It felt like a slap in the face and oh yes I told them all !!

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Specializes in OB, M/S, HH, Medical Imaging RN.

I love HH, doing the visits, but the administration/office is really really getting hard to take. Friday I felt as though I had been slapped in the face and I told them too!

This company is very disorganized, I've been there 10 months and have yet to have even one paycheck correct and yes the mistakes are "always" in their favor, once to the tune of $1,500. We only have 3 intermitant visits nurses, me included, and all the checks are always short. Doing private duty recerts I hear from those nurses that they have payroll issues as well.

It seems for every admit, recert, DC, resump or Dr's order I submit, I get questioned about at least 1/2 of them. Where is it? Where is this form? or that order? It happens to all of us. I started making copies of everything at least 6 months ago. I show them the copy and tell them "you had it, you find it". The DON is very supportive and about ready to pull her hair out over these situations. She been working so hard to correct these issues. I think the problem is that there are 3 companies in our one office. Owned by the same woman and all with similar names. All the office employees work for all 3 companies and everything gets so mixed up, everyone always seems confused, no doubt! This has been addressed with the owner numerous times but she obviously doesn't get it. I can't believe she's stayed in business for the past 5 years.

The DON came up with an idea for us to fill out a simple form, prior to payday, we list how many visits we did, how many office hours and how many admits, etc.....tally them up and the payroll per person will know on payday how much our checks are supposed to be. I thought great, this is pretty simple. Mind you we only have 3 nurses and an average of 90 visits or less per week between all of us.

I went in Friday to turn in my notes and turn in this form to the payroll person. She said "I cannot accept this". (I only had 12 visits) I said "Why not?". She said "It has to be verified and signed by the DON and owner to prove you made these visits". "WHAT?". I have the copies right here for proof. "Sorry it has to be signed and verified". I marched into the owners office.

"I feel as though I've been slapped in the face, thank you very much!". "I've worked here 10 months, have not had one check correct, I have trusted this company to pay me and have had to go through the charts myself to pull visit sheets to prove I made visists I never got paid for and was not paid for my searching time, I therefore started making copies but then that wasn't good enough, payroll had to see the originals. I am a professional woman, if you cannot trust me please "fire me". "I will NOT have this form signed every two weeks like a kindergardener and I refuse to be treated like a child."

I got a call on my cell about 5 minutes later from the DON. She said "don't worry....the forms no longer will have to be verified and signed".

Thanks guys for letting me vent! .............Oh I'm still angry but a victory for me!!!!

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Good for you. I'd be mad too. I don't understand how some people can stay in business with such an obvious lack of management skills.

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The HH agency I work for also owns the private duty staffing agency next door. Patients constantly ask me what's the difference between Company A and Company Z? It was awfully embarrassing when I would have to tell them I wasn't exactly sure. Even now that I understand it is still hard to explain it to people who don't.

I am wondering if it has anything to do with TennCare and Medicare?

The new DON herself told me she believe's private duty nursing is on its way out within the next year or two (only TennCare will pay for private duty) Tenncare is paying obscene amounts of money for indigent people (well, indigent if it wasn't for TennCare) to have around the clock nursing care, like $20,000 monthly for certain patients. One patient I am thinking of, in particular has a feeding tube, vent and PICC line and is too high acuity for home care in my opinion. He is frequently in the hospital for infections because his home environment is so deplorable and filthy. So it isn't just private duty TennCare is paying for, but no telling how much they are paying for this guy to come in and out of the hospital. But his private duty care is over $20,000 a month. At around $150 daily, this would put a lot of people in LTC facilities. Sorry to stray off the subject, but what really irks me is you have people who have never worked a day in their lives getting one-on-one around the clock nursing care, and other people who did not qualify for TennCare because they worked and had insurance can't get anything, unless it is a CNA to come in 2-3 days a week to assist with a bath. But it is a pretty safe bet these private duty patients are on borrowed time. As a matter of fact, TennCare is making cuts every day. One of my patients recently failed to qualify for another cert period and in fact got a bill for $7,000 from TennCare for back pay for services TennCare says they will not cover.

Anyway, I don't think it may just be the nature of trying to sort through TennCare and Medicare that makes everything so disorganized. At my agency, we have to have different charts for different insurances. You walk in the door and within a few minutes you have so much crap piled on you it's hard to stay on track with any one patient long enough to get anything done. And it doesn't help when you have doctors who won't sign the 485's and get them back to you to file in the patient's chart, And if you don't stay right on top of changes in care and meds before you know it you will be drowning. So I am thinking it is just the nature of HH agencies to be disorganized.

However, one thing the agency I work for has been pretty fair about is the paychecks. They haven't shorted me yet, but if they made a habit out of messing with my checks I'd have to leave and report it to the labor board.

They have messed up my insurance. I was supposed to get health insurance when I started in April but last time I checked (a couple of days ago) I didn't have it. I'm starting to get a little annoyed about this.

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Specializes in M/S, home health, LTC, rehab/orth.

What is it with home health agencies and payroll? I work for one too (not as much now as I used to) and the checks were almost always wrong. They would 1) forget my mileage 2) pay me straight time for my overtime hours 3) pay me 4 hours for a 16 hour shift (the timeslips are the ones where you circle AM or PM and they were clearly circled right) 4) pay me medicaid pay for what was supposed to be higher private duty pay, or for facility staffing which was supposed to be higher. These are the ones I can think of off the top of my head, I know there's more. The staffing agency I mostly work for now has never got my check wrong (knock on wood). I just keep all my time slips and paychecks until I make sure everything is correct. Tonya

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Specializes in Home Health.

I thought you were talking about my office at first. I moved to Texas from the Northwest this year and my boss keeps telling me the irregularities are because "this is Texas" I hear that wages are supposed to be good here but after 6 months I make less than I did at my last job and she won't pay milage and the payroll is rarely right and I am ready to move on but scared it might be this way all over. I can afford to work there, I am going broke!

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Specializes in L&D.
I thought you were talking about my office at first. I moved to Texas from the Northwest this year and my boss keeps telling me the irregularities are because "this is Texas" I hear that wages are supposed to be good here but after 6 months I make less than I did at my last job and she won't pay milage and the payroll is rarely right and I am ready to move on but scared it might be this way all over. I can afford to work there, I am going broke!

Hi. No, it is definately not like this all over. I have never had a problem with my checks, never been questioned about whether visits were made or not. I'm sure it's because we're on computer charting...thank God! I can't imagine being put throught that stress! Good luck!

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It sounds like the norm in hh to have messed up paychecks. When I started with the company I'm with now 2 years ago I was paid per visit. Should be pretty simple to figure out right? Not, the checks never matched but I knew about what the amount should be and it was always close. Now I am salaried and, except for my call time/call visits, and cell phone reimbursement, my check should be easy to figure out- not. For some reason it is still divided up by different types of visits and now travel time and office time. So far the checks have been off but in my favor. Is it possible they pay more if we exceed our quota?

Ann

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