ragtopnurse

ragtopnurse specializes in LTC, HomeCare, a little med/surg.

Latest Activity

1. Spouses scheduling conflict

   ragtopnurse replied to wayunderpaid's topic in Safety

   I think maybe you misunderstood what I was saying. I was actually referring more to the advice that someone had given you to "just call in". I wasn't criticizing you in any way but apparently you thought I was. And in answer to your question, yes I h...

2. How Bad Is The Charting???

   ragtopnurse replied to deniseS's topic in Home Health

   I agree totally.

3. Charting question

   ragtopnurse replied to temprn2's topic in Home Health

   We don't use computers and I don't really think our company ever will. We are supposed to do our charting in the patients home but with recerts and PHEs you have to review the chart in the office so that is where we complete it. Of course we all are ...

4. 5 day discharge notice

   ragtopnurse replied to msshowme's topic in Home Health

   This is correct. We have to give all Medicare patients a 48hr DC notice if patient is remaining in the community with the exception that the patient is requesting discharge from HomeCare. In this case you don't have to give one.

5. Anyone seeing decreased visits per episode?

   ragtopnurse replied to ragtopnurse's topic in Home Health

   From what I have learned Medicare pays a lump sum per episode based on the case mix diagnosis and the clinical, functional and service scores compiled from the Oasis MOO questions. If you don't get at least 5 total visits it falls into what they call...

6. On Call dilemma

   ragtopnurse replied to AngiRN's topic in Home Health

   Our on call system is very similar to this except on the weekends our RNs take first call and the LPNs take backup. This is because we do so many weekend admissions and PHEs. Our field nurses take call, office nurses do not. We do get a day off durin...

7. On Call dilemma

   ragtopnurse replied to AngiRN's topic in Home Health

   In our office only the full-time nurses take call. We have 5 full time RNs and 4 full time LPNs, we have several prn of each but they don't take call. We do call one night at a time during the week and it rotates. On the nights that an LPN is on call...

8. Mediport Flushes And Hh

   ragtopnurse replied to JennyHHRN's topic in Home Health

   No, Medicare doesn't see port flushes as a skill to keep patients solely for that, but we can keep them for monthly B12 injections if they have a diagnosis of pernicious anemia, now tell me how that makes sense. I would much rather have a family memb...

9. weight gain in home health

   ragtopnurse replied to tnurse63's topic in Home Health

   I gained about 10 lbs the first year I was in HomeCare but I got back to walking and eating better and it came off. I have since stopped walking very much but I still try to eat right (most of the time). I really want to start walking again because I...

10. Anyone seeing decreased visits per episode?

    ragtopnurse posted a topic in Home Health

    Is anyone else being told to decrease the number of nursing, therapy, etc visits per episode. A few years back we were told that we couldn't keep patients if their freq was only one time a week. Now we are being told to decrease them to one time a we...

11. Need ideas for teaching...

    ragtopnurse replied to DutchgirlRN's topic in Home Health

    Great idea!

12. Need ideas for teaching...

    ragtopnurse replied to DutchgirlRN's topic in Home Health

    Is teaching your only skill and have you taught everything on the disease such as meds, s/s to report, ways to manage their disease when HomeCare has DC'd? I know that frequently this happens, the patient is stable and you have taught everything 2 or...

13. Thinking about HH and VERY nervous!

    ragtopnurse replied to saireyRN's topic in Home Health

    I have been in HomeCare for 7 yrs and I love it. It is like anything else, it has it's good days and bad days but overall it is a very satisfying career. I don't really think you will put in more hours than you do now if you are working full time. Ou...

14. RN Case Manager...........

    ragtopnurse replied to dreamrider_212's topic in Home Health

    I have been in HomeCare for 7 yrs but I have recently been thinking about case management myself. Our company doesn't have such positions so I would love to hear what you think of it if you take this position. If anyone else can tell me how to pursue...

15. Visits vs. Shift work?

    ragtopnurse replied to MA Nurse's topic in Home Health

    So true about the paperwork. Putting it off is a very bad habit to get in and once you start it is hard to break. If you put it off for one day you will be trying to play catch up all week. It took me awhile but I did break the habit and I was much l...