Dilemma; small local agency or large national company?

[Chaya, ASN, RN]

I have experience in acute inpatient rehab and in med/surg. I have 2 offers in Home Health companies and I'm trying to decide between a large national agency and a local, single-office agency that has been around many years.

The large agency seems to have better benefits. The smaller one seems to be a little more pro-active in terms of initiating close monitoring to prevent readmissions.

It's hard to tell which might pay better b/c of their different pay structure with regard to hourly pay/ pay per visit.

I'm tempted to assume the larger one might have better back-up when needed but don't know if that's valid. I'm guessing the smaller one may have a more closely-knit team but again, don't really have that much to base that on.

I don't know anyone working at either agency at this time, nor has anyone I've spoken with heard anything negative about either. I got a good feeling from clinical staff I spoke with at both places.

Any thoughts/ relevent experiences on the pro's and con's of smaller/ local agencies vs larger/ interstate agencies?

[paradiseboundRN]

How are you getting paid for each of them? Hourly? per visit? salary? To me, that makes a big difference.

[Chaya, ASN, RN]

One is salaried until you're out on your own, then per case. The other is an hourly salary. Both have a quota for the number of visits per week, differentials according to acuity of task or visit and how long is alotted and a per mile reimbursement. At this time anyway there seems to be no problem getting enough visits at either and the numbers given the expected number of visits are only slightly different and offset by other benefits.

[paradiseboundRN]

Take the hourly salary. Most nurses get screwed on the per visit due to high acuity patients (their visits take longer).

[Aggie RN, ADN]

Having been per visit in the passt, I made way more money than I would have on a salary position.

[Chaya, ASN, RN]

Thanks to you both for your feedback. I went with the larger agency and just finished my first week. Most of my new co-orkers seem to think highly of it. There's a lot to learn but I'm excited-we'll see how it goes!