Shortage of home health aides in your agency?

  1. It's not only nurses that are leaving like birds flying south for winter, but we are having a serious home health aide crunch as well.

    We were asked to not offer HHA anymore, unless the pt is bedbound, and then to see what other resources we could use, like PCA under caid instead.

    So what about you all, are you having problems recruiting aides as well??

    What kind of salary are your aides offered?? Ours are offered a starting salary of $8/hr and go usually no higher in this area than 10-10.50 per hour.

    How atrocious!!!!! Can you imagine working as hard as a HHA does, and under those conditions for that measly salary??

    Do your aides get bennies? Only our FT aides do, not PT'ers, and no union for them either, which I think is their biggest problem.

    How much do you think an aide should get? I think $12 per hour, but at that rate, Caid only pays 14 - 15 per hr to agency in NJ, how can an angency afford to give them bennies at all?? Not sure what the Medicare reimbursement is.
    Any creative ideas in use out there?
  2. Visit hoolahan profile page

    About hoolahan

    Joined: Dec '99; Posts: 3,786; Likes: 129
    Quality Nurse & Home Health Nurse


  3. by   luvbeinganurse
    I think the aides are WAY underpaid. At our agency, the per diems get $12 an hour, no shift differentials, no benefits. If someone goes FT or PT, they get benefits and PDOs, but the wages drop to $7 an hour, maybe more depending on experience. Of course, they do get raises every year, but I'm sure it's not much, considering my last raise was $ .22 an hour, and I'm an RN! That was getting the most that was allowed. Our homemaker/companions who have no hands-on experience or training start at $10 an hour for per diem, without benefits as well. I don't know how these poor girls (and guys) do it - they work their butts off and get little appreciation in the form of money. It just doesn't seem right.
  4. by   LoisJean
    I'm keeping my nose to the road pretty much these days.

    About the aides: What I am seeing in our area is a lot of transient today, gone tomorrow. Agencies hire off the street, provide little in the way of training and then put them in the homes with clients who are pretty fragile for the most part. What really bothers me most is the lack of certification...(in many, but not all instances).

    More than once I have asked an aide why a wound wasn't reported and am told something to the effect....'I didn't see it' or 'I didn't think it was important' or 'well, the client wasn't complaining'. This gets me back to my other question to them: "How often does the RN make supervisied visits with you?"
    Most of the time the aides don't know what I'm talking about and, in fact, can't tell me who the nurses are because they've never met them.

    I have noticed that the aides who stay on the job are the ones who are: #1 Certified and #2 work for a hospital based home care agency.

    For those of you who work for a private, non-hospital based home care agency, are your aides certified? How often do you make supervised visits? Are your aides included in care conferences? In my experience with home care, when aide input is acitively included in the care planning process, there is a higher degree of dedication to the work because their input becomes a part of the patient care planning process and because they are given on-going inservices and RN precepter training to meet the needs of their patients.

    I know this doesn't address the pay issue, but honestly, when has anyone working in HHC been paid a decent wage--considering the work that requires doing?! That complaint can go from aide to LPN to RN with great justification.

    That gets me back to the old question that used to keep me awake at night.....'where does the money go'? Someone is making a big salary and it's not the employees. Even when all has been taken into account including wages, supplies, mileage reimbursement (if there is any), office supplies and help, office rental (if any), advertisement (if any), how much is left over and who does it go to? (Just look at the charges to insurance or out of pocket fees for home visits and then start deducting).

    I could never get figures to quite come out right...any way it was sliced or diced, the employer ended up receiving the greatest share of the profits which are, 'in-their-pocket', profits.

    If a belt needs to be tightened in order to provide quality patient care from the nursing assistant on up, then who ought to be cinching up first?

    Lois Jean
  5. by   renerian
    We have seem many aides but they are only paid $8.00 per hour or 12 per visit for certified cases. High turnover. None get benies.

  6. by   LoisJean
    My question is WHY???
    Why is the pay so abysmal? Why, why, why???

    Okay, then, here's my next question: If YOU were the owner of an nursing agency, had met all of the requirements for insurance reimbursements, were established in your community setting...what would you offer as salary and benefits for your nursing assistants? What kind of hire-in requirements would you have for them? Would you provide for their training? In other words: If you were an employer, what would you expect from your help and what would you be willing to pay for those expectations? These aren't fantastical questions; these are exactly the questions that some nurses are asking themselves because of the daily frustrations surrounding their powerlessness to provide their patient's with the quality care deserved.

    I'm getting too long in the tooth to manage any more in-depth research projects--but for some of you out there, research is right up your alley--

    Hoolihan, your question is a really good one and it begs the answer answer to WHY, not just figures on how much or how little the HHC aide is paid--

    Lois Jean