hourly rate for a HHA visit are looking at it from a reimbursement perspective as opposed to an obligation persepctive.

The committment was made to provide HHA services and an agency must meet that obligation.

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Specializes in COS-C, Risk Management.

I am not aware of any Medicare regulation that prohibits skilled nursing and home health aide visits being conducted on the same day, nor any that prohibit the same person from conducting both visits. The only caveat is that you have to have separate visit times for both. Just as when seeing a husband and wife in the same house at the same time, I would divide the time in half and document accordingly. So if I was there from 1130 to 1330, I would document 1 hour for skilled nursing and one hour for HHA visit. The skilled nursing-appropriate assessments, teaching, etc would be documented on the skilled nursing note and the personal care would be documented on the HHA note.

There may be some obscure regulation somewhere, but I have read every condition of participation at both the state and federal levels, every G-tag, and I've never seen anything to prohibit this. Doesn't mean it's not out there, but if someone knows where it can be found, I would be happy to bookmark it and add it to my list of resources. :)

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It could be an agency rule. I was doing both for a while before I was told it wasn't allowed. Could you link me some info on Medicare regulations for home health care? I've been told so many different things from time to time that I'd like to read it myself, but never knew where to start.

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Hi Kate. I know this convo happened in 2017 but I wanted to reach out to you to see if you ever heard any different regarding the above. We use to have an LPN do all our baths now RN's are doing all our aide visits. So if a nurse goes for the skilled and aide can we just separate those times to 2 separate visits? I was told here that we can no have the same nurse do both visits but I cant find anywhere in the regs that is says that. Any info would be great.

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