Just got my RN - can not work in home health due to CA regs

Specialties Home Health

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Hi,

I have been LVN for 8 years, last 4 years I was working in Hospice and Home Health. I was hoping to continue working in my home health agency as RN, but they told me that they can not employ me as RN. There is a certain Medicare regulation, that RN in home health supposed to have 1 year of experience at the facility (acute or subacute). I am very frustrated. I love home health, and it is incredibly hard to find a hospital job for a new RN grad in California. I worked at hospitals at LVN and do not like it at all. I do not mind "paying my dues" and work at the hospital for one year, but how am I supposed to get this job??? So far, I continue working in home health as LVN. On the other hand, I keep hearing about new grads hired by home health elsewhere. How does this work? Are there are any loopholes in this Medicare regulation?

Alicia

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Specializes in CTICU.

I worked for three years in home care and we were able to employ new grads without experience. We couldn't use LVN/LPN's though, I'm not sure what the regs are in Cali as I am in NY, and they might vary greatly. The thing is in home care out here RN's didn't really do anything clinical, it is more of a visit to assess and re-certify the case as opposed to actually servicing it as you would as an LPN (in home suctioning etc.). As an RN you would play more of a role as a case manager and you wouldn't be going to the same home every day to work with one client. Is there a new grad program you do can do to work in an underserved area? Perhaps a nursing home? Have you looked into HRSA?

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Specializes in Complex pedi to LTC/SA & now a manager.

Some of the agencies hire new grads in home health are not medicare agencies they either work with private pay, medicaid, or pediatric patients and thus the rules are different.

There are also some state regulations in addition to medicare regulations that a nurse cannot work independently in home health without a year of acute or subacute experience as a registered nurse. I believe CA is one of the states that mandates RN's working in home health must have a minimum of a year of acute/subacute clinical experience as a registered nurse.

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Specializes in CTICU.
Some of the agencies hire new grads in home health are not medicare agencies they either work with private pay, medicaid, or pediatric patients and thus the rules are different.

Sounds about right, my agency is primarily a special needs CHHA! We also have a LHCSA branch and our new grads could work through it as well on medicare cases, but I guess NY isn't one of those states. Sounds like your best bet is working in a rehab facility or nursing home, maybe even doing it part time with your position at your agency as an LVN so you can stay on the radar for when your year is up and they can consider taking you on as an RN.

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I am a clinical manager for a home health agency and we have LVNs that get their RN and then can't work for us anymore. The state of California requires 1 yr of experience for HHAs, LVNs, and RNs. Unfortunately, you will need to work in a subacute facility since most hospitals won't hire new grads either.

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weird, I'm a new grad RN, BSN and I interviewed with a home health company yesterday, they didn't say anything about needing 1 year of experience...

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weird I'm a new grad RN, BSN and I interviewed with a home health company yesterday, they didn't say anything about needing 1 year of experience...[/quote']

What state are you in chelseafm?

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Well it all depends on the state as a previous poster stated. I started Home Health with four years of LPN experience and one month of RN.

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What state are you in chelseafm?

I'm in California

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hi, im in anaheim.. im also interested? what are some of your daily routine if you dont mind? how much per patient? and in case your not good in iv can you tell them to your boss so they wont give u that pt.. is there a trining for iv here in cali ,or assessment? thanks

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Specializes in Home health.

The agency I worked for did require LVN's who had become RN's to have 2 yrs of hospital experience. The rule applied to an LVN coworker who had worked for our agency for several years, she ended up leaving until she got the experience required. The agency then rehired her.

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Specializes in SNF, home health.

Great to know this info. I've been an LVN for 9 years in HH, and I'm working towards that prestigious RN title. I hope that when that time comes I won't have a hard time finding a job.

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