jeanneb1

It just means you're being interviewed for a field position, as opposed to an office position. It could also mean that you will be paid "per visit" as opposed to salaried or hourly. And, this usually means no benefits, but the per visit pay rate is usually quite a bit higher than salaried/per hour. By the way, not a stupid question at all! Home health terms belong to a world of their own -- and what is common here in Texas may mean something entirely different in other areas of the country!

I wouldn't jump ship right now. The company took appropriate action at the appropriate time -- if they believed you weren't an asset, they would have "sweeped you out" with the others, I believe. Just my opinion, of course.....

Wouldn't it be lovely if all state surveyors simply followed the Medicare guidelines and didn't lend their own interpretations to determine "findings"? Tinker, good luck on your survey -- We've been expecting ours since December........ running just a tad late! Jeanne

A lot depends on your surveyors -- surveyors in Texas (San Antonio, anyway) instruct to use 0 as a "placeholder". Illogical to me, but I've had them insist that all weeks in the episode are included -- therefore, there are instances, (particularly at the beginning of an episode, say on Friday or Saturday when a visit was made earlier in the week, in the old episode), where 0 is used to account for the week in the episode. Hope I didn't confuse the issue....... Jeanne

I would be honest with your manager. Ask that when you are on call, an experienced staff member be also assigned to work that weekend; and if the clinical director will be available to field questions, offer advice, etc., after hours/weekends. If your agency is "worth it's salt", they'll appreciate that you are concerned enough to speak up -- you are putting the patients first, and that's important. Good luck! Jeanne

OK, I've looked at this for days now, and can't believe no one has taken the bait. So, I will....... I cannot conceive of any reason on God's Green Earth that a person or entity would name their hospice "Alive Hospice". Yes, a tad tacky, to my way of thinking! But, maybe there's a perspective that I'm not seeing -- just had a quick "gut reaction" and can't get past it!

$22 flat fee per visit, without mileage, and not paid until 6 - 8 weeks after the visit is a joke, in my opinion. Good that you had sense enough to say "no, thank you"! I hope your hospital position works out well for you. I don't hire anyone without at least one year of hospital experience, anyway -- there are too many situations that come up in home health that require quick thinking, and it's a very autonimous position to be in -- no one handy to assist if needed. A nurse with hospital-based experience is more capable of handling such situations. But, don't give up on home health -- once you've had some experience under your belt, try it again, if you're so inclined. It's a very rewarding niche in nursing. Best of luck to you. Jeanne

So, Loricatus, how'd the interview go? They were probably "salivating" because there have been lots of "bad" agencies around, teaching nurses/other staff "incorrectly". They're glad to get someone "green" that they can teach correctly, not having to break any bad habits. At least, that's when I salivate! Good luck to you........ Jeanne

Hi, Fellow Home Health Folks. The 485 is the plan of care, and I've always used as the careplan. How you track what's been taught is by placing a teaching log in the home folder -- as a med/procedure/etc. is taught, it is documented on the log, so the next nurse in the home (or, the same one on a day that dementia clouds the brain!) can readily see what's been taught, can question pt/cg to see if knowledge was understood and retained, then can re-teach with proper documentation of pt/cg confusion/forgetfulness, etc., or move on to something else. The teaching log, when full or completed, goes into the patient's chart as verification of services performed/information taught. It's a good, simple, effective tool.

Your agency management was derelict.... at minimum, the patient's physician should have been contacted and an MSW consult should have been ordered........and, based on what you have reported, an APS (Adult Protective Services) report should, in all probability, have been filed. You also have rights, as an employee -- these were violated. You have a strong case to file a complaint with the State regulatory body that governs your former agency. If something should happen in that home while the patient is under the agency's care, BIG TROUBLE FOR THE AGENCY! Good luck to you. You've made the correct interpretation for self-protection. Hopefully, you'll be driven to now do the correct thing for the patient, even though you're not any longer an employee of this agency. I'm the administrator of a home health agency; if you want to post your email address, I'll be happy to talk to you outside this forum. Jeanne