I have been working in home health for 20 years now. Over the years, I have seen the pay scale/type change back and forth. I worked 5 years for a hospital based agency, but the remainder has been with an independent privately owned for-profit agency. Prior to PPS, the nurses were all paid hourly. When PPS came into existence, our agency made a total change and all visiting staff were made per visit....mileage was cut. This lasted a few years. Now we no longer have per visit case managers....the only staff who are per visit are the contract staff, or prn staff. We have some nurses who are paid hourly, and some who are salary....just depends on their situation, hours worked, etc. The home health industry is ever changing and some agencies have to make changes in order to stay in business. I don't think you can generalize where every agency is headed, but I do think every agency is different.....much depends on owner status, independent vs. hospital-based, for profit, or not. Your best bet would be to investigate fully in each agency you are interested in. What are their expectations in relation to the type of pay they offer, etc. I have worked salary, per visit, and hourly....benefits and problems are associated with each type of pay. It all depends on what you need, what you are willing to do, and what you want to get out of your position, not only with pay, but with job satisfaction associated with it. I have not worked in the acute setting in a very long time, so I don't have anything to compare it to as far as money.....just from what I have read, home care pay is lower than acute care. But the rewards are many! And I live in the midwest, so our pay scale would be different than Florida I'm sure. Hopefully, someone from the Florida area can give you some advice on what the average pay scale for home care is in your area. Good luck.