Home health nurse compensation

caliotter3 · Apr 13, 2021

If your wife is doing three 12 hour shifts versus x number of ‘visits’ in one work day, she is being paid an hourly rate. Each agency sets their own wage scales, often based on how gullible the prospective employee comes across, how new or naive they are, and lowballing, depending on people being desperate for work. Good paying agencies are known for being pretty well-staffed from the local workforce, so it can be harder to get work from them. Medicaid patients will usually garner approximately one half the Medicaid rate of reimbursement: look at ballpark $44.12 reimbursement yielding $22 an hour, give or take, for the nurse. Cases with patients paying out of pocket and/or private insurance will pay more per hour. Getting the paperwork to the office is on your wife. Some agencies provide self-addressed, stamped envelopes for nurses to mail in notes. Others accept faxed notes for weekend shifts to make payroll with hard copy to be mailed immediately. She can provide her own envelopes and stamps. Or she can drive to the office. Her choice. Typically the agency demands that nurses provide their notes within 48 hours of completing the shift and may have a weekly deadline to make payroll. I would mail two days of notes on a set schedule when working full time. Only drove to the office if I had to. HMMV

Nunya, BSN · Apr 16, 2021

I would check with the Dept of Labor. I couldn't find anything about this specifically but I remember that sometime didn't get paid for travel time in between patients and that's illegal. It seems that if it's required she drop off notes in person then that's part of the job and she should be paid, however, they may consider travel time not reimbursable, as it only takes a few minutes to actually drop off the notes. As noted above she should check and see if she can mail/fax/email notes in.

truckinusa, BSN, LPN, RN · Apr 17, 2021

9 hours ago, Nunya said:

I would check with the Dept of Labor. I couldn't find anything about this specifically but I remember that sometime didn't get paid for travel time in between patients and that's illegal. It seems that if it's required she drop off notes in person then that's part of the job and she should be paid, however, they may consider travel time not reimbursable, as it only takes a few minutes to actually drop off the notes. As noted above she should check and see if she can mail/fax/email notes in.

Thank you for the information. Got her first paycheck and lots of problems. Hopefully, they get straightened out. Especially the incorrect pay rate that was agreed on. One more quick question. Can the family lock you out of being able to adjust the thermostat? It just seems odd, but maybe nothing you can do about it? Not really sure how to handle that one. I told her if the patient is physically cold she should have the ability to adjust things if nobody is home. My wife can just put on a sweater or whatever.

Kitiger, RN · Apr 17, 2021

I would not adjust the thermostat in a client's home unless I had their permission to do so. In my client's own home, he can have the temperature where he wants it. The nurse can wear warmer clothes.

Of course, if the nurse is too cold, he/she doesn't have to work there. If the client keeps the house so cold that nurses won't come, a compromise might be needed. There are always consequences, good and bad. I would work there if the temp was 68 or even 66. But if he kept it at 55, I'm outta there.

truckinusa, BSN, LPN, RN · Apr 17, 2021

44 minutes ago, Kitiger said:

I would not adjust the thermostat in a client's home unless I had their permission to do so. In my client's own home, he can have the temperature where he wants it. The nurse can wear warmer clothes.

Of course, if the nurse is too cold, he/she doesn't have to work there. If the client keeps the house so cold that nurses won't come, a compromise might be needed. There are always consequences, good and bad. I would work there if the temp was 68 or even 66. But if he kept it at 55, I'm outta there.

The specific situation is a foster child that has no ability to mess with temperatures since they are wheelchair/bed-bound. They also do not speak or make any intelligible communication. Family is gone most of the time and password locked the thermostat. It a brand new home so everything is under warranty and no worries about breaking anything like that. Its just super cold. I haven't been able to asked where it was set exactly. I think a reasonable range of 65-80 is just something you have to deal with.

Kitiger, RN · Apr 17, 2021

You could bring in a thermometer to check the temp. Is the child comfortable?

Are you working days, when you could do more range of motion exercises? Depending on the size and strength of the child, this type of exercise can warm me right up!

Of course, I'm a hot body. I carry my own rain forest with me! So my difficulty is when the house is too hot.

caliotter3 · Apr 17, 2021

I warn client families when I meet them that I have temperature limitations for medical reasons. If they can not or will not adjust so I can withstand it, I just move on to another case. Your wife can, and should, speak to them about the temperature. If a compromise can not be agreed upon, she should change cases with the agency. Under no circumstances should she change the thermostat without their permission. And in some cases it could be said the agreement should be in writing, because some clients will turn around and directly contradict original instructions given.