new to home care

annaedRN, RN · Mar 16, 2010

unfortunately there are many new "fly by night" home health agencies popping up everywhere..their biggest concern seems to be making money. Not all of them mind you...but quite a few! Home health is a very autonomous field, and if you are a new grad..and haven't had the benefit of any hospital experience..you need a very THOROUGH orientation -in OASIS, as well as all the assessment and skills you need to be independent in the field. It is your hard earned license...and if this agency is not equipped to help you become proficient in your job...you really should look for something else. If your heart is in home health, then look around for a more established agency...often a non-profit one. Or try getting some hands on experience in a facility first. OASIS and coding for home health is a complicated, time consuming thing to learn...I hope things work out for you.

mariarn80 · Mar 16, 2010

Thank you soo much for your post. I onestly believe that i should not work there. However, as for a new grad it is impossible to find a job in hospital or elsewhere, but have bills to pay. This agency is only one option so far. I will think week or two, a am not putting my signature anywhere yet. How i can find a non profit agency, how do they called? Thanks a lot

CrazierThanYou · Mar 16, 2010

I am new grad that has been hired to a home care agency. They are relativelly new, opend 6 months ago. As i understand nowbody in office know what they are doing. I ask questions and they do not know how to answer them. I am so overwelmed by paperwork and liability. How do i check if they are not doing fraud? I worked for my licence so hard and do not want to loose it. Where i can get orientation info on home care nurse, so i can do everything right? OASIS is pain, diagnisis is even worse. How do we come up with these diagnoses? Do we have to have MD oreder for them? Cause in my agency nurses write some dx from referal, and some create themselves. I did not know that RN can come up with diadnisis. Plese help

I am a CNA but I am working for a home health agency that sounds like yours... they have no idea what they are doing!

nikki005 · Mar 16, 2010

I am a new grad in home care as well. Being that your agency is new, it's difficult to research the facility. Being that mine has been around for a while, I could find all sorts of reviews on my agency. I completely understand your situation, and to save your own butt in case something goes wrong, documentation on your patient is always key. Document patient progress and if anything looks out of the ordinary, don't be affraid to call it in to your supervisor or the RN in charge just to notify them of what is going on. make sure you document who you spoke to and what you said and what he/she said to you. If I were you, I would continue to ask questions even if they don't know the answer or you can take the initiative to find the answer yourself.

annaedRN, RN · Mar 16, 2010

Most VNA (visiting nurse associations) are non-profit. You could do a google search for your state or possibly ask your local hospital/community centers.

And with the coding - we dont come up with the diagnosis. We take the patient info provided by MD/hospital and use that to enter the ICD-9 codes. It is very complicated and tedious work. I am so thankful we have a full time coder. If things are not coded right - it can cost the agency serious money. Also, if coded erroneously, Medicare could cause problems for you when they are surveying. There are alot of rules, policies, etc that are needed to survive in home care. Your agency needs to learn them and follow them to be in compliance...especially concerning Medicare

HmarieD · Mar 16, 2010

You should go to the Home Health Forum, there are many many useful threads there that should answer a lot of your questions. You will also find a lot of good references there that will help you understand home health compliance and regulations. Good luck.