Hourly per diem pay?

84RN · Mar 22, 2012

I work per diem and get paid per visit. This is in Florida.

Start of Care: $75

Resume of Care/Recert/Discharge: $65

Regular visit: $40

I can see an advantage to getting an hourly rate for SOC, especially when it takes a long time or there are issues with the med reconciliation. It often takes me at least 2 hours or more just with the patient, including driving time, plus finishing paperwork on top of that. I don't get paid mileage either, so that's an expense.

ruthalittle · Mar 23, 2012

Thanks for answering :) I am an LPN in northern Illinois. I now officially work per diem for 2 different companies (re visits only of course, I can't do SOC's, ROC's or D/C visits as an LPN). I agree, hourly is MUCH better for the RN. 20 years ago I withdrew from an RN program half way through when my son became seriously ill. The original plan was to get my LPN, work until my children were grown & on their own, then bridge to an RN program. After seeing the mountains of paperwork the RN's have to complete, I decided to get certified in wound care & remain an LPN. (I'm 51 years old & really enjoy what I do)

I really enjoy working for the "first" company even though they have no patients within 25 miles of my home, so I do a lot of driving. Other than the driving (& cost of gas!!) I couldn't ask for a better work environment. Whenever the RN case managers I'm working for ask anything of me, as long as it's within the scope of my practise, I have a real problem saying no, (even when I'd rather not) because they ALWAYS back me up when I need them, such great clinical skills & even better communication skills. I'm trying to remember the last place I felt as though I were really part of a team that puts our patients first.

I don't know what the work culture at the 2nd company is like yet. They serve an area within 25 miles of my home, but, for now, this will not be my primary job.

84RN · Mar 23, 2012

I enjoy wound care and would love to become certified, but right now it's just too expensive. Your job sounds good to me, since I'm not a fan of doing the mountains of paperwork associated with SOC, ROC, etc.

cathrn64 · Mar 24, 2012

I am an RN in Illinois (DuPage). I have worked both per diem and hourly. There are advantages to both. The issue was, when the company I worked for went to hourly pay, they decided they would only pay for paperwork time if it was done in the office. It was a pain in the butt to have to go to the office everyday in order to do paperwork. I now work per diem. The paperwork time is "built into" the visit rate. It is nice to be able to go home, or where ever you want, to do your paperwork. On the other hand, no work, no pay.

ruthalittle · Mar 25, 2012

cathrn64; at the new (2nd) job I will have to go to the office to do paperwork in order to be paid for it. & since they're converting to computerized charting soon I wonder how that will work. It's in Lake county, the office is 5.1 miles from my home.

Now the "first" job, I get to do my paperwork where & when I please, as long as it's in on time & done correctly. It's all "built in" as you say, & I really like that. I can organize my time myself, with no one "breathing down my back". The down side is that I take calls that need follow up at home or when I'm out other places, & I don't get paid for it, but I can do the follow up in my pj's! The office is 30 miles from my home & I really hate having to attend meetings & drive all that way.

Since you are an Illinois RN I may as well ask you, do you have any idea where I might find documented that the state of Illinois considers LPN's taking phone orders to be altering the 485? Just thought I'd ask.

BTW my GOD do you have the paperwork to do as an RN in home care! I think ppl who haven't worked in home care just couldn't imagine the amount of paperwork you have to deal with!

cathrn64 · Mar 25, 2012

I don't know about Illinois LPN's. The Scheduling coordinator in my office is an LPN and I know they do not have her taking orders.

A lot of nurses come to home care and MANY of them leave because of the paperwork. Also because of the after hours follow-up. It is not what they expected! I precept many of the new nurses and it is something I try to cover early and often. It is disheartening when I have spent a month training and they leave a week or two after they are on their own! One good thing is my agency allows staff to mail in paperwork, and they mail you supplies. We have weekly phone conference calls. People have to come in to the office maybe once a month for in office staff meetings

GimiRN · Mar 25, 2012

I'm just curious if anyone else has worked pay per visit, at an hourly rate. I will be starting work at a new company today and they pay by the hour not the visit. I've asked around & no one's ever heard of this before.

I've been a nurse for a while, but am new to home health. I started a few months ago as a per diem visit nurse. I got paid per visit, and the rate depended on what I was doing (admission, discharge, supervision, etc). I couldn't take all the driving around, and really wasn't making any money. It seemed I spent way too much time driving around, and by the end of the week, the compensation for my visits was very small once added up. So I left the company and got another job.

But then a couple of weeks later, the same home health agency I left, called and offered me a full-time staff position, working mostly in the office, but doing some visits if needed. They said I would get paid by the hour, work Monday through Friday, and have a guarantee of 40 hrs a week. I accepted right away. And I am so glad that I did.

I spend most of my time in the office, and average between 2 to 6 visits a week. But I have a lot less stress, and I don't mind the driving, because I know I am on the clock, and will get my regular pay every two weeks. Plus I get a little extra for gas, for any visits I do. I also have the option to do visits on the weekend if I want extra money, but those are at the per diem rate.

So even though I don't work strictly visits, I still think hourly pay is better than per visit. However, if they are doing it where they are actually adding up the time you spend with each patient, I'm not so sure it would be better. :twocents:

LaRN · Mar 25, 2012

If the rate per visit is high enough, then per visit is the best way. With hourly, some companies tend to have the mindset that you should see however many patients they need you to see, which sometimes ends up being more than what one can do in 8 hours....and most don't pay anything over 8 hours/day. They say that it works out in the end because some days are light and you don't have many patients. Only thing is, "light" days don't occur that frequently, whereas "heavy" days do.

But really, whether you do per visit or hourly, the company will come out ahead because they've been at it longer than you have. They know what works best for them. :twocents:

ruthalittle · Apr 6, 2012

I worked for a home health company (I won't name) where I was full time "salary". Minimum quota of 8 visits/ day but it was supposed to be ok because all of the visits were between 1 or 2 buildings. I once made 15 visits in 1 day. No overtime and even if there was I still would have left. It didn't resemble any type of home care I had done. I hope I never encounter anything like that again. The RN's had it even worse. They had their own quota of visits/ day, AND all the SOC's, ROC's, transfers when pt's went into the hospital...I will NEVER forget that experience.

sbarger1 · Apr 8, 2012

I'm just curious if anyone else has worked pay per visit, at an hourly rate. I will be starting work at a new company today and they pay by the hour not the visit. I've asked around & no one's ever heard of this before.

I've never heard of pay per hour. Where did you hear of this, now I'm curious. Where are you located?

keke0708 · Apr 13, 2012

I have worked in home healthcare as a rn for almost 3 years in southern iowa and it has always been hourly rate pay to make stats/quota we are to make 5 visits a day pay though is 19.94/hr.