S.N. Visit

If the client has been discharged due to being in the hospital or away on vacation and we pick them back up to readmit during a cert period, then we use the new SOC date because it's a completely new episode, but we don't change our SOC for routine recert's. Instead we use a "Follow Up/ Resumption of Care date" as the date we actually assess our patient for recertification (within 48hrs of order)then our SOC remains unchanged. I imagine you are now using the SOC date as day order is received, so tracking those pesky important dates are easier to be within compliance for CMS but it confuses me to why you'd use a new SOC date if you are doing that on all recerts. Hope that made sense and answered your question.

I can only speak from my experience. I hire LPN's & brand new RN's to perform less critical types of cases, for example: simple wound dressing changes, Foley Cath's, or to set up routine medications. I leave the complex cases & management to experienced R.N's.

Care Scout, is my favorite other Insurance company. Paperwork is a breeze in compared to Senior Bridge.

I just bought into a Home Health Care Franchise as non skilled at this time. All in all, I think you are looking to start with about $125,000 to get started through the first year. The banks, and SBA are being very tight at this time with lending, as there is no collateral in a home health agency. Just lots of blue sky.

I have severe allergies as well and take 3 rx strength antihistamines daily (optical, nasal and by mouth). Benadryl and other OTC antihistamines are useless to my reactions, so I understand completely about having to take a ton of antihistamines. I am sympathetic to you, however it was your first day, I would have went to work unless I was going into anaphylaxis or mentally impaired from the antihistamines. To answer your question, I'd go to the supervisor but keep in mind that if she or he has never experienced a severe allergic reaction, he/she may also belittle your decision to call in sick. I'd bring a note from my allergist. Best of luck with your new job!

I'm on a new path too, sort of.. My current employer (HHA) is shutting the doors this friday. I'm going to give it a go and start my own. Best of luck to you!

Too much to post here and not enough time to list my reasons I feel they hated me. I agree the above examples weren't the best to use. Maybe they didn't "Hate Me", instead they really disliked me intensely. I had nearly 2years experience with them to know. Those two quotes were actually the nicest things they ever said to me.

:lol2: This makes me chuckle!!

I cannot deal with vomit either! It grosses me out to no end. Luckily to date, I have not had to clean it up in my short nursing career. I started as an RN in inpatient psych (all patients physically stable) and now I am a Case Manager, RN in Home Health . I spend minimal time with the patients compared to the LPN's and CNA/HHA's. My point is, maybe you should stay in nursing but find a different area to work in.

RN's in Iowa most definately pull PICC lines. Additional training comes into place when an RN "places" a PICC line according to policies of workplace/BON.

Maybe she became an LPN?

Oh Yes, I had two med surg clinical instructors absolutely hate me. To this day, I still don't know why. I sucked it up, did everything they asked and passed. Biting my tongue during the last face to face evaluation with the two who hated me was the hardest thing to get through. I was told by one "I feel that I failed you from becoming a good nurse & you are narrow minded." My second CI told me that "if I go into mental health after graduation instead of Med surg, I would be throwing away everything I learned and I wasted 2 yrs of her time. " They made my clinical days hell, but i survived. I am however thankful that the majority of my instructors did like me. My point is you are not alone. Hang in there. Do what you have to do to be a survivor.

I also work home health, so I will reschedule as well.

Nurse, mother and 7th & 8th grade certified Cheer-leading coach.:anpom: It really depends on the day which occupation I prefer. The pay & my mental sanity is so much better being a nurse.

Studies have shown that artificial nails, as well as chipped nail polish, possess a greater amount of gram negative bacteria and pathogens than natural nails. The grooves and rough areas create a perfect space for bacteria to reside.