cny4rn

From what I can tell the point system only benefits the company. I started about two months ago for a company that uses it and gave a two and half week notice this week. We are reimbursed at 1 point for regular SNV, 1 point DC, 1.5 for RC, 2.0 for ROC, and 2.5 for SOC. My point system is worth 41 dollars per point for me. I don't know what the other RNs are worth. We do get mileage at 40 cents per mile. This sounds pretty good at face value but we have a PDA computer system called HCHB and it is very repetitive and takes more time than paper.I spend time at home charting probably 5 hrs a week, after long days.Maybe I'm just burned out after this scorching Texas summer heat and getting in and out of a hot car. Pun wasn't intended! I have been in home health over the past 15 years part time and full time and paper just seemed better to me. Is anyone else familiar with the hchb computer system?

The owner told us at the mandatory meeting we had when he announced the other superivisor being let go, that our goal was to get the patient to a level of health and independence to be discharged in a timely manner. Of course some of our patients are so unstable this isn't going to happen, but for the ones that are stable this is refreshing to hear the owner and new supervisor say...........we will see. I think of getting out of home health due to these issues but I truly love my patients and the ones that need us deserve good care.

You know you're right actually. The truth should always prevail but it doesn't. She was let go for not doing her job .......the owner just took a while to figure that out. She wouldn't have lost her job over recerting someone that wasn't homebound. Sad but true. Medicare fraud in for profit home health agencies is common isn't it?

DeeAngel, your name doesn't fit the harsh reply you gave. Hope your not that judgemental all the time.

Thank you all for your replies. The patient I was concerned with does not require a taxing effort for her to drive or leave her home. I know I did the right thing. It was interesting that after I said I didn't feel right recerting this patient the supervisor sent another RN out to do it. Then she told me there wouldn't be enough parttime visits any more for me...........but this week that supervisor was fired! So I have my job back. The truth always prevails in the end.

I am being told they can drive short distances to visit the doctor, church, etc. but I didn't feel good about it and am glad I refused to recert the patient.

Are you being paid 20 per hour or 20 per visit? If they are paying your travel time then 20 per hour is a fair payment. I am an RN and am paid 40 per regular visit with a 7 dollar trip fee if it is the second or more visit of the day. No trip fee for the first visit of the day. And if it takes me 45 to an hour to get from one visit to the next that is not paid for. So I think 20 dollars per hour is not bad. I work in the Fort Worth area of Texas.

I have worked in home health for about 8 years now. Most as a part time RN in the field but some as a full time case manager. Recently I refused to recert a patient that had current medical changes but was driving daily. I was told by my supervisor that it was within medicare guidelines for a patient to do this. Please let me know if this is correct. I feel if a patient is able to drive without exerting a taxing effort and is able to do this on a daily basis then they do not need home health care.

Ten patient visits is four too many to do a good job in my opinion. Eight should be tops. That is just ridiculous. Is there much driving on those days or are they close to one another? Anyway you definitely should stand up as you did and say you can not adequately cover that kind of patient load. So glad there are actually agencies out there that are ethical and care about the patients and the staff and not just the almighty dollar and census!!! Glad you found a rewarding job! So many of these little elderly patients really just need a caring attendant to see that they get good nutrition, their medications taken correctly and a safe bath. Too bad that medicare won't pay for just that. The ones that meet Medicaid income levels can get help through their programs but the ones that have any savings to speak of can't.

I am getting into this discussion late but I am glad to see other nurses standing up and saying they will not admit a patient that is not homebound or doesn't need home health services. I quit home health after 6 years cause of this type of thing and the enormous amount of paperwork. Anyway hooray for those of us that try and be ethical and follow medicare guidelines and boo to the money hungry agencies that look the other way and encourage marketers and some nurses to do the same.

I also worked for an agency that had those that liked to put others down and start rumors. I suppose with any office type atmosphere there will be some of that but this place has one girl in particular that is full of bitterness. She went to the supervisor with some information on me that was untrue. The supervisor believed her and called me in to put me on probation. I defended myself,but it was my word against the other girl.I had been planning to put in my two week notice the end of that week anyway. I had a 6 month bonus that was due the day they called me in to put me on probation and said my bonus was null and void because my work was unsatisfactory, which it wasn't......I had problems getting my paperwork in on time but I am a good nurse and honest. This supervisor hasn't been there but about a month and a half and has the big bad boss syndrome. Comes in and starts throwing her weight around without earning respect first.This girl that is the instigator of the rumors is 21 and is the receptionist/file clerk. She is trying to get in good with the new supervisor. Very immature and almost mean. She was just on probation herself a month before she made up the story on me. Why they keep her is beyond me.

At the agency I am working for, they told us that they would like the oasis turned in within 48 hrs, but if we got it finished in 7 days it was not considered late. So that is how we have been doing it. Well now the new supervisor is saying that was wrong and that it MUST be turned in within 48 hrs and at the latest 72. What is your policy?

Also check into your companies policy on your PTO time. I just found out at the home health company I work for that the minute you give your resignation your accumulated PTO time is forfeited!!! Start using it if you are planning on resigning.Unless they will pay you for your unused time. I have always given a two weeks notice but I think this is wrong about the PTO time policy.

Your right about the good and bad in everything. I am trying to work on my attitude cause sometimes it can be a bit stinky. Thankfully Texas doesn't have much ice or snow. It is the August heat that will kill you. Again, good luck to you in your new venture!

That's funny that you are going back to psych. A few of us were talking the other day about how we were disillusioned with home health and were remembering how we liked psych. My only problem would be I would have to drive about 40 miles or more to the metroplex to work in psych. Would you work three 12's? Good luck to you!!