Pts wanting to pay privately...

[KP RN]

What if a patient asks you to continue to see him on a monthly or weekly basis to help fill pill boxes...and they offer to pay you privately?

They no longer qualify under medicare, goals are met, not homebound, no skilled need...

Do your agencies have written policies regarding this issue?

What about legal ramifications?

Have you ever done this??

Thanks!!!!

[NRSKarenRN, BSN, RN]

KP:

Most agencies have private duty rates so the patient can continue with care that is not insurance eligable. When you sign on as an employee, usually their is a clause stating you won't accept employment from patients.

If you agency hasn't a policy, I would:

a. Write a note on a pieice of paper that the patient can sign stating ground rules:

RN will check vital signs and prefill med planner for XYZ dollars/ week. Patient is responsible for obtaining meds and notifying RN of med changes and doctors office visits.

b.Notify patients physican of this client need also patients next of kin so all above board.

c. Get a black n white bound composition book from dollar store: Use this as your "chart". Keep an updated copy of med sheet in front. Use the book to write date of visit, vital signs, note any med changes and any contacts to doctor, any instructions to the patient. Leave it in patients home. I've used this type of book in home care, even with own grandmother and found it invaluable.

d. Get professional receipt book from stationary store and give patient receipt each visit. This income is income taxable---but you can also deduct business expenses too!

d. Make sure you have malpractice insurance.

Good Luck.

[nursemicke]

KP

Check out the nurse entrepenuers discussions on allnurses. You may want to start your own business.