Ok, so I just graduated nursing school then passed the NCLEX... I got hired over the phone with a "home health agency" although I actually am a private duty nurse doing 8-12 hour shifts. The service is paid for by medicaid. Medicaid pays my company and then the company pays me. I clock in and out using the clients mothers phone (my client is pediatric).
On 2 separate instances (once in August and once in September) the clients phone was unavailable, so as instructed by my supervisors, I called management, with the fathers phone, and they were supposed to clock me out. In BOTH cases the managers never clocked me out and I received a call from the office the following mornings wanting to know why I had not clocked out. I never got paid for these two days. I spoke with the owner of the company numerous times and she insisted they would be on my next paycheck. But paycheck after paycheck came and the hours were never added.
Then, the owner calls me just last week and tells me she will not be paying me for those two days as she had just found out I have been taking a lunch break. I was told by the woman who hired me, the pt's mother and the nurse who has been working for this company that lunch breaks were allowed. There is NOTHING in my contract that says we are not allowed a lunch and I have not even taken a lunch everyday. I might get to take a lunch 2 days out of 5 that I work. I spoke with the medicaid case manager about it and she said the company was paid for all of my days, including the two where the office had to manually enter my departure time the next day. The owner of the company said that the only way she will pay me for the two days is if she goes back from my start day (over 6 months ago) and takes 1 hour lunch out for every day... Which would make me owe her money!!!!
So just to summarize, the company was paid during every lunch I took, and was also paid for the two days where my managers did not clock me out, but I was not paid for the two days because "of the lunches" i have taken. I am no longer taking lunches now that I know that it is not allowed, but I was counting on that money and I feel its not fair that the company was paid for doing nothing while I am being shorted for almost 25 hours of work! I am still a new nurse, this is my first nursing job and I just feel like it isnt right.
They have hired 7 nurses total for this case and I am the only nurse who has stuck with it. The rest of the nurses quit due to pay issues as well, but this has been my first negative experience. I have had several people tell me they are not allowed to just take my pay like that. Does anyone know legally or from any aspect how all this works?
I'm not saying that the agency is right in not giving us a break. Yes, labor laws require us to take a break. I agree with that and a break would be nice, real nice. But its not realistic with most cases. Who is going to stop by for 30 min for me to take a break? A parent that gets a 30 min break at work, but not the time to drive home and back? Most cases that's hard to do. And if we just leave the pt for a lunch break, its abandonment. We can't get paid during that time and medicaid/medicare won't pay an agency if we aren't working. We take "breaks" as we go. Eating when a kid sleeps, bathroom breaks between meds/txs/therapies. Many times I've had to use the bathroom when the therapist has started working with the pt.
My agency has a policy that if a pt must be left unattended even for a sec, that the pt must have all monitors on with alarms. But at the same time it doesn't mean we can sit outside of the pts room all shift because insurance doesn't allow that.
I'm not saying that the agency is right in not giving us a break. Yes, labor laws require us to take a break. I agree with that and a break would be nice, real nice. But its not realistic with most cases. Who is going to stop by for 30 min for me to take a break? A parent that gets a 30 min break at work, but not the time to drive home and back? Most cases that's hard to do. And if we just leave the pt for a lunch break, its abandonment. We can't get paid during that time and medicaid/medicare won't pay an agency if we aren't working. We take "breaks" as we go. Eating when a kid sleeps, bathroom breaks between meds/txs/therapies. Many times I've had to use the bathroom when the therapist has started working with the pt.
My agency has a policy that if a pt must be left unattended even for a sec, that the pt must have all monitors on with alarms. But at the same time it doesn't mean we can sit outside of the pts room all shift because insurance doesn't allow that.
A few things:
1. Those "breaks" on the go ARE breaks; you stated that in your initial post that insurance don't allow breaks, but again, one is still entitled to breaks; meaning, based on what you just posted, you do get breaks; to insinuate otherwise and put this on a forum that "breaks are not allowed" per you in total post presented a totally different interpretation.
2. I have worked on cases where monitors, vents, etc and STILL got a bathroom break and a lunch break; some days are more challenging, but I still got them in; again, to insinuate that that is "rare" again is not taking into account of other factors, including maximizing time management, even with one client.
3. I don't knowing where this "sitting outside of the room" comment is going, and it has no place in this discussion; the bottom line is, CMS funding covers nursing care per acuity and is given to the agency and individual; most insurance companies follow the CMS model; the agencies and the individual-if one is a participating directly with CMS and not an agency when I am speaking about individual/contractor-still has to adhere to labor laws; again, that doesn't go out the window, and stating otherwise initially can cause confusion and also presented that there was a serious labor violation going on.
We can agree that we take breaks "on the go" during shifts; however, breaks are still being taken; the main point of the thread was that the OP was not being paid for their days due to the OP not taking a break, which sounds like a major labor violation, and has a convincing solid case.
1. Those "breaks" on the go ARE breaks; you stated that in your initial post that insurance don't allow breaks, but again, one is still entitled to breaks; meaning, based on what you just posted, you do get breaks; to insinuate otherwise and put this on a forum that "breaks are not allowed" per you in total post presented a totally different interpretation.
2. I have worked on cases where monitors, vents, etc and STILL got a bathroom break and a lunch break; some days are more challenging, but I still got them in; again, to insinuate that that is "rare" again is not taking into account of other factors, including maximizing time management, even with one client.
3. I don't knowing where this "sitting outside of the room" comment is going, and it has no place in this discussion; the bottom line is, CMS funding covers nursing care per acuity and is given to the agency and individual; most insurance companies follow the CMS model; the agencies and the individual-if one is a participating directly with CMS and not an agency when I am speaking about individual/contractor-still has to adhere to labor laws; again, that doesn't go out the window, and stating otherwise initially can cause confusion and also presented that there was a serious labor violation going on.
We can agree that we take breaks "on the go" during shifts; however, breaks are still being taken; the main point of the thread was that the OP was not being paid for their days due to the OP not taking a break, which sounds like a major labor violation, and has a convincing solid case.
The law doesn't consider it a break if you are clocked in. Doesn't matter if you eat, drink, or whatever.
I get time between tasks to eat, drink, sit, or whatever but I'm still caring for my pt at that time and clocked in. Its not a break, but I get a break in a sense to eat lunch. But its not a legal break.
The sitting outside the room is if the OP is leaving the room to break and eat.
The OP may be confusing other jobs with this one in thinking s/he can just leave and go eat or rest. The shifts are straight through in this job. I'm sure if others speak up, they would share that they don't get a break as you describe it and they must eat on the clock too.
I'm just stating what insurance says. I've even provided proof. I'm not saying I agree or don't agree. But I'll follow their rules so I don't end up in front if a judge or the nursing board.
The law doesn't consider it a break if you are clocked in. Doesn't matter if you eat, drink, or whatever.
I get time between tasks to eat, drink, sit, or whatever but I'm still caring for my pt at that time and clocked in. Its not a break, but I get a break in a sense to eat lunch. But its not a legal break.
The sitting outside the room is if the OP is leaving the room to break and eat.
The OP may be confusing other jobs with this one in thinking s/he can just leave and go eat or rest. The shifts are straight through in this job. I'm sure if others speak up, they would share that they don't get a break as you describe it and they must eat on the clock too.
I'm just stating what insurance says. I've even provided proof. I'm not saying I agree or don't agree. But I'll follow their rules so I don't end up in front if a judge or the nursing board.
And your proof is questionable, especially if it's not from CMS or the Labor Board.
Your interpretation of the rules are questionable; again, we have had this conversation many times on many threads, and I have informed you before that your interpretation may be one that needs to be reviewed, especially when you are posting information that may be not as factual as you believe it to be.
The fact remains, as long as one doesn't leave the house and is in realm of the pt, that's not abandonment, and the fact remains, that one is entitled to a break; many PDN nurses have went on bathroom breaks and take a lunch; again, to insinuate that leaving the room is "not covered" as nursing are is absurd; think about it...if I did to leave the room to empty a suction canister in a bathroom is not abandonment; and that wouldn't be covered under I share is laughable.
As long as one remains in the home or is outside of the home with the client, nursing is covered; if one decides to step out of the room and let the child sleep and have a break in the home, or if they leave with the parent to do out to the store ON their break, that's not abandonment.
If you want to be rigid in the interpretation if the rules, so be it, but don't post information that doesn't supersede federal labor laws as proof; because it doesn't...show me federal CMS and labor laws that back up your claims, not something from an agency that may be questionable to the practices that may be violating labor laws.
To add: the OP, never stated that they left the house; the OP did state that they were informed that she was to getting paid those hours because she took a break; that's NOT legal, and again, the point of this thread; per the OP, I believe she should be contacting a labor board to see what they say.
Specializes in Complex pedi to LTC/SA & now a manager.
Most states do not mandate 30 minute breaks for those over age 18.
A break is 30 or more minutes of uninterrupted time where you transferred patient responsibilities to another qualified caregiver. You may or may not leave the property. Federal labor laws mandate that you are paid if your break is less than 30 minutes or if you are still on duty. Eating lunch while monitoring your patient is not a break. Taking a 2 minute bathroom trip is not a break. Running dirty diapers out to the trash while your patient is safe and monitors on is not a break. Sitting outside your monitored patient's darkened room while they sleep so you can document.
Notwithstanding what the labor law or CMS says, several of my agencies have told me that I am paid for eight hours instead of 7.5 hours because I must remain within sight of the patient while I am eating my lunch. I can not physically leave the home when working extended care cases. I don't care if people call my breaks, breaks, lunch, or whatever, I am still physically there for eight hours if I am being paid for eight hours. And I spend a good deal of that time, depending on the case, sitting on my tush providing "skilled observation" of my patient. I am not going to complain. But what the OP described, sounds off the grid. They need to consult the labor board as a minimum and probably should also touch base with a labor law attorney.
I don't want to get into the "is this a break?" debate. I will say, however, my employer (a hospital, not PDN) automatically deducts 30 minutes from my daily hours worked unless I specially select "no lunch" when I clock out. I'm wondering if that happens for the OP?
Notwithstanding what the labor law or CMS says, several of my agencies have told me that I am paid for eight hours instead of 7.5 hours because I must remain within sight of the patient while I am eating my lunch. I can not physically leave the home when working extended care cases. I don't care if people call my breaks, breaks, lunch, or whatever, I am still physically there for eight hours if I am being paid for eight hours. And I spend a good deal of that time, depending on the case, sitting on my tush providing "skilled observation" of my patient. I am not going to complain. But what the OP described, sounds off the grid. They need to consult the labor board as a minimum and probably should also touch base with a labor law attorney.
Agreed; what doesn't make sense is that if the agency alleged that they are not going to pay for the whole shift because of an alleged "break" that sounds fishy, or there is more to the story...if it is the former, then they need to consult with an attorney, no question.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
This link has the info that explains that the agency is responsible for making sure that the nurse has a year of experience/training. I'm still looking for the link about staying in the same room.
I'm just stating what the rules are. I don't make them, I follow them. I'm not a betting person, but if I were, I'd bet that the OP had no clue about all the documentation requirements on that link...but they are responsible for it even if they don't know. Many nurses don't realize this stuff. But its up to us to find out...the agency will never have our backs.
Your link is for THE STATE OF NORTH CAROLINA's Medicaid program.
Do you have anything FEDERAL to show this is the case in ALL states?
And yes, I'd still love to see something that says we have to drag the kid around the house in the Hoyer for every single trip outside the bedroom (or room the child is in at that moment in time).
As I stated, it may vary by state. But many states are very similar to what I posted.
I'm at work and on my phone, so I haven't had a chance to find the other one yet.
It seems some people get very defensive when they don't like the laws/rules or when they have been breaking them. I was simply responding to the OP with the rules that apply to the situation. Whether you like the rules or not, we have to follow them. Simple as that. Arguing about their rules is pointless.
It seems some people get very defensive when they don't like the laws/rules or when they have been breaking them. I was simply responding to the OP with the rules that apply to the situation. Whether you like the rules or not, we have to follow them. Simple as that. Arguing about their rules is pointless.
No one is getting defensive, the issue is that you are spreading inaccurate information; from CMS and labor law regulations down to who can work in home health; that didn't help to add to this discussion; however, because yI have informed you in past discussions about your inaccuracies and yet they still continue, there are going to be posters other than I who have more experience that are going to inform you of you inaccuracies and point them out; it does no good to inform people of inaccurate information.
I posted a link to information from the source. Doesn't get any more clear than that. If that is spreading false info, I guess the link I posted is lying about their own rules as well.
SDALPN
997 Posts
I'm not saying that the agency is right in not giving us a break. Yes, labor laws require us to take a break. I agree with that and a break would be nice, real nice. But its not realistic with most cases. Who is going to stop by for 30 min for me to take a break? A parent that gets a 30 min break at work, but not the time to drive home and back? Most cases that's hard to do. And if we just leave the pt for a lunch break, its abandonment. We can't get paid during that time and medicaid/medicare won't pay an agency if we aren't working. We take "breaks" as we go. Eating when a kid sleeps, bathroom breaks between meds/txs/therapies. Many times I've had to use the bathroom when the therapist has started working with the pt.
My agency has a policy that if a pt must be left unattended even for a sec, that the pt must have all monitors on with alarms. But at the same time it doesn't mean we can sit outside of the pts room all shift because insurance doesn't allow that.