smartnrse

Our agency just decided to "re-adjust" rates to come in line with the rest of the company. Mind you all of the readjusted rates were a decrease. Significant changes in reimbursement on varous oasis visits (even though they take the longest). Guess we were just overpaid all this time. Makes me wonder about the health of the company if lowly field staff are taking a pay cut.

Which ones? I'm scared to swap because I don't know if one is better than the other?

I was an MCP with gentiva and I would not recommend it. It may vary from area to area but my experience was horrible. The pay was less, the hours were longer and there is not a single person on the planet that is happy at the end of the day. I went back to the field and I am happier but have considered going to another agency because of the horrible attitudes in our office. I stay because of the vacation time I have built up. If you are happy-stay where you are, that job will eat at you 24hours a day.

I too know exactly why home care nurses quit. The only reason I stay is because I can remember when I worked for a wonderful agency, even though it is a terrible place to work now. There is no respect for your time or your paycheck. Unfortunately I did management and for a year and a half I had to fight to do what was fair for the nurse and the patient. After someone has been in management a year, its not that they don't remember what it was like- they just don't care. Upper management is always on you about numbers and field staff always has something going on, it was a constant struggle. Where I work they have decided it is just too much work to try to cover visits or arrange visits so that the nurse is not drowning. If you assign someone to do 3 admissions, 1 resumption and a visit, are you really doing what is best for the patient? I know it's not what is best for the nurse. I went back into the field because it was best for me and my family and I promised myself I would not be a complainer but it is so hard when the scheduler and the mcps-oh, don't forget the branch director- really just want what is easiest for them instead of what is best for the patient. Complaints are made about oasis accuracy, but if it is your 4th oasis of the day how accurate can you be? The real kicker is we were told they were going to try to do call a little differently to try to make it better and wanted suggestions. The nurses wanted to sign on a calendar days they requested no call and rotate out accordingly - but that was too much work for the mcp. So now our call is set in STONE, meaning until they have to change it to suit them. It's sad that such a small request couldn't be done, we have many nurses who only see their children every other weekend. They shouldn't have to work those weekends. The real kicker this week was when one of the mcps asked a swamped nurse to do a visit on a patient that was not his and told him if he couldn't work it in he could see it that night because he was on call. It is really sad- I do so love home care but I really hate the place I work now. I have thought about transferring to one of the smaller offices but my current area is right around where I live. I miss the home care company I worked for 5 years ago- when we truly did care about the patient.

"nurses are a dime a dozen" is something that has come out of our area director's mouth before. They act that way until someone quits and then they just can't seem to find anybody to replace them. The fact of the matter is that good nurses are worth their pay and it costs more money to hire and train new employess than it does to pay good nurses what they are worth.

I have been doing home health for 6 years. You can't beat the flexability but it is like it NEVER ENDS. Time at home is spent on paperwork and case management means many hours doing things you don't get paid to do. Seriously thinking about going prn with 2 agencies which would mean no case management and no call. Just concerned about census drops.

If anyone knows more about how to do this, I'm interested. I already do assessments with a home care agency. Thanks

How is your agency not getting denials if you are keeping patients that do not require skilled care? Our intermediary checks everything so closely that we get denials on wound patients if it is not a particular kind of wound care. It is hard to work in an environment where you feel like you are having to fight to do what is right. Patients should be educated concerning discharge on admission. I Know they get selective hearing but discharge plans should be discussed every visit by every discipline.