Home care pay

[LauraRn]

I work as a case manager for home health, I do recerts, starts of care, SNV. We get paid hourly but we are capped at an hour and a half. So if I work 2 hrs in home an chart on this person later for 2 hours I never get paid more than 1.5 hrs. That’s wrong Isn’t it!?? What can be done about this if it is in deed wrong. I’ve ask management for us to be paid for the work we do they said they can’t afford this. ?

[pmabraham, BSN, RN]

I would be reporting this to the labor board. This sounds illegal.

[DallasRN]

It does sound illegal, agreed, but I found that to be the case (similar case) at three agencies I worked for and that is the exact reason I left home health care and will never do it again. I'd work at Walmart before home health.

These agencies want to pay you 2 hours for an OASIS. Well, maybe 1 out of 5 can be completed in 2 hours, but most will take longer. Some considerably longer. The last one I did I spent about 5 hours! Pt just home from hospital, in an apartment that boarded on "hoarding", medications scattered all over..."just look in that little box in that bookcase" after you moved the sofa, the cat litter box...to this day I don't know if I located all the meds. She was in a recliner but up to the commode multiple times during the time I was there, friends calling on the phone, the cat had to be fed...wounds not reported at time of referral (back to car for wound care supplies/waiting on call from physician, etc)...on and on it went. Then the hour + drive home in traffic, almost 3 hours of charting (which included trying to get in touch with providers) and they wanted to pay me for just 2 hours.

Personally, it wasn't just the pay that did me in but also the fact that I rarely completed a visit feeling like I did a good job. Always in a hurry, having to get to the next pt, having to get to office for clinical conference, never-ending phone calls from patients, office, providers, calls all weekend and into the later hours of the evening. Having to use my phone, my computer, printer (toner/paper)...home health was exhausting and expensive. For me.

One more comment: IMHO, because of the reasons I listed and others have listed in previous posts, many of these companies can't keep nurses. Therefore, they hire whoever walks through the door - some of whom I wouldn't want to take care of my enemies (I did meet some great nurses but they are no longer doing home health - tells you something). Until these less than stellar and lazy, corner cutting nurses are eliminated from agencies, nothing will change other than agency owners raking in more and more $$'s.

[davebigs]

Which state are you in? I work in home health in California and that would be illegal here.

[DallasRN]

Texas.

[LauraRn]

How you describe it is just how they pay me and just like you described it’s working before work, during work, after work, doctors call me on my day off, the offices call me when I’m off. I chart for hours and hours and don’t get paid for it. I live in Ohio.

[GapRN]

Federal law says they gotta pay for time worked (in your scenario) plus OT for > 40hr/week. In California OT is also for > 8hr/day. There's case law that found BECAUSE we get paid hourly for weekly meeting that even if we are paid per diem we qualify for overtime SO KEEP TRACK OF ALL TIME WORKED. Your emloyer will try to say you are an exempt employee but this is incorrect. I talked to a labor lawyer who said A) I'm right and B) it's not enough $ for anyone to take the case even if I'm willing to take a loss for the principle! BUT I have gotten payouts from a couple of past jobs after a class action law suit.

You can claim unpaid wages for 2 years. The most profitable course (other than leaving HH!) would be to document time carefully, including time spent documenting till midnight and that 6th day on call every other week, and then sue them yourself after 2 years. And make sure you don't get trapped in a class action law suit.

In our data rich industry the medical documentation software could track all this pretty easily. All we really need is a government that gives a flying-enema about enforcing labor law.

[DallasRN]

GapRN, thanks for reply and I know you're right, but trying to keep up with all of that time can become exhausting in itself. (Sitting here documenting on A, Dr. calls about pt D, hang up and call D, office calls about new admit...now where was I???)

Maybe not everywhere, but here in Texas it seems to be a cluster. Admittedly, I don't have much HH experience but even nurses that have been in this specialty for years seem to struggle.

And your last line..."Am we need..." Amen!