katnursey

Thank you for your response. I have worked the past 2 days and absolutely no air filled into the balloon on its own while I was on duty. I checked the balloon continuously throughout the day. However, both yesterday and today, when I arrived on duty, once again I noticed the balloon looked slightly inflated, more so this morning. I withdrew until it was completely deflated....no water, just air. The mom told me it is filling with air as the day progresses. I showed the balloon several times to her today, that it was completely deflated and NO air was seeping in there. She said it is happening in the evening. She also spoke to a RRT, who she said, informed her yes, air can get into the balloon....couldn't say how. All I know, is I have never seen this happen before when working with any child or adult with a trach.

Thank you for your responses. It will be interesting to see what I find Monday morning. I have my own thoughts about what is going on. Almost 100% sure air is not getting in there on its own. I found nothing wrong with the inflation line, balloon cuff port or luer valve. Strange that the balloon stayed completely deflated during my 8 hour shifts both Thursday and Friday. It is important for that cuff to remain completely deflated for the Passy-Muir Valve.

The child is vent dependent. We were using the sterile H20 as ordered. I have never used air in a trach cuff. I discovered the air this morning when I was doing my nursing assessment. The ballon was inflated. I slowly began to deflate the cuff.....no water, all air. I thought, what the heck. I took care of him for 8 hours today and the cuff stayed deflated. I took care of him yesterday.....no air in the balloon. Thought it strange, now that I am at home and not there, that I receive a "FYI" text message that the cuff now has air in it somehow. I told them to contact their physician if they have a concern about the cuff, as I am off duty. The child can get the balloon/cuff port in his mouth if he wanted too, but does not chew and cannot blow. There is no tubing to close off. There is the inflation line with the balloon/cuff port at the end. It has a luer valve where a syringe screws on and is used to inflate or deflate the cuff. Like I said, I had no problem today or yesterday with air getting in. Just finding this very strange and thought if someone is not injecting the air, well maybe someone has heard of this happening.

Has anyone ever heard of air getting into a completely deflated trach cuff? As far as I know, no one injected the air. This child has a trach that we were keeping the cuff filled with 1.5ml to 2 ml of sterile H2O, as ordered. Has been weaned down to no H2O in the cuff. Air was noticably in the cuff this morning, as the balloon was inflated. Balloon was completed deflated all day (8 hrs). Received a text a while ago as I am off duty, stating, FYI that cuff gets air in it somehow.

It is obvious to me who is accepting this crap! Independent providers are.... We have the one group of independents who are not even aware yet of what has gone down. Then, we have the group of independents who are aware of what has gone down, but have no balls. Then, we have a very small group of us, who are too small of a group and are unable to fight this, because we have no voice behind us.

It continues to amaze me how many independents still are not aware of the 20% pay reduction. I was talking with a friend the other day, whose neice is a HHA and has been with the program for 4 1/2 yrs. The next thing I knew, her niece was calling me about this, because she was in the dark about the pay reduction. She told me, she had called a half dozen for her IP HHA friends she works cases with and NONE knew about this. I then, referred her to documentaion where this bill had already been signed by the governor. We all knew there would be cuts made to the Ohio Home Care Program, but none expected this. So, they worked all this out behind our backs and made this pay cut to balance their budget and avoid having to take pay away from the agencies. They cut the pay of IPs and there are how many of us in Ohio actually working? Hmnn, I have heard maybe 1000 or so. How many home health agencies? A LOT. How many agency nurses and aides are being sent out day after day? A LOT....thousands. But, yet they are reducing the pay of the smaller group by 20% and the agencies by 5% for the 1st hour only....that is a pay cut for agencies of $2.75 a day (the large group). Now, what is wrong with this picture?! The confusion is still present as to whether we are cut 20% for the 1st hr only or for all hours. A statement was written by home healthcare organizations, that IPs pay will be cut 20% for the 1st hr and for every subsequent unit. "The administration was able to reduce the cuts for agencies by reducing the rates paid to independent providers. Aside from receiving the 5% and 3% cuts on first hours for nurses and aides respectively, all Independent Providers will receive 20% less than the price paid to home care agencies, on the first hour and subsequent unit rates. The funds saved by this reduction will be used by the state to offset the cuts that were proposed for the first hour rates." In regards to the meeting on August 15th.....take that statement with a grain of salt. Nobody seems to know anything about that or who the person is who is making that statement. IPs and consumers needed to have a voice prior to this all going down, not after the fact. Just the fact, many IP aides and nurses are not even aware of the 20% pay cut, says it all. I guess, they will find out when they start getting a lower pay amount come this October.

I was stood up for an interview by the administrator and clinical director of a home health agency. I arrived for the interview and the secretary told me to have a seat. She gave me an application to complete. While I am filling out the app, a HHA came into the office and started c/o paycheck not being right. Said, "I am getting sick of this sh*t." The secretary, said, "I know what you mean." On and on this went and they started making plans to go to a bar after the office closed. Well, I finished completing the app and gave it to the secretary. Her and the HHA continued on. After a while, I glanced at my watch, because I was just sitting and sitting.....I had been there close to 1 1/2 hrs already. Then after the HHA leaves, the secretary (could not have been more than 20 years old) calls me over and has me sit in her area with her. Says, "sorry about that" and starts to giggle. She starts asking me all kinds of questions about things on my resume, that had been faxed to the administrator 3 days prior. The phone kept ringing and she kept stopping to answer it. Finally, after another 1/2 hr passed, I asked her where the administrator was. She said, "oh him and the clinical director are not here.....they had flu shots to give and got behind." I asked if they were coming, especially since he had requested I be there that day/ time. She said, "no, he called here a couple hours ago and said for me to just interview you."

You need to chill. Everyone has an opinion. The past, is the past and does not matter, but the future facing IPs does. We can learn from the past and not make the same mistakes. All IPs need to focus right now on finding a reputible healthcare organization to advocate for us. But, IPs need to remember if they don't start helping themselves and pull together united, no organization is going to be our voice.

NO, Independent Providers do not need a union. What we need is a home healthcare organization to advocate for us. An organization who believes in us, and who cares about issues facing independents, not just agencies.

Many IPs were going to give their support to the Ohio Council for Home Care several years ago. The membership offered to us, I believe was only $125/year. Myself and others were excited. They made up a separate membership form for nurses who were independent providers to complete. Then, after talking with them, we learned, we would have no real membership benefits.....no voice, no voting rights, would not be able to advertise on their site, etc.. For these reasons, many IPs chose not to support the OCHCH. I feel, the decision amongst many IPs to vote in the SEIU was a hasty decision. Several IPs I know, told me they felt desperate for support and thought the SEIU would help them. When people feel desperate for help, they want something to believe in. It's unfortunate they did not find the support, although they were paying dues. It was and is difficult for IPs to know which way to turn. One of the organizations/websites you mentioned, did in fact offer support for the SEIU at first when they were trying to gain momentum, and then pulled her support. Also, offered her support for the OCHCH. This confused many, especially when you are being told one thing, one week, then told something different the next week. Independent Providers need a healthcare organization to strongly advocate on our behalf. But, it needs to be an organization who will treat us as equals and one that will truly support us. Then, perhaps IPs will start paying membership dues. I know, I gladly would.

Why is this a surprise to you? This all went down weeks ago. Why would they have notified us on the 'myohiohcp' page? That would have made sense. Some of us are lucky if we can receive a correct, updated ASP on the 'myohiohcp' from a CM after asking 10 times.....no exaggeration. We are never informed about anything of importance or that will effect us until after the fact. That is how it goes, plain and simple. If I were you, I would not post anything of importance for independent providers about a hearing or what you have going on, on this site. It can be read by all. As you can see, there are not many IPs responding to the 20% pay cut here, so you may want to start emailing them.

If you have something to announce, then please do so. Why wait to give out info? Just wondering, are you an Independent Provider?

I had actually worked that homecare case with the LPN about 5 years ago. I worked days and she worked nights. This was not a medicaid waiver case. I remember reading about it too in the Chronicle and Lorain Journal. I read about the other nurse in the same newspapers. How can an agency get away with sending a nurse out and not verifying her license or completing the criminal background check? Pay reduction for Carestar? Are you serious.......don't hold your breath!!! Was it the VNA who use to oversee the OHC waiver program for ODJFS before Carestar? They should really try to get the contract back.

My billing company told me, it was the 1st hour and subsequent units. I received a forwarded email from my billing company, that they had received, where it was stated: "Aside from receiving the 5% and 3% cuts on first hours for nurses and aides respectively, all Independent Providers will receive 20% less than the price paid to home care agencies, on the first hour and subsequent unit rates. The funds saved by this reduction will be used by the state to offset the cuts that were proposed for the first hour rates." Just so you know, the ones who announced "Victory for Home Care!" do not have this statement that they released above on their website word-for-word any longer. The part about independent providers is left out. Maybe tomorrow, a different statement will be posted. LOL I am going to make a few calls in the morning and find out for sure what is going on. I will send you a private email. I am really surprized there does not seem to be much interest or thoughts from other IP nurses. I did hear, that many were leaving the program, which is sad for them and the consumers. I am hoping it is just a rumor.