Is it possible . . .

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Specializes in COS-C, Risk Management.

. . . to find a decent home health job? I ask this after the umpteenth time of getting home after 8pm and being so burnt out that I just typed up my letter of resignation. I absolutely *love* home care but the situations I find myself in have been ridiculous. In the last 20 years, I've worked for two agencies that have been indicted for Medicare fraud, one that is currently on its way, and this last one has just driven me into the ground. Is it too much to ask for:

*Not more than 5 visits a day (and admits and ROCs count as 2 visits)?

*A decent per visit or hourly wage that takes into account all the paperwork, not just the amount of time spent in the home?

*A director who understands that I have a life outside of work and would like to participate in it?

*A travel area that doesn't add 3+ hours to my work day?

*A decent wage for all the administrative stuff that has to be done, or someone else to do all that administrative stuff?

*A decent benefits package that provides me with a level of care that supports and maintains my overall health?

*Training and the opportunity to advance my skills or go to conferences to improve my knowledge base?

What's been going on lately: I came into this small agency with the understanding that it was a small travel area, but they neglected to tell me that we also cover 2-3 surrounding counties, as well as the largest county in the country. I could stay within the city limits and still drive 100 miles between visits. We were supposed to have 2 RNs, 2 LPNs, a Psych RN, and a couple of PRN folks who could pick up overflow. Well, now there's me (RN) and an LPN and the Psych RN is on her way out the door. The MSW quit as of this week, so I was just told that I have to be a social worker, too. Yesterday, after spending 2 1/2 hours on administrative stuff, my schedule was 2 regular visits, 1 IV visit with labs and sterile dressing change (and this was on the far north end of the city with the blood needing to be transported back downtown to the lab), an admit, and a ROC/recert on the far southside. Too much.

My husband was hopping mad and upset because he had to put MIL in a nursing home yesterday and I wasn't there to help answer the questions or give him any kind of support. My toddler hasn't had anything to eat but fishsticks and ramen in weeks because that's all his 16 year old sister can make. I manage a sandwich in the afternoons and an apple if I'm lucky but rarely eat dinner during the week. I think I've lost about 10 pounds in the last 6 weeks.

I am expected to do all the sup visits, all the admits, ROCs, recerts, as well as case manage 40+ patients (wonder what I'll do with the psych cases when the psych RN leaves?), obtain DME for them all, follow up with all their physicians, call the ones that were sent to ER or emergent doctor's appointments, and never forget anything. Plus travel up to 100 miles a day. Oh, and I'm supposed to call all my patients the day before to make an "appointment" for the visit. Oh, and I still have hours and hours of computer-based training modules to do or they'll shut off my computer. When am I supposed to do all of this?

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Specializes in LTC/hospital, home health (VNA).

yes it is possible! my agency is fairly like the ideal one you describe. We see 5-6 patients a day..SOC/ROC are considered 2. On the rare day I see 7...it is never a OASIS visit. I travel 30-50 miles a day routinely. We work with RN/LPN teams. We have clinical managers that take care of authorizations, referrals, insurance issues, most faxing/office issues. We have a lady that manages supplies. We have a lady that codes. Our supervisors back us up when patients are not homebound of no longer need skilled care and we need to discharge.Unless I am precepting, I am usually home 2-230 and finish with charting and phone calls by about 4 or so. We take call about every 6th weekend. No weekends working. While there is no perfect job or agency, I am happy with mine :loveya:So... keep looking...they are out there!!

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Specializes in Hemodialysis, Home Health.
yes it is possible! my agency is fairly like the ideal one you describe. We see 5-6 patients a day..SOC/ROC are considered 2. On the rare day I see 7...it is never a OASIS visit. I travel 30-50 miles a day routinely. We work with RN/LPN teams. We have clinical managers that take care of authorizations, referrals, insurance issues, most faxing/office issues. We have a lady that manages supplies. We have a lady that codes. Our supervisors back us up when patients are not homebound of no longer need skilled care and we need to discharge.Unless I am precepting, I am usually home 2-230 and finish with charting and phone calls by about 4 or so. We take call about every 6th weekend. No weekends working. While there is no perfect job or agency, I am happy with mine :loveya:So... keep looking...they are out there!!

Sounds a lot like MY agency as well !!! :up:

Yes, they ARE out there... perhaps in the smaller town/rural areas.. small, privately owned and operated agencies as ours is.

What you have described above is pretty much identical to ours, and yes, I love it ! :)

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Specializes in Psych, LTC, Home Health.

Wanna move to "middle of nowhere" MO? We have a good agency as well. Just filled the open position but I don't look for this one to last long based on a lot of what she said today.

:)

The good ones are out there! :)

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Specializes in COS-C, Risk Management.

Thanks, I moved from the middle of nowhere MO a few years ago and made more money there than I do in higher cost of living FL. I think I made more as a home health aide 20 years ago, even.

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Hi Kate,

I ask myself the same question, too...although my job doesn't sound quite as bad. Wonder if it's because we're in FL and there's so much competition??:cool:

mc3

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Specializes in COS-C, Risk Management.

It's settled, I made more as a home health aide almost 20 years ago. My average paycheck is around $1500, including all visits, hourly pay, and mileage reimbursement. My average paycheck as a HHA was . . . . get this . . . . around $1500 back then. If you consider cost of living adjustments and inflation, my four year degree and license, not to mention many years of experience, have actually cost me money!

I turned in my notice on Monday, now the agency is scrambling to try to keep me, but the only concession they'll make at this point is to give me additional time in the office to get caught up on administrative stuff, at the whopping rate of $20/hr. I will lose money with this proposition. I would like to go on salary and avoid this whole per-visit nonsense, but so far the higher-ups are not interested. They *want* to work people to death, I think. Burn 'em out fast and worry about the consequences later. Ugh. I have agreed to stay "a little while longer" to give it a try, but I can already see that this is not going to work.

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