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I currently work for an agency and have for 2 years doing pediatric home health. For the last year I have worked with the same child. The family wants to leave the agency since they have been unable to staff their allocated hours. (Medicaid allows 80hrs/week and agency has only staffed 40-actually 50 since I have worked 10 hours of overtime every week for the past year). They asked the agency if they would case share with independent nurses, which would allow the family to staff the remaining hours that the agency could not. The agency said they don't case share since the situation can get sticky. After being understaffed for a year and overall issues, they want to leave. I can work as an independent nurse and I have in the past for another child. I have never case managed. I intend to take over the current case that I am working on right now and both case manage and work on the case. This is what the family also wants. We have wonderful doctors and a hospital case manager that will make this okay. Plus the agency is so lazy that majority of the time I am getting the orders and managing the paperwork flow back and forth at the current time. I signed a Do Not Compete upon hire. I have spoken with my attorney and based on the verbiage and the state statues the Do Not Compete is very weak and would most likely not hold up in the court system. It is a risk I am willing to take for both myself and the family. My question is.....has anyone done this? Left the agency and "taken" client with? But then worked independently? I want things to go as smoothly as possible, though realizing the hand off of the case is going to be the challenging part. Again, I am not worried about the Do Not Compete. The agency has failed to fill the hours allotted to the family for over a year. For that reason the state took away 20 hours per week of their time because it was never filled so there was no documentation proving the need for the services. The family is not interested in moving to a different agency since there is only one other and it does not deal with complex pediatric cases. Thanks in advance.

Not sure where to post this. I currently work for an agency and have for 2 years doing pediatric home health. For the last year I have worked with the same child. The family wants to leave the agency since they have been unable to staff their allocated hours. (Medicaid allows 80hrs/week and agency has only staffed 40-actually 50 since I have worked 10 hours of overtime every week for the past year). They asked the agency if they would case share with independent nurses, which would allow the family to staff the remaining hours that the agency could not. The agency said they don't case share since the situation can get sticky. After being understaffed for a year and overall issues, they want to leave. I can work as an independent nurse and I have in the past for another child. I have never case managed. I intend to take over the current case that I am working on right now and both case manage and work on the case. This is what the family also wants. We have wonderful doctors and a hospital case manager that will make this okay. Plus the agency is so lazy that majority of the time I am getting the orders and managing the paperwork flow back and forth at the current time. I signed a Do Not Compete upon hire. I have spoken with my attorney and based on the verbiage and the state statues the Do Not Compete is very weak and would most likely not hold up in the court system. It is a risk I am willing to take for both myself and the family. My question is.....has anyone done this? Left the agency and "taken" client with? But then worked independently? I want things to go as smoothly as possible, though realizing the hand off of the case is going to be the challenging part. Again, I am not worried about the Do Not Compete. The agency has failed to fill the hours allotted to the family for over a year. For that reason the state took away 20 hours per week of their time because it was never filled so there was no documentation proving the need for the services. The family is not interested in moving to a different agency since there is only one other and it does not deal with complex pediatric cases. Thanks in advance.

I am in Wisconsin. Per Medicaid you cannot work more than 60 hours per week or more than 12 hours in a day or more than 6 days in a row and must have at least 8 hours break in between shifts. Hospital RNs have different regulations than private duty. I am just wondering if because even through the agency it is medicaid (only they are getting a cut before me), if those hours are counting towards the 60 as well as the private duty on my own.

I have never run into this situation before, but it looks like I may in coming weeks. I work both with an agency and also privately. Do these hours get combined and need to stay at or under 60 for the week? For example I typically work 50hours (5-10hrs) through the agency and then one day on the weekend privately for a different client. I know that individually I cannot work more than 12hr days or 60hrs in a week. But does that mean combined as well since it is is all private duty care? Please advise. Thanks!