NP in Nursing Home/SNF

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Specializes in Cardiac, Home Health, Primary Care.

I've looked through and searched several pages but cannot quite find much about this topic with many good answers.

Does anybody here work as a NP in a SNF/nursing home/assisted living? There are many postings in my area through independent companies placing NP's in these facilities and was wondering how the work was, if pay any better or worse, what a typical day is and anything else that might be helpful.

I went rounding at a local SNF with one of my preceptors and it didn't seem like bad work.

Thanks in advance for any help!

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I once worked in a facility where an advanced practice nurse was hired with nontypical duties in mind. She was supposed to incorporate new policies for improving care but got caught up when the place erupted in disruptive turmoil. The DON walked off the job and this nurse got handed the DON job against (according to her own admission to me) her better judgement. She ended up eventually leaving the facility sometime during all the investigations that commenced. I always thought that it would have been interesting to see how things would have turned out if this nurse had been able to do what she was hired to do instead of acting as the secondary scapegoat.

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Specializes in Peri-op/Sub-Acute ANP.

I work for an independent company that places providers into facilities. I currently cover two facilities, around 140 patients, split between rehab., snf, and ltc. I really enjoy the variety of patients I see and I like the independence. My company really does not care what hours I work as long as I cover my patients and make the minimum numbers. If I need to go early one day I will make the time up later in the week. Depending on what is going on at the facility, I can see anywhere from 6 to 15 patients in a day. Because I am not employed by either of these facilities I don't get involved in too much drama or internal politics - I just do my rounds and move on. Not saying there are no frustrations with this kind of work, but on the whole I prefer it to being employed at one facility because of the kind of politics caliotter3 has mentioned.

I certainly think it is worth looking into if you are interested in this line of work. I am salaried with a production bonus that is well within my ability to maximize, and I have fully paid health benefits as well as the usual add on's - mileage, CME credits, 4 weeks vacation, 7 days paid education days, sick pay, etc.

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Specializes in Cardiac, Home Health, Primary Care.

Thanks for a little insight! I wonder if the one who wound up DON was hired by the facility or an independent company?? I have applied to an independent company and like the flexibility as it's what I've come to know doing home health.

While I am thankful for those who can do primary care in a clinic setting I just like doing something a little different. I'll happily go to a clinic if that's where I get a job but I just prefer getting a little sunshine and not having that monotony that can be clinic work.

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The individual I posted about who ended up becoming the DON, was hired by the owner/administrator of the facility.

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Specializes in Cardiac, Home Health, Primary Care.
I work for an independent company that places providers into facilities. I currently cover two facilities, around 140 patients, split between rehab., snf, and ltc. I really enjoy the variety of patients I see and I like the independence. My company really does not care what hours I work as long as I cover my patients and make the minimum numbers. If I need to go early one day I will make the time up later in the week. Depending on what is going on at the facility, I can see anywhere from 6 to 15 patients in a day. Because I am not employed by either of these facilities I don't get involved in too much drama or internal politics - I just do my rounds and move on. Not saying there are no frustrations with this kind of work, but on the whole I prefer it to being employed at one facility because of the kind of politics caliotter3 has mentioned.

I certainly think it is worth looking into if you are interested in this line of work. I am salaried with a production bonus that is well within my ability to maximize, and I have fully paid health benefits as well as the usual add on's - mileage, CME credits, 4 weeks vacation, 7 days paid education days, sick pay, etc.

Thanks Caliotter3 for some issues you have seen.

TakeTwoAspirin, this sounds very similar to the company I am speaking with. I need to ask about mileage and more specifics about sick pay, licensing cost, etc. They are a fairly new company but are growing pretty quickly. They only mentioned 2 weeks vacation but that may grow as you're there longer (something I need to ask). The vacation wouldn't quite be a huge issue for me as I don't take many vacations really. And if I could manipulate my schedule to have several days off in a row that'd be enough to do some small trips if I wanted.

I also need to ask about mileage when I speak with them again. Today was just a quick information type call but I was told I should hear in the next week or two about a face to face interview. Thankfully they also said they have a good orientation for new grads as well as experienced NP's available for questions (something I've been worried about)

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Specializes in Peri-op/Sub-Acute ANP.

I have one site that is considered my "home base". I do not get mileage for this site, but when I go to other sites to cover other practitioners, or to my secondary site which is much further away, I get mileage/toll reimbursement. Not sure what the per mile rate is. I've never broken it down. I get paid sick leave (I think it's up to 10 days/yr) in addition to 4 weeks paid vacation and one additional week for CME/conferences. They pay for my licensing/DEA etc., costs and $1,500/yr towards CME costs. I would not sign a contract with only 2 weeks vacation. While I seldom take all of the leave I have available to me, 2 weeks is not enough. You will be working hard, and will be under a lot of stress. With autonomy comes the weight of responsibility. You NEED to take vacation and look after yourself or you will burn bright after about a year! Push for 3 weeks vacation. If you don't use it, fine, but I think you might find that you need more breaks than you anticipate.

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Specializes in Cardiac, Home Health, Primary Care.

Thanks for the guidance!! I'll try to push for a little more vacation. Perhaps they start low just to see what happens. I thought it seemed a little low also....

Thanks again for input!!

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Specializes in Cardiac, Home Health, Primary Care.

And that is push if I for sure get an offer lol. This first conversation was really just an overview and to answer some general questions I might have.

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hello. I cover two SNFs, approx 200 total beds (about 70 skilled). I agree with the other poster; be sure to get 3 weeks' paid vacation...as well as CME, etc. I do not receive mileage, but I work within my local community. I spend about 8-9 hrs/day in each facility; I bill for anywhere from 6-9 actual "visits" per day, but I see alot more than that. Much of my day is analyzing lab results and other studies, coordinating care, speaking with nurses and family members, and just making sure that patients who are transitioning from hospital to SNF have all of their "t's" crossed and "i's" dotted. :) For instance, transition of care assessments, etc can take me well over an hour for one patient. I love the folks I care for and generally, this work is my "happy spot" each week. I also work two days/week in primary care....and I find that a completely different challenge. Overall, I love my work in SNF and don't feel stressed by some of the problems that one sees in a primary care office. Like the other poster, I am not a facility employee....which is nice. I am also a very autonomous individual, so this work serves me well. I am an older NP and like practicing solo. I have a wonderful collaborative MD who supports everything I do. I think you will enjoy the work. Very rewarding. The only downside is that you won't see children or do much in the way of reproductive health. (I am FNP, so that matters to me a wee bit...which is why my primary care hours are important to me).

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Do u have to lift/transfer pts while working in SNF/LTC as NP?

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" The only downside is that you won't see children or do much in the way of reproductive health. (I am FNP, so that matters to me a wee bit...which is why my primary care hours are important to me)."

I just discussed an opportunity to round SNF patients for a physician. I need the flexibility for little children at home. I am also an FNP. If I take the offer and then I won't see peds at all. Will this effect my FNP cert renewal? I looked up the requirement on aanp website and found this "a minimum of 1000 hours of clinical practice as a nurse practitioner in the NP's population focus". Does this mean I need see peds in order to recertified?

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