crunner

OK, I am an LPN with 14 years experience in home health. I have been Home Care Coordinator which included all aspects of marketing, ADON (Not because I supervised licensed staff in clinical aspects but because I knew the systems), performed visits, been an intake nurse for a national company, written 485's (checked for content and signed by an RN. This was OK with surveyors),set up insurance contracts, maintained provider relationships helped start an agency from ground up and, I think- everything else. I started working at a company (3 offices and more coming) about six weeks ago and am to be named G.M. on June 1st. But.............the things I have found. The 485's are poorly written, lacking proper goals and interventions. I see assess and evaluate on all 485's but little in the way of skills. Dressing changes are being done without orders (for a year!). Nurses are poorly trained. 50-60% of supervisory visits are past due (unskilled cases), nurses didn't know how to document (is better now since I was asked to coach them. I was trained by the best) and there are never any chart audits or 60 day summaries. How can 95% of Dx be "chronic"? I could go on and on................... I was told when I was hired that I would intimidate the DON because of my experience and the fact I am an LPN. It has been a fight to get even basic nursing started on the right track and there is such a long way to go. In six weeks I will have an even more responsibility. Does anyone know any websites that have info that will help me get this in order................writing 485's, documentation etc. I seem to have to pull up documents that support what I know needs fixing........seems to be a fight the whole way Because I am a LPN with the skills and experience I have it is tough to find a job. I need this one (was out of work for almost a year) and want the GM position.

I worked for Gentiva for over two years as an Intake Nurse Specialist and occasionally performed some visits. The Gentiva open paperwork is overwhelming and the company is frought with a the micro-management mindset, the nurses' paperwork was constantly sent back to them for correction. Compared with other area agencies the pay was on the low side. None of the field nurses were happy and turnover was very high. I could say more but if you know homecare it should be enough.