Finding a following MD

[aspiringrn1987]

I really just have to know if I’m being gaslighted by this company. Because they keep telling me this is how it’s done in the city where I just moved, but I’ve worked for 3 agencies in the past and never been required to perform so much work for free or so many administrative duties. I’ll preface this by saying my company primarily accepts managed care plans that require continuing auth for everything we do.

So first off, if I have an SOC, I have to confirm the following MD. As in, we have no idea who it is, I have to track them down based on the patients statement of who their pcp is and get them to verbally confirm they are following the POC. If the patient hasn’t had a F2F or has no pcp, I then have to do all the leg work of coordinating with the liaison and patient to send a mobile MD so that they can follow the patient for the POC.

additionally, if I am assigned an SOC and the patient doesn’t discharge on time from the hospital, I’m responsible to continue to follow up and coordinate with the patient/hospital/facility/case manager, obtain delay orders, etc. some of these patients never end up being admitted after I spend an hour or more working on the case for which I am not compensated in any way. So I make no money to perform that work. We are a large agency with an intake team who I’m told doesn’t do any of these functions because once I accept the patient it’s my responsibility until they are either admitted or a nonadmit, at which point I make $0 for anything I’ve done.

It’s also a big monumental issue every time I am assigned an SOC on a Friday who doesn’t discharge from the hospital as expected. I either have to see them on Saturday or “get permission” from the clinical manager to have the patient reassigned. Why would I need permission not to see a patient on my scheduled day off? It’s very strange to me. Most of these things were functions of the intake team or liaison in past agencies I have worked for.

How can I be asked to continue to follow up and perform administrative duties with no pay for SOC that don’t work out or fall through?

Am I totally losing my mind or is this not normal?

[starmickey03, MSN, RN]

None of what you described is normal. I have only worked with two HH agencies but neither have required me to follow patients while they are hospitalized (especially if you’re paid per visit and NOT salaried). The intake dept and liaisons/marketing dept is responsible for that. The following doctor is also finalized by them when they accept a patient. If your schedule is full time M-F, then no, it’s not your responsibility to see patient on the weekend. That should be the duty of the weekend nurses or on-call nurse if the agency doesn’t have weekend nurses. Honestly, I’d move on if I were you.

[NRSKarenRN, BSN, RN]

Your scheduling department/marketing team should confirm patient home prior to assigning case to the SOC nurse--thus avoiding not discharged/unable to locate. I always followed up on patients assigned to me + tracked whereabouts so they could return to my care. However, we were paid flat rate $15-$25 for these efforts.

[caliotter3]

Sounds like this agency is saving the cost of a salaried office person by making you do some of their duties to start the case. Something tells me that down the road you will find yourself responsible for more and more, anything and everything, particularly when they need someone to blame if a ball gets dropped. You probably should look for an agency that is more 'normal'. Reread your second to last paragraph. No. If the SOC does not work out you still did the work. Same as a salaried intake/liaison/marketing employee. They get paid for their work. What do you think the Labor Board would say about this? Move on. This is not worth starting a war with the employer about their employee cheating ways.