Home Health Nurse pay??

old&improved · Sep 20, 2019

I haven't done home health in many years, but when I did (per diem) I was paid a set amount for visits and much more for intakes (admissions) because they took a lot more time and I was paid an amount per mile since I had to use my car. If I were you I'd do as I did and start with per diem on days off and see if you like it. One thing full timers complained about was how they could not complete their charting and visits in an 8 hour day. They ended up taking their work home and completing it there, but they weren't paid for it. You're also expected to be on call and how often depends on how well staffed they are. Generally, you make less in home health than working in a hospital.

Silverdragon102, BSN · Sep 20, 2019

Moved to the Home Health forum

Queen Tiye, RN · Sep 23, 2019

You can go to Linked in or Glassdoor to see how much nurses are averaging at any HHA. I looked at one pediatric hha and the average RN earned $40-50/hr.

DAL2010 · Sep 24, 2019

Former Home Health. Enjoyed the work. Could not live on the pay. Paid per visit: $30 regular, $45 admission/recert. Recerts are every 3 months. Medicare/Medicaid require 60 minute visits. Private insurance 45 minutes. So, while a company may say $40-50 per hour, I never saw anywhere near that because travel time is your own (some companies pay mileage - mine paid less than the Federal Government allowed, so I filed my miles at tax time). The amount of work taken home can be a lot - requiring paperwork before leaving in the morning and after getting home at night. I was required to use my personal cell phone - which meant patients/families had my phone number (I've heard some companies give out company phones). I had a 20 patients a week, with most having weekly visits, occasionally two for wound care. That was less money than I'd made as brand-new grad on Med Surg. I went back to hospital nursing to make more money and have my time off really be time off.

Numbers could vary a lot based on geography and agency size. I was with a small agency and lived in the Midwest at the time.

Queen Tiye, RN · Sep 24, 2019

2 hours ago, DAL2010 said:
Former Home Health. Enjoyed the work. Could not live on the pay. Paid per visit: $30 regular, $45 admission/recert. Recerts are every 3 months. Medicare/Medicaid require 60 minute visits. Private insurance 45 minutes. So, while a company may say $40-50 per hour, I never saw anywhere near that because travel time is your own (some companies pay mileage - mine paid less than the Federal Government allowed, so I filed my miles at tax time). The amount of work taken home can be a lot - requiring paperwork before leaving in the morning and after getting home at night. I was required to use my personal cell phone - which meant patients/families had my phone number (I've heard some companies give out company phones). I had a 20 patients a week, with most having weekly visits, occasionally two for wound care. That was less money than I'd made as brand-new grad on Med Surg. I went back to hospital nursing to make more money and have my time off really be time off.
Numbers could vary a lot based on geography and agency size. I was with a small agency and lived in the Midwest at the time.

Peds home health is different. You can have one full-time case, work part-time, or combine 2-3 cases to get full-time hours and have variety.

totallackofsurprise · Oct 11, 2019

I have been doing HH since May and I am looking for another FT hospital or ambulatory job because I can't live on this money, as another previous respondent said. I really love the work itself... but I have bills and rent. I didn't expect my income to drop so severely. Did not expect that at all.

My agency pays per visit. (That's standard AFAIK). $60 for admission; $55/regular visit for Medicare; $50/regular visit for private insurance.

I do not get reimbursed for mileage.

I don't get paid for travel time.*
I do not get paid for all the time spent on paperwork & computer charting.**

No matter how much time a patient visit takes, I only get paid the flat per-visit pay.***

I was told all home visits must be a minimum of 45 minutes. OK fine. One day, they tell me most of the HH RNs handle 8 patients per day -- and their best HH RNs have 12-14 visits per day. I didn't say anything... but I thought, "Well, then either all 12 patients live in the same building or on the same block, or she travels between patients in a hovercraft doing warp speed."

Or maybe she works a 16 hour day. But I doubt that; most of my coworkers seem to work HH as a second job -- most have another FT job. (I understand why, now!)

So, most likely, her visits to all 12-14 patients in a day are not the 45 minute minimum. Because if you do the math, add in moderate travel time... it's just not possible. Laws of physics apply, lol.

I'm pretty bummed out. I was really looking forward to HH care. But I just can't live on what I'm making, and as the newest team member, I don't get the preferred patients or the patients in a good grouping, location-wise. Mine are spread ALL OVER. Literally from one airport to the other.

But what can you do. Gotta eat.

~ ~ ~ ~ ~

* I can spend nearly 2 hours going only 10-12 miles between 2 patients (because everything outside that sweet spot of 10am-2pm is rush hour). I get no pay for those 2 hours -- and I also can't use that time to see other patients, because I'm trapped in my car going from Patient A to Patient B.

**The amount of paper is incredible. Everything is duplicate (patient copies, agency copies). Then redundancy in charting: everything on paper must also be entered into our HH e-charting software. Which is the worst e-charting software I've ever used. Which is actually saying something. My agency does not provide laptops to bring to HH visits. Even if they did, they would still want paper copies of every thing.

** If I have a patient with 4+ packed wounds with wet to dry, and I have to change them all plus educate/reinforce the patient/family about proper care, toileting, dressing changes, I could be at that patient's house for 2-3 hours... But I get paid for just. one. visit. And those 2-3 hours spent with one patient is time I can't see other patients.

GapRN · Oct 11, 2019

Home health give you 2 options:

1) Do your job well, DC patients with goals met who can take care of themselves, and enjoy a fulfilling pt care experience helping people. But you don't get paid much. Labor law does not seem to apply and each bit of work you put in just cuts into your hourly pay in the pay-per-visit model.

2) Run around doing VS and collecting pt signatures as fast as you can. Unload complex wounds and other visits that require actual time consuming labor on unsuspecting co-workers. Create fraudulent documentation about patient education that you didn't really do. Pull down $120 K and don't worry too much about you license because oversite is a joke as long as you're not actually falsifying visits.

totallackofsurprise · Oct 16, 2019

On 10/11/2019 at 4:58 PM, GapRN said:
Labor law does not seem to apply and each bit of work y'u put in just cuts into your hourly pay in the pay-per-visit model.

I was hired as 1099 employee -- 'independent contractor' which means an 'at will' employee. Meaning labor laws do not apply.

On 10/11/2019 at 4:58 PM, GapRN said:
2) Run around doing VS and collecting pt signatures as fast as you can. Unload complex wounds and other visits that require actual time consuming labor on unsuspecting co-workers. Create fraudulent documentation about patient education that you didn't really do. Pull down $120 K and don't worry too much about you license because oversite is a joke as long as you're not actually falsifying visits.

Exactly! That is the exact description of the 'best' employees at my HH agency. I do find the work fulfilling, but I actually care about the patients' outcomes & preventing readmissions... so I can not work like #2. I'm the unsuspecting coworker who gets the complex wounds and actual labor. Well, I was initially... I wised up fast.

LuisHH · Nov 17, 2019

$50-$60 here in Southern California

caliotter3 · Nov 18, 2019

Posted before that I literally had to leave visit work because I had to find money from other sources to put gas in my car to go to work. You can only buy so much gas with borrowed money. One client kept her tv on full blast during the visits and wouldn’t allow me to do or say what I was supposed to. A visit that should have been 50 minutes at most approached three hours due to her behavior. She got more and more verbally abusive. It dawned on me why the agency was giving me these types of cases. Went back to extended care and have not looked back.

NYARN · Dec 1, 2019

So I am going to say that it depends on to many factors to decide. I am currently the clinical manager of a small home health company. We specialize on psych and our visits are 15 minutes on average. Paperwork takes 5-45 minutes depending on type of visits. I think its a great, easy, flexible job and i get paid more than when I was on med surg. Plus no nights, weekends or holidays unless I feel like it.