Dilema: Hourly or Per Visit

Specialties Home Health


Ok I have 2 job offers. The first is PRN at 28.00 hr plus .42 per mile. Call is 60 on weekends, 25 weekdays.

The 2nd is Fulltime, 65 for SOC,ROC, 35 skilled visit, call is 85 weekends, 25 weekdays! Plus this company has computers (laptops for nurses to use)

Which should I take? I worked home health before but was paid hourly. I am kinda scared to do per visit but I think I may be able to make more money. Plus I like the idea of no paper Oasis! Feedback is appreciated!

Thanks Yall

Shelly RN


1,191 Posts

Specializes in COS-C, Risk Management.

Be careful of the promise of "no paper OASIS." I've heard that some of the computer programs actually take longer.

The pay rates would depend on your area, so can't comment to that.


38,333 Posts

I will not do intermittent because I have no desire to be taken advantage of regarding the paperwork that ends up being done on my own time and I don't want to sit around holding my breath waiting for them to give me enough visits to make it worthwhile. Two visits because "the census is low" does not pay the rent. So, I only work shifts for an hourly wage.


214 Posts

i first think it depends on whether you are looking for PRN work or being full time,,,, remember the PRN's are the first to be canceled when the census is low, at least they are at the agency i work at, as the FT nurses have to be full first, and we are per visit, but FT have to meet a quota.

Specializes in Med/Surg, Home Health.

At our agency, it used to pay per hour, then was restructured and we now do it as "pay per visit". We make alot more money with this new system of being paid per visit. But we have no problem with our census. We are overloaded with patients so there is no worry there. I would ask them what the average case load is for each nurse. Here, PRN has no benefits. I never accepted a PRN position because I need insurance and vacation hours, etc.


43 Posts

Specializes in Home Health.


If you don't mind, I would like to know what were your wages per hour compared to per visit? Our company is getting ready to do the switch to per visit rate and they claim we will make more money, but I don't know yet


11 Posts

I wish nurses were more open to talk aout salaries. I work home health and think I made a huge mistake salary wise. I work for a straight salary. I am "on call" for every other weekend and that is included in the annual salary, I am required to work holidays and that is included as well.On call includes any SOC that come in as well as daily wound cares and any emergent prn visits. I am expected to do at least 30 points a week but dont get paid for any above that but I dont get paid less if there is not enough work either which rarely happens. I do not get any mileage either. Is it as bad as I think?


1,191 Posts

Specializes in COS-C, Risk Management.

Yes, Peggy35, it is as bad as you think. While I don't really like the company I work for, I can't c/o about the salary. I get a straight salary that essentially covers my hours from 8-5. Call pay is $25/day for weekdays, $50 for weekend and holiday. If I make visits outside of my required quota, after hours, on weekends or during call, then I get an extra after-hours per-visit rate. Mileage is paid at $0.42 per mile. I will never be able to go back to straight per-visit pay again, it's just not worth it when you're the primary case manager. There's just too much that doesn't get captured in the visit time/rate--all those tedious calls to docs, sending faxes, arranging with DME companies, the minutiae that no one really thinks about.

And a comment about the paper OASIS--I've done both paper and computer and find our current computer system to be absolutely longer and more time-consuming than paper, but it does the job of double-checking for errors. As much as I gripe about the computer system (and all that's wrong with it), I don't think I could go back to all-paper, either.


74 Posts

My agency is currently doing away with the hourly to per per visit., with no consideration for travel time between pts. Currrenty the min pt visits per day is 6. Doesn't sound bad until one figures my territory is a 100+miles a day. I have had to go off the clock to get the charting complete because the policy is "no overtime". Since this implimention Im working 12 hr days...being paid for only 8.

Yesterday was a 118 mile day...3 hours travel, 7 visits; and the district manager wants all work done between 8-5. SOC, avg 2 hrs just to get the new oasis done., forget getting IV or wound vac teaching done!

Is this the way in other agencies?

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