HH worth the pay?

[KalipsoRed21, BSN, RN]

I work in Illinois around the STL region. My agency pays hourly, gives us a car and gas card. We work on a point system 3 SOC, 2 Resume Care, 1.5 Recert, 1 regular visit. I do have some exceptions in there like my 3 hour IVIG visit counts for 3 points.
I’ve been doing this for 2.5 years now....no lie an SOC in my agency takes 4-6 hours to complete. Most regular visits I can do in an hour, but I have quite a few patients with IVs and wounds and I can’t quite get those charted before time is up. I drive 50-75 miles a day. I am responsible for 6 points a day. And while from reading other posts I feel my company must be pretty fair because I get to charge for ALL the hours it takes me to chart, my goal for taking the job was to be on days and to only work 8.5 hours a day. Like there is rarely a time when I am not spending the first 6-8 hours of my weekend catching up on charting and managing my patients (we keep 20-30 patients) or working 12 hour days every day so I can have a weekend. I really find this unacceptable but from the looks of other posts most homecare agencies don’t pay you for all your time worked AND you are putting the hours I describe. That is really crazy. I do not want to work more than 40 hours a week. Any suggestions?

[caliotter3]

I found that I lost money when I did visit home health but extended care is just eight hours pay for an eight hour shift. No work at home, follow-up, or getting ready for the next day's visits, no driving around the countryside, etc., etc. Same chance at getting problem patients/families, but that can occur anywhere. Big plus, near same pay for one patient for the eight hours instead of being responsible for dozens, or even an entire facility. Can't argue with that aspect.

[KalipsoRed21, BSN, RN]

3 hours ago, caliotter3 said:

I found that I lost money when I did visit home health but extended care is just eight hours pay for an eight hour shift. No work at home, follow-up, or getting ready for the next day's visits, no driving around the countryside, etc., etc. Same chance at getting problem patients/families, but that can occur anywhere. Big plus, near same pay for one patient for the eight hours instead of being responsible for dozens, or even an entire facility. Can't argue with that aspect.

Interesting, what is extended care? Like private duty?

[caliotter3]

Shift work, some call it private duty. Won't get into the argument about what to call it. I was taught that true "private duty" is shift work that is paid for by the client him/herself.

Most criticize extended care because they say you will lose your skills. Well, you can lose certain skills in every area of nursing your choose. It is just a matter of learning or relearning stuff when you change. You have to do it anyway. Drawback to extended care is that it is routine care for stable patients and almost all of it is reimbursed at the LPN level. Many agencies will force an RN to take LPN wages if they want to do this kind of work. However a good agency will pay an RN higher than they pay the LPNs to work on a case. Some would take the lower pay as OK since they only have one patient to take care of, normally in an environment that is usually very much lower in its stress level.

[KalipsoRed21, BSN, RN]

Huh, I had no idea that insurances paid for 24 hour care! Do agencies that hire for this kind of work call themselves home health too?

[caliotter3]

Yes. The agencies are known as 'home health' or 'home care' or 'healthcare' agencies. Some offer both intemittent visit work and shift work. Some only offer intermittent care. Some also will do staffing for say, long term care facilities or hospitals.

Insurance has gone away from 24 hour care. Most cases are only staffed for one or two shifts a day nowadays.

[aspiringrn1987]

My agency is a little bit abnormal but they done use a point system and count SOC just like any other visit. We are supposed to do 6 total visit a day, 3 SOC and 3 follow up. They often will schedule 4 or 5 SOc in a day and then fuss if you don’t want to do them all. But then also fuss if you accept them all but can’t cover all the follow up visits ??‍♀️. The pay is worth it though. If you put up with that crap you’ll make 6 figures. Of course it’s totally unreasonable. There are a few nurses that don’t have children or seemingly any life outside of this job that enjoy the pay. 
 

myself I have a special needs child that requires therapy and appts that I have to manage and my job is not accommodating so I may be reconsidering, despite the easy ability to bring in $400-500 per day based on the amount of work they schedule.