New to Home Health

Libby1987 · Jul 18, 2016

I don't know Brookdale but the points are simply a measure of productivity. They likely require 5-6 points per day which is the equivalent of 5-6 routine revisits/day. Or 1 admission and 4-5 revisits or 1 recert, 2 discharge oasis, and 1-2 revisits (all of which are a normal full time day).

If you were paid by the visit, you would self regulate your productivity and make that many visits without being monitored. (it's the best for both employee and employer in my experience, if you work for a reasonable place that also compensates for excessive drive time or extended visits).

It's not the points or the pay structure as much as it is the office organization and assignment of territories. You want to keep your schedule accurate up to the minute and receive early heads up on new admissions so that you can plan and make schedule adjustments timely and smoothly. You also don't want to have excessive driving unless you are compensated and/or the point requirement is adjusted.

mommabean0608 · Jul 18, 2016

Thank you for all the detailed information & suggestions. Been reading that things can be a bit crazy with Oasis/finding a balance scheduling patients and etc, but to give it 6months and things should smooth out. Appreciate your insight.

Libby1987 · Jul 19, 2016

It takes more than 6 months, a year is more realistic. And depending on your experience, ability to learn a large volume of information and stress tolerance, it can be a rough year. But a good career can be on the other side if you can succeed.

mommabean0608 · Jul 20, 2016

I've been a nurse for 11yrs (Med/Surg, urology, etc), but the past 4 years I've been behind a desk doing telephonic work with patients (previously burned out being in hospital). I tend to be a very independent person, but have lots of questions until I feel I master something & then love being able to share that with others. Do you have any suggestions for the 1st year "home health hazing" (not sure what else to call it) to not only survive, but to excel? Sounds like your in HH if so how long if you don't mind. Appreciate your time and any feedback.

Libby1987 · Jul 22, 2016

I've been in home health since 1988.

The first year will require you to dedicate most of your time and energy to learning and you'll need to put the typical idea of work/life balance on hold. Go into it like boot camp and feed/rest yourself well, study on off time, wound healing principles etc.

If you've been out of patient care for 4 years, you should be able to utilize most of your skills but the acuities will shock you. You will repeatedly say these patients should be in the hospital, but don't.

Disease management has increased in responsibility for both patient and home health staff.

No matter how hard they tried to describe the amount and detail of documentation required you will still understimate it and when that realization hits, it will make you question your choice, but if you can just roll with it until you get it you will have less frustration.

You will need to accept that you are both responsible for reimbursement as well as positioning your team to be able to reflect the improvements they achieve with the patient by the baseline assessment you establish. You will need to look at patients from a safety perspective in the home setting which will run contridictory to what you're accustomed. Every nurse in my experience has struggled with that concept but so much is riding on it, both covering the cost to provide care and your agency's reputation with the public, CMS and referral sources. Take it very seriously and lose everything you know about patient is A & O X 3, resting comfortably... You'll need to put on your UR hat and justify why all of the services ordered and referred are medically necessary.

It's a lot to learn in a year but it is doable if you have strong nursing skills and the ability to take in and process a large volume of info without becoming anxious or resentful. It will pay off, experienced home health case managers who grasp the above concepts are very marketable.

Many have posted organizational tips on this forum that are very helpful for starting up and managing your day.