Hospice On Call Compensation Structure

ray2512 · Sep 23, 2007

This sucks. I will get paid about $25 bucks for answering calls, and $25 per visit or $50 for death visits. I have all ready gotten 4 calls and its only 615pm Sunday night, I started at 5pm. I will be on call till 8am tomorrow, then work my regular 8 to 5. The census is about 165. Still have about 14 hours to go. Hope its a quite night but I know several people are actively dying.

I am a hospice and palliative care nurse who takes scheduled call quite a bit (every other weekend, and every Monday night). I'm curious about how on call pay is structured in other organizations. Here's how ours works: We get paid by the hour to "carry the beeper" weekend nights from 1630 until 0830, and a little more for the weekend 24 hour periods from 0830 Saturday until 0830 Monday. We get mileage door to door for visits. No extra money for admissions, Friday nights, holidays or middle of the night visits.
Many healthcare organizations get a base rate for call and then a different hourly rate for visits. Are there hospices out there in allnurses land who operate that way? No need for specific dollar amounts, I'm just curious how others are set up.
Thanks!
Kat

Sabby_NC · Sep 23, 2007

In our organization we get an hourly rate for call.

If we get called out we get the mileage and visit.

We get so up to $-- for a 2 hour visit up to $-- for a 3 hour visit, up to $-- for a 3 hour visit and so much per every visit over 4 hours.

We get a flat rate for carrying our pager for a weekend day (24 hours) only plus visits we make and mileage. Our on call schedule rocks :)

ray2512 · Sep 24, 2007

We have a full time on call nurse who is now sick. He works 123 hours every 2 weeks, covers 155 home care and about 17 pace clients. He is sometimes called to pick up meds for the hospice house (oh brother) and misc duties there. He also has to give up 24 hours eto for weekend days off. I did the same job about a year ago and they figured my eto at about 2/3 of the hours, because I worked about 43 hours more than everyone else in two weeks. But now it seems they have gone to hour for hour. That I think is very unfair and he is now sick and burnt out. I also had a director that thought call was "not that bad" and made me work 96 straight hours over Thanksgiving. I almost fell asleep at the wheel twice. I immediately put a application in for case manager. I hope I will never have to go back to full time call as it is now. And I feel that when we do have to take it occasionally we should get paid the same as the on/call nurse, a full days pay!

JSCOOBY · Sep 29, 2007

Our RN Case Managers are salaried - no pay when on call, but paid set amounts for deaths, tasks, visits and admissions.

PeacePisceRN · Oct 12, 2007

The hospice I work for has 4 night on call nurses. Two work each night and alternate making visits. We (I am one of the night on call nurses) are on call for 15.5 hours weekdays (4:30p-8:00a) or Friday nights 4:30p-7:00a, Saturday 7p-7a, and Sunday 7p-8a. We are paid regular time +$2.50 as a night shift diff for 11.5 hours. We work 7 nights of a 14-day pay period. Essentially we are paid for 80 hours (per 2-week pay period) but available to see patients for about 110 hours. We are considered salary employees. We can be called out to make a visit as late as 7:30a and may be on that visit for hours with no additional compensation.

Our census is around 150 and we cover 7 counties in two states. Sometimes I may drive well over 200 miles per night. We are compensated for door-to-door mileage as well.

This would all be wonderful, EXCEPT, of late, we have been also starting our nights out with scheduled visits which may keep us out for 6-8 hours. Then, we are still on call for nearly 8-10 more hours! Sometimes, that is quite exhausting.

At times this pay seems unreasonable with all the scheduled visits we are also making.

Any thoughts?

shrinky · Oct 12, 2007

Thankfully we have two on call nurses who cover all call. Each one works two nights a week and every other week-end so we don't take call except for Holidays and vacations. They are salaried employees and get benefits so I think they are 32 hour employees. They do get mileage, door to door, and extra money if they do visits during the day or come for inservices or meetings. If we take call we get 1.50 an hour plus overtime for visits if we are over 40 hours, which usually we are since we work 40 hours a week. We also get door to door mileage.All of us case managers and the admission nurse are hourly full time employees so we get shift and week-end differential just like our counter parts at the hospital.

indianahope · Oct 13, 2007

Thanks, Aimee. I will go back to administration and request reconsideration of this policy.....all they can do is say no.

Well, we did ask about compensation above our beeper pay of $2.00/hr for any work we did on the telephone and received the response that any symptom management/triage/consultations...Anything done on the telephone was covered by our $2.00/hr beeper pay and we would not be compensated beyond that.

I still can't believe it.

grdmdb · Dec 20, 2007

working stickly on call:

fri 4 until mon 8am

10:50 an hr

with 65 a visit

drive over 400 miles easily on weekend

take phone calls/ call home care/ make recomendations and do physical care

is this what other on call nurses make?

grdmdb · Dec 20, 2007

do staff perdiems ever get a raise?

grdmdb · Dec 20, 2007

my company told me staff pdiems never get bonuses or raises

i've with with the company 3 years- is this common?

rnkalee · Dec 26, 2007

We take call apx. every 6 weeks. We get paid $1.50/hour base pay just to carry the pager. Then from the minute we get paged until the situation is resolved and we are back home (whether that be phone calls, responding to a patient in need) we get paid our regular hourly rate. We also get paid milage door to door. We used to get paid $65 for each after hours admission and $50 for each after hours nursing visit (less for the LPNs) but that has thankfully changed. There is also always a secondary back-up nurse on call who gets paid $1 per hour to be back-up but rarely gets called.

Forgot to add, we are on-call from Friday 5pm until the following Friday at 8am. If we go over 40 hours of work, the additional hours are paid at time and a half. We do *not* do scheduled visits. We are all either case managers, LPNs, or the admissions nurse (me).

karen

rnboysmom · Feb 29, 2008

I have been doing this for awhile, took three hospice companies in 8 years to find the right one for me.

first company (huge for-profit national corporate company just bought by another huge company)I worked for paid $1.50/hour pager pay and $60/visit each time you went out on a call and door to door mileage, if the call went on for more that 3 hours, you got another $60---this sounds great in theory, but is not fun in practice at all as huge company, huge census meant you were often caring for patient #1 (dying or in crisis) and on the phone about patient #2 and #3 at the same time. Sometimes you may have been on the phone all night with as many as 18-20 phone calls and not make anything more than pager pay. You might be out all night and have to take a PTO day the next day as you were too exhausted to care for your caseload from being out all noc.

second company (even worse, also a large corporate, for profit southern based company) I was admissions nurse and did not do clinical call, but the clinical nursing turnover was horrific, pay for this company for on call was the same as original post $25 weeknight and a little more for entire weekend, they couldn't keep staff as the CM's were also overworked and understaffed. It was common knowledge in this company (management and administration told the story) that it had been presented to the owner of the company (an accountant---hmmmm) many times to consider paying staff for on-call and his response was that if these nurses really had a hospice heart that they should be willing to see their patients anytime as the company did not get extra money for on-call (funny that the company also did not compensate staff for any continuous care hours after hours even though they DID get an hourly rate for this levle of care--thank goodness for the hospice heart)

third company (small fairly new for-profit, but privately owned and locally operated company) pays $1.50/hour beeper, door to door mileage, and pays the nurse her regularly scheduled pay for any visit time, we also are paid for all phone time and any documentation time related to on-call at our regularly scheduled rates, this includes admissions and death visits.

What I can tell you, is that I personally helped develop the guidelines for company three, do I wish we could pay staff more, you bet, but the only hospice companies I have ever seen pay time and a half for on-call are hospital based hospice companies that have to pay that wage as they are regulated differently and they are also , usually, operating at a loss (which can be a plus for a big hospital sometimes).

As I have seen some of the abuse that happened at other companies with other types of on call firsthand, such as company one management and "select staff" taking the weekend "easy" call visits, such as PICC flushes or SQ pump checks and collecting a big fat check and the actual clinical on-call nurse having to manage all of the crisis calls OR or as with company two, patients needing after hours visits, but on call staff trying to manage every single call over the phone as they weren't even being paid enough to hire babysitters for their kids (not an excuse at all, but definitely a deterrent) We have tried hard to develop a system of pay that is fair for all and allows our nurses to care for their patients too. We try to give any nurse who has had a tough call night or weekend a paperwork day the next day and often, the other nursing staff divides up that nurses visits so she can go home to rest after her paperwork is done. WE HAVE A GREAT TEAM!!!!! :yeah: