New RN asked to "consult" for a new home care agency?!

[iheartej]

An old friend has asked me if I would be interested in consulting for a new home care agency she is starting up. I would be assessing pts to determine if they need homecare upon disharge from hospital. I don't know very many details yet, except she would only need me a few hours a week. It is going to be in home adl care, but the insurance requires an RN on staff to do assessments. Does this sound like something for a new nurse? I have a few months experience on a med surg floor. I don't want to get myself in over my head

[jennycRN]

It's hard for me to understand exactly what your role would be. Many home care agencies employ 'transitional care' nurses who evaluate pts in the hospital to help with continuity of care, make sure the right services are in place, avoid readmissions, etc. PT and OT usually make the specific assessments about whether help with ADLs are needed.

Typically these positions require familiarity with the reimbursement system, insurances, applicable laws etc. As a new nurse at a new company, think about how you will get the mentoring you need to navigate these complex systems. My gut feeling is that this job is about more than just simple 'assessments' and that you might be in over your head.

[krisiepoo]

are you just filling out like an LTCC assessment to see how many hours of PCA they'd need?

[iheartej]

I'm not sure exactly what I would be doing. We haven't gotten together to discuss details. I was just wondering if anyone had experience with this. I would hope she would want someone more experienced for something so complex. She knows I am a new nurse. I

[iheartej]

Thanks for replying. We are sitting down together this week. I will post back with details. Maybe she doesn't realize the complexity of what she is asking me to do.

[HouTx, BSN, MSN, EdD]

Please be very careful. Considering your lack of familiarity with reimbursement rules, you may find yourself inadvertently embroiled in a 'fraud and abuse' situation. This could effectively end your career before it has even begun.

[NRSKarenRN, BSN, RN]

Many new agencies start by providing Private Pay Home Health Aide (HHA) care along with contracts from states Medicaid program via contracts with area Office of Aging program under Home and Community Based services.

Home and Community Based Services

Services covering a wide range of needs are available allowing individuals to remain in their communities and homes. These services include home health care; personal care, providing assistance with bathing, dressing, eating, grooming, toileting, etc.; health support services such as housekeeping, shopping assistance, laundry and mending; respite care (caregiver relief); other routine household chores as necessary to maintain a consumer's health, safety and ability to remain in the home.

There are specific HHA supervision time frames that must be meet depending on program contract.

Do you know what to do in these situations:

• Home Health Aide is not following the care plan?
  
• Home Health Aide is not at consumers home for any scheduled Supervision visits, consumer states aide changes schedule to accommodate another client. RN stops in unannounced and aide still not in home: Aide and consumer splitting monies ment to pay for her care with services never provided.
  
• Consumer's home is disheveled, loosing weight and has pile unpaid bills on dining room table despite living with daughter?
  

This is NOT a position for a new nurse. If you've never practiced as RN, how can you "consult" as you have no knowledge base of home healthcare, especially older adult regulations and no other colleagues to bounce ideas/get second opinion.

noun: consultant; plural noun: consultants

1.

a person who provides expert advice professionally.

[TABLE=class: vk_tbl vk_gy]

[TR]

[TD=class: lr_dct_nyms_ttl]synonyms:[/TD]

[TD]adviser, expert, specialist, authority[/TD]

[/TR]

[/TABLE]

Most area offices of aging provide orientation sessions few times a year to educate community professionals on depth and breath of services including expectation RN Consultants.

Find your local AAA or Title VI Native American aging program

Example programs

The fact they would consider a new grad for this position is a HUGE red flag. Please proceed with caution.

[iheartej]

Thank you for the advice and the links. I will do some research before I accept the offer. I don't want to get in anything that could make me lose my license. I am happy where I'm at right now In med surg. I will talk with her about the expectations of the job and my concerns.