Considering Job Change To Hospice. Need Information!

nursenetto · Nov 3, 2005

I am currently a Director of a Hospice, will soon become the administrator. I went for Administration in CM to hospice and love it. My case managers are required to manage the entire case, oversee care, manage the HHA and volunteers in addition to keeping both the medical director and/or the pts primary care MD informed. I am familiar with Vista Care in Georgia - I was offered a position with them. I declined due to the negative information I was getting. A good friend of my is a director with them, and I will tell you this.....where ever you go the management is key. The Executive director/Administrator makes or breaks an office (anywhere you go) The company policies, benefits is info that should be readily accessible to you, however, how the office is managed, the philosphy and management style of those you report to directly is key.

We here at Hospice Advantage started this office in GA because of the reputation of Hospice RNs being overworked and underpaid. Our goal is to make the staff comfortable and they will take care of our patients. As an example....our CMs hold no more then 15 patients at a time. THAT is incredible...and I wouldnt have it any other way.

Good luck.:balloons:

doodlemom · Nov 3, 2005

I am currently a Director of a Hospice, will soon become the administrator. I went for Administration in CM to hospice and love it. My case managers are required to manage the entire case, oversee care, manage the HHA and volunteers in addition to keeping both the medical director and/or the pts primary care MD informed. I am familiar with Vista Care in Georgia - I was offered a position with them. I declined due to the negative information I was getting. A good friend of my is a director with them, and I will tell you this.....where ever you go the management is key. The Executive director/Administrator makes or breaks an office (anywhere you go) The company policies, benefits is info that should be readily accessible to you, however, how the office is managed, the philosphy and management style of those you report to directly is key.
We here at Hospice Advantage started this office in GA because of the reputation of Hospice RNs being overworked and underpaid. Our goal is to make the staff comfortable and they will take care of our patients. As an example....our CMs hold no more then 15 patients at a time. THAT is incredible...and I wouldnt have it any other way.
Good luck.:balloons:

15 patients!!!? Our hospice rarely has us see more than 12-14 unless we have a bunch of patients at one nursing home. The nurses on the home team see no more than 10-12. Even 10 patients can be sometimes be hard if the acuity is high. I've been working as a hospice CM for almost 10 years and it used to be that 10-12 patients was the golden standard until all of the competition from the for-profits came into play. Things have changed a lot. I used to work for another non profit in another state and they are still using the 10-12 max. Do you have prn nurses helping out with 2nd and 3rd visits? Before you went into hospice administration, did you practice as a hospice CM? Your nurses manage the volunteers, as well? We have a volunteer coordinator who manages ours and the volunteers call us with updates but we don't manage them. Our hospice is a non profit and we are managing to run in the black without any problems, so I don't foresee our board and administration going in the direction of cutting back staff and quality of care. If a hospice is managed well, there is no reason to have staff overburdened with patients.

doodlemom · Nov 4, 2005

I am an RN, and have worked in a Nursing Home for almost 2 years now, and I am considering changing avenues to become a Hospice Nurse. Would like to know if any one can tell me what the starting pay is for a RN working at Vista Care would be, and also what the duties of the RN case manager would be doing? What kind of training would a new RN case manager have? We have Vista Care where I live and I would like to know as much as possible about being a Vista Care RN case manager. Any and all help is appreciated.

I think that the starting pay depends on the city and state you live in. Hospices in large cities with a higher cost of living receive a higher rate of reimbursement from Medicare for their services - therefore their employees get a higher salary. VistaCare is known for their higher salaries and their good vacation and healthcare benefits. Depending on who is running the office that you will be woking out of and how high their census, the quality of your work life could be really good or really bad. The higher the census, the more likely they will not need you for much on-call. Hopefully the hospice that you go to has a good deal of initial training in symptom management and end of life care. You should have a preceptor that you go out with until you feel comfortable going out on your own. Also, you should have support at the office for you to be able to call on to answer questions and for help. Good support is important, because when you're out there, you're alone.

Depending on where you work, a case manager would handle most aspects of the patient's care. You would manage the CNA's care of the patients and they should report to you any noted changes in pt's status, skin, etc...You should be able to request a volunteer, if appropriate - and hopefully the volunteer will keep in touch with you. You are responsible to obtain any orders necessary from the pt's physician to manage their care. You are responsible to keep the physician updated - usually this is done during the hospice IDT meeting (interdisciplinary team). You would also be reponsible for keeping the rest of the team updated on the patient. If you feel a patient needs more visits from the SW or chaplain, you should be able to request that. The hospice team should be truly interdisciplinary - working as a team to take care of all of the patient's needs, whether it be spiritual, psychosocial, or medical. Hospice can be really rewarding work - so good luck to you.