Hospice Contract RN Salary

[leniz]

This is my first time actually posting a question, but I've follow the threads before. I've been an RN for 14 yrs. and I've done Acute Care, Blood Bank Supervisor, Hospice Case Management & Hospice Admission RN. Recently, I was contacted by the owner of new Hospice Agency. She is starting out in different counties of S. Ca. to establish her business. When she asked what was my hourly rate in my past position, she implied it might be to high for doing hospice admissions (37.00/hr+mileage). She wants to hire one RN to do admissions and case management (15 caseload) on their own, with no other license nurse to help handle everything hospice: scheduling of staff (CHHA, MSW,Chaplain) ordering and receiving supplies, in charge of med. coordination & DME, Death, GIP, Respite, leading IDT meetings, coordinating with Medical Director, supervising staff, and all other things that come along with hospice. My response was that she requires more license nurses, since one nurse can't cover a whole county. You can't expect one RN to do admissions/case mgt. and everything in between plus drive from one extreme of the county to the other. What are you going to do if you have a crises, an admission, and a death at the same time? She admitted that she has no experience in hospice, that she just purchased this agency, and that she is on a budget. She's been contacting me over the past week and I didn't respond, but finally I spoke to her today. She send me an e-mail with her plan for this county and she is offering me a contract rather than part/full time. This is what was sent:

#1

Contracting status:

Pay per admissions

Pay per RN supervisory visits

Pay per case on managing ptnt care and coordinate with staffing.

Pay on call pick up and deploying.

#2

Full time

But see, we don't have patients yet to compensate for full time.

=======

Currently , this will be the set-up for the Inland area:

RN to do admissions

LVN to follow

RN to do the bi monthly supervisory .

CHHA

MSW

Chaplain

RN to do case mgmt

RN to do IDT meetings

After I review it, she said we will discuss the rate which will be per visit not per/hr.

My question is how much should an RN get (or charged) being under contract? Obviously, this will be under the #1 plan.

I'm sorry that I just went on to long with this. I just have to respond by tomorrow. I've always worked hourly never by contract.

Thanks Everyone

[Ginapixi, BSN, RN]

I hear a lot of agencies will pay per visit, especially off hours; a case load of 15 should be manageable if there is back up if needed; who covers nights/on call? and how large is the area you cover?

I used to work for a company who paid salary to RN, hourly for HHA and LVN; case load of 30+/- 2 RNs, 1LVN one admission RN who ran under marketing and had to fill in for nursing when ever needed (which was more often than not); on call (from after office close to the next morning and the weekend) was on rotation between RNs and the DON, so one week/month; this was not too bad 90% of the time; but once we were to cover continuing care, some times up to 3 days - you work the night and were expected to be back on day shift the next day! no extra pay mind you ..... turnover there was rather huge!

[leniz]

Thank you so much for your info. I spoke to her again, and she told me to send her a rate proposal. She will review it and then decide. I have never written a proposal before, I research it, wrote it and send it to her. She not only wants me to do pt. care, but everything I stated in my post. In addition, she wants me to help her hire the staff, to act as an adviser to the other sites that are located in other counties when issues arise. She said she wants me to be in charge of everyone and everything, and keeps on adding things to the list (which keeps growing). She lives in Palos Verdes (L.A.) and I'm in Riverside County, so she won't be out here and physical office is nonexistent. And she won't be hiring a DON. She assume that with electronic documentation, the amount of time spent in an admission, pt. care, or anything that my arise should not take no more than an hour. I've worked in this field for 3yrs. and there is always something unexpected that happens. And yes, the turn over rate is high. Well, I'll wait and see what her response will be. In the meantime I have another interview coming up. Maybe is time to switch fields.

[caliotter3]

I started to develop fatigue just reading your listing of all the add-on responsibilities. She wants you to do all of that and probably even more, and won't hire another person? Wow. I read too much work in this proposition and I'm not even experienced in the role you are describing. I hope the other interview is positive. Think this lady is expecting too much from you. JMHO

[leniz]

I agree, I don't think she'll find anyone to take on the task. I will not considered it anymore. My sister in law stopped me midway through the job description. She said this person is insane, this job is not for you. Moving on! Thank you, for your replied.

[edmia, BSN, RN]

I agree, I don't think she'll find anyone to take on the task. I will not considered it anymore. My sister in law stopped me midway through the job description. She said this person is insane, this job is not for you. Moving on! Thank you, for your replied.

Thank goodness! It sounds like a person with no hospice experience trying to make a profit and not wanting to pay the salary an administrator deserves. The description you gave was for you to run her hospice agency, not a staff RN. Ridiculous. Good luck on your job search!

[toomuchbaloney]

Yes., perhaps this is another example of a non health care individual believing that they should make their million in hospice care. meh

[leniz]

I agree, she wants me to run the agency and be a staff RN at the same time. Indeed, she doesn't have no hospice experience she said it herself.

[leniz]

Yes, she has no healthcare degree. She decided to do this because her mother was in hospice and saw an opportunity to make a profit. She has no business plan, but she already purchase the hospice agency for $500,000. Of course, she wants this to be running ASAP because she's loosing money. She has been interviewing physicians for the role of Medical Director, but can decide who to choose and she has no other staff. I left the last agency because the administrator running is a non healthcare individual with a Science degree who loved to tell the RNs/LVNs how to do their job, because all she cared was the budget.

I appreciate everyones comments.