Paid by the case and not hourly

[smartnurse1982]

I started this job 2 months ago.

It is only supervising HHA and doing some reassessments,new admits,etc.

I still work Private duty nights,which is skilled nursing. My supervisor for the HH agency said this is not skilled nursing. However,there are some pts with gtubes,and i am supposed to teach the HHA how to administer feedings through them. I thought that is not in their scope of practice?

Also,i make about 30 calls and night,but only 5 people pick up. How am i supposed to get paid and do all of these visits when nobody answers the phone?

The nurse supervisor said to jut sign the reassessments and have the HHA come into the office to sign their portion. That does not sit right with me.

I did not realize this side might be worse than PD.

[caliotter3]

It seems they want to pay per case instead of hourly to take advantage of the person getting the tasks done.

[smartnurse1982]

Do most companies pay by the case/visit or do they pay hourly?

Funny thing is,I cant even say i get paid per visit,because I cold agree on a time,go to the patient's home,and they do not open the door. What a waste of time.

I am trying really hard not to go back into extended care.

[caliotter3]

For intermittent visits, most agencies pay per visit. The nurse's goal is to get in and get out in the least amount of time possible (to get the job done correctly) and move on to the next visit. Your first post made me think they were paying you X amount to manage a case, not X amount per visit per se. Either way, if you can't make an efficient visit, you aren't maximizing your income, as you have already found out. I would not sign any reassessment that I had not done. The supervisor might be ok with that practice. Let her sign them then. If this is the same agency that you are doing the night shift extended care case for, I don't envy your current position. If this heads to a showdown, you might have to find a new agency.

[LVNblue8]

This sounds like a shady company. HH can be enjoyable but the agency can make or break your experience.

We do have to bill whether a visit is hands on or not but they are all considered skilled if they MUST be done by a licensed nurse.

HHAs are definitely not allowed to give g tube feeding in California but not sure about other states.

This place just sounds like bad news to me