Questions about Private Duty Nursing

[marbear28]

It seems like, from a lot of the posts I've read, that RN's that work thru an agency have very low compensation. Some nurses have written that the pay is about half the amount, or like the pay of an LVN.

Could an RN be self-employed, rather than going thru an agency? Would he/she need to know a lot about business?

Thank you for the answers. :)

[JustBeachyNurse, LPN]

The low pay isn't because of agency but more because Medicaid reimbursements are low. Very few are private pay or commercial insurance. One Medicaid HMO wanted to pay agencies $13/hr for RNs regardless if a basic case or high tech ventilator case. Which would be about $8-10 for the RN, barely above minimum wage.

As as an independent contractor you would be responsible for writing all care plans & ensuring care plans and physician orders are signed within time limits. That you are credentialed for Medicaid & insurance as a provider with an NPI number. You would need independent practitioner Liability Insurance (which can be the same as an employee in NY or 7 times higher in other states). You would be responsible for quarterly income tax payments to the IRS and state. You also would need to ensure you provide your own health insurance. If you are in a state like NJ with a strong state temporary disability plan you need your own policy as you would not qualify as an independent contractor. It would be prudent to consult with a CPS or tax professional to ensure you have your employment tax situation set up correctly.

[Hello_Pretty, RN]

You are confusing private duty with home health. I worked both. Home health agency is usually contracted thru Medicaid so you get paid crap dollars. Your job duty depends on the specific patient/case you work. Often times this includes medical care AND housework.

I work in Los Angeles private duty. Thru an agency I do surgical aftercare at an expensive hotel near the Beverly Hills surgical centers. These patients have been discharges to home, but they spend 1-3 days in a hotel recovering with a personal nurse/caregiver instead. This costs $1200+/night depending on the accommodations they choose. They are private pay! Or the cost was included in their surgery. I once cared for a woman who got a face-lift, and other patients with elective surgeries. I get paid very well! Only downside is I'm an independent contractor so no overtime over 8 hours. But I work the days I choose. The agency does whatever paperwork that is required to keep their home health license, but all I submit to them are my daily nursing visit notes and my invoice/time sheet. I also do home visits and 1:1 care, all of which are super easy. Dealing with wealthy people complaining and whining is probably the worst part.

Agency private duty is easy because they schedule everything and do most of the administrative side, you just show up and work. Best part is that I'm not vacuuming floors or doing laundry like some HH agencies!

Sorry I couldn't answer your question on starting your own business.

[JustBeachyNurse, LPN]

You are confusing private duty with home health. I worked both. Home health agency is usually contracted thru Medicaid so you get paid crap dollars. Your job duty depends on the specific patient/case you work. Often times this includes medical care AND housework.

I work in Los Angeles private duty. Thru an agency I do surgical aftercare at an expensive hotel near the Beverly Hills surgical centers. These patients have been discharges to home, but they spend 1-3 days in a hotel recovering with a personal nurse/caregiver instead. This costs $1200+/night depending on the accommodations they choose. They are private pay! Or the cost was included in their surgery. I once cared for a woman who got a face-lift, and other patients with elective surgeries. I get paid very well! Only downside is I'm an independent contractor so no overtime over 8 hours. But I work the days I choose. The agency does whatever paperwork that is required to keep their home health license, but all I submit to them are my daily nursing visit notes and my invoice/time sheet. I also do home visits and 1:1 care, all of which are super easy. Dealing with wealthy people complaining and whining is probably the worst part.

Agency private duty is easy because they schedule everything and do most of the administrative side, you just show up and work. Best part is that I'm not vacuuming floors or doing laundry like some HH agencies!

Sorry I couldn't answer your question on starting your own business.

Private duty nursing is also 1:1 shift care whereas by definition home health nursing is skilled intermittent visits. The most common setting for private duty shift work is pediatrics

[NurseMecca]

Hi Hello_Pretty, do you mind mentioning what agency you work for? thank you

[IGSD777]

Hmm, I make very good money as a private duty nurse. My rate is the same as the hospitals/facilities around, but I pick up lots of OT, whereas some facilities don't like their nurses to work OT.

[caliotter3]

I found that private duty nursing paid more than the regular extended care nursing jobs I got with agencies. The worst deal for me has been intermittent visit work. I now avoid visits for that reason. It would have been a different matter had my per visit rate been reasonable and they paid mileage. The wear and tear on the car was not worth it.