Independent LPN Private Duty?

JustBeachyNurse, LPN · Jan 18, 2014

In what capacity? LPN's must work under the direction & oversight of a licensed RN, APN, MD, DO, DDS, or DMD.

Jay7821 · Jan 18, 2014

Thanks for replying, I've heard that RN's must open homecare cases and kind of oversee what an LPN is doing on monthly basis but if that's the case I can just hire one and pay her to come and overlook my work, but can LPN's contract their own cases and work for themselves in NJ

JustBeachyNurse, LPN · Jan 18, 2014

Thanks for replying I've heard that RN's must open homecare cases and kind of oversee what an LPN is doing on monthly basis but if that's the case I can just hire one and pay her to come and overlook my work, but can LPN's contract their own cases and work for themselves in NJ[/quote']
I was told no by the BoN but I wouldn't hold that as an absolute as I asked as an aside.
Yes an RN must do the assessment and start of care plus create the 485/plan of care(and sign off on it then secure MD signature ) An LPN must be supervised with the client once every month by an RN. The RN must recertify the need for skilled nursing every 60 days and resubmit the 485 for physician signature. If you start working without a signed plan of care you cannot bill for services.
You would need to be credentialed by the Medicaid HMOs if doing pediatrics and Medicaid/Medicare if doing adults. The reimbursement rate is not high....Horizon is down to $16-18/hr for LPN/ RN.
NY gives a 30% rate increase for verified complex children (trach/vent generally) but NJ does not. The LPN rate in NY is ~$20/hr and $30 for pedi trach/vent.
Another thought is you would need your own malpractice/liability policy. A $1M/$6M policy when you work full/part/per diem for an employer is about $105. If you are independent (1099 contract) the policy can jump to $700 last I checked. Many insurance companies now require electronic claims submission or your rate is penalized. You cannot bill for the required RN supervisory visit of you & client. There are a lot of expenses plus you need to pay quarterly taxes to the state & IRS (penalties are high if you fail to do so ) and would not be covered by unemployment or state disability.

JustBeachyNurse, LPN · Jan 18, 2014

According to this chart

http://kff.org/medicaid/state-indicator/private-duty-nursing-services/

Independent (non-agency) private duty nursing is not a covered service in NJ. This matches a rumor I heard. I know at least one of the children's Medicaid HMOs only covers PDN if through an agency.

VickyRN, MSN, DNP, RN · Jan 18, 2014

Moved to Private Duty Nursing Forum, as better suited to this type of inquiry :)

caliotter3 · Jan 18, 2014

If the contract is between you and the private pay patient, your rate of pay, as well as other specifics are what you and the client agree upon. This service is between you and the client, no third party payors are involved.

CloudySue · Jan 19, 2014

IMHO, life is much easier when just show up, do the work for my slice of the pie, and go home, and get my weekly direct deposit. No muss, no fuss.

LadyFree28, BSN, LPN, RN · Jan 19, 2014

Hello everyone I'm new to this site. I live in NJ and I'm an LPN interested in working independently my question is can LPN's be contracted on their own without working for an agency. I'm sick of working for agencies cause they keep half your money and I would just love to work on my own. Can anyone tell me if this is possible and if it is how much would I be paid..... Thanks[/quote']
Welcome!
I worked as an independent contractor in a neighboring state as an LPN, but was through a home health agency.
I kept my malpractice insurance up to date, paid taxes, etc. There is a lot involved with being an independent contractor; it is not meant to be a delay in paying taxes plus you are subject for more scrutiny.
If you want less taxes taken out, always adjust your W-2 for tax purposes.