RN Home Health

sunnysideRN · Sep 8, 2018

I'm in Socal where a 3 bedroom apartment rents for approx $3000/mth (just for context)

SOC- 100

Recert/ROC/DC- 65

SNV- 55

Non-billable discharge- nothing, not a penny (curious if other agencies reimburse for this)

Libby1987 · Sep 8, 2018

In affordable part of California where you can rent a 3 bd/2 ba home for $1,800 and with experience and doable 5-6 points/day:

SOC 130

R/C and ROC 97.5

Routine 65

IV/NPWT: 81

Discharge to agency 71.5

In response to above poster's question re a no visit discharge: discharges are necessary for outcome data, occurrence of no visit discharges go way down when they are considered part of case management and not individually compensated. At the hourly organization where I now work, the high incidence of no visit discharges is a problem.

CPLibra, ADN, BSN, RN · Sep 16, 2018

New Grad RN in Home Health for about a month.

SoCal area; 3 bedroom home rent $2300/month.

SOC - 50

R/C - 40

SNV - 30

Discharge - unsure; have not yet done a d/c

Looking at both above poster's rate really makes me feel discouraged, but I am assuming that this is the new grad rate.... That, and, the agency I work for does not reimburse for any miles... Do these rates mimic the new grad in HH for your agency as well? Or is the agency I am working for just exploiting us new grads?

Libby1987 · Sep 16, 2018

New Grad RN in Home Health for about a month.
SoCal area; 3 bedroom home rent $2300/month.
SOC - 50
R/C - 40
SNV - 30
Discharge - unsure; have not yet done a d/c
Looking at both above poster's rate really makes me feel discouraged, but I am assuming that this is the new grad rate.... That, and, the agency I work for does not reimburse for any miles... Do these rates mimic the new grad in HH for your agency as well? Or is the agency I am working for just exploiting us new grads?

I'm about speechless.

That rate structure would perpetuate avoiding SOC ("patient didn't answer their phone, oh well I'll just see my revisits..") and discourage you to R/C ("goals met..." followed by rebound referral with PEP (that's a payment penalty if Medicare) and/or hospital redmission (referral and CMS rating penalties) which doesn't make sense since those visits generate revenue.

Are you working for a large chain, hospital/systems based or smaller mom and pop agency!

A new grad (rare hire) or no HH experience (a couple of years ago at my old agency in Northern California) would be about:

SOC 110

R/C and ROC 82.5

Routine 55

IV/NPWT 68.75

Discharge to agency 60.5

Libby1987 · Sep 16, 2018

With PPV there is no reason to severely financially penalize nurses who are new and take longer to complete visits. You're already working longer for the money and the payment structure will incentivize efficiency.

I didn't even mind newer nurses making my rates, the job was so much easier and enjoyable for me and I performed quality work in a lot less time.

I do discourage new grads from home health however unless you have sustained mentoring and oversight for a year. I've only considered exceptional candidates with relevant experience, either as an LVN in home health or in an ancillary position.

CPLibra, ADN, BSN, RN · Sep 17, 2018

I'm about speechless.
That rate structure would perpetuate avoiding SOC ("patient didn't answer their phone, oh well I'll just see my revisits..") and discourage you to R/C ("goals met..." followed by rebound referral with PEP (that's a payment penalty if Medicare) and/or hospital redmission (referral and CMS rating penalties) which doesn't make sense since those visits generate revenue.
Are you working for a large chain, hospital/systems based or smaller mom and pop agency!
A new grad (rare hire) or no HH experience (a couple of years ago at my old agency in Northern California) would be about:
SOC 110
R/C and ROC 82.5
Routine 55
IV/NPWT 68.75
Discharge to agency 60.5

I am working for a small mom and pop agency. Wow that rate, for even in Northern California for a New Grad and from your experience as a HH RN makes it seem like this agency is taking advantage of new graduates or the "system". As of now, they mainly have me do follow-up visits and IV therapies. They are training me and another fellow new grad RN to do SOC, recerts, and discharge in case the DON or the usual RN who does these is not available... The office manager does the specific Medicare codings for us, while the RN only inputs the assessments.

Should I look some place else?

CPLibra, ADN, BSN, RN · Sep 17, 2018

With PPV there is no reason to severely financially penalize nurses who are new and take longer to complete visits. You're already working longer for the money and the payment structure will incentivize efficiency.
I didn't even mind newer nurses making my rates, the job was so much easier and enjoyable for me and I performed quality work in a lot less time.
I do discourage new grads from home health however unless you have sustained mentoring and oversight for a year. I've only considered exceptional candidates with relevant experience, either as an LVN in home health or in an ancillary position.

My agency does not provide pay for extra time needed to document. I am only getting paid per visit, which is just 1 hour. So when times I do have to go pass 1 hour due to discussions with family or the patient or anything else comes up, I only get paid a flat rate of that hour. This then also means that when I do come home, I have "homework" of documenting and although that is necessary and inclusive of the job, I am not getting compensated for the documentation. At times, I feel as if I am only making $10/hr. Did I also mention I am not getting compensated for mileage or gas?

I was only offered an orientation with the DON that was inclusive of 3 follow up visits, 3 SOC, 1 IV therapy, and I have yet to go tag a long on a recert or discharge. I also had no idea there would be different rates for IV therapy as well. The SOC new grad rate is $50 a visit. The office manager told me that once I had more experience, that the SOC rate would increase to $60.

As a new grad RN, I do not have prior experience as a RN in Home Health, but I have been a Home Health Aide in the home health and hospice area. However, I will have to admit that those two aspects of care and roles are completely different.

Libby1987 · Sep 18, 2018

My agency does not provide pay for extra time needed to document. I am only getting paid per visit, which is just 1 hour. So when times I do have to go pass 1 hour due to discussions with family or the patient or anything else comes up, I only get paid a flat rate of that hour. This then also means that when I do come home, I have "homework" of documenting and although that is necessary and inclusive of the job, I am not getting compensated for the documentation. At times, I feel as if I am only making $10/hr. Did I also mention I am not getting compensated for mileage or gas?
I was only offered an orientation with the DON that was inclusive of 3 follow up visits, 3 SOC, 1 IV therapy, and I have yet to go tag a long on a recert or discharge. I also had no idea there would be different rates for IV therapy as well. The SOC new grad rate is $50 a visit. The office manager told me that once I had more experience, that the SOC rate would increase to $60.
As a new grad RN, I do not have prior experience as a RN in Home Health, but I have been a Home Health Aide in the home health and hospice area. However, I will have to admit that those two aspects of care and roles are completely different.

You might want to look up the CDPH requirements for new grads. I had to develop a year long orientation plan including what/how the new grad would be instructed, supervised, measured and monitored.. after I provided proof that we had to hire a new grad due to a shortage of nurses in the area. It was quite the undertaking that had to be reviewed and approved so I imagine something sketchy is going on with your employer based on the scanty training they've provided you.

CPLibra, ADN, BSN, RN · Sep 29, 2018

You might want to look up the CDPH requirements for new grads. I had to develop a year long orientation plan including what/how the new grad would be instructed, supervised, measured and monitored.. after I provided proof that we had to hire a new grad due to a shortage of nurses in the area. It was quite the undertaking that had to be reviewed and approved so I imagine something sketchy is going on with your employer based on the scanty training they've provided you.

Yeah I feel that there might be something sketchy going on. I feel as if I still have a lot of things to learn and further divulge into such as the basics of "bag technique" and the other nitty gritty things that I had never heard of before in nursing school. Oh, and did I mention Home Health allows so much autonomy, that as a new-grad I am not sure whether that's a good thing. Sometimes it scares me, haha. I would like to stay at this home health job since it is providing me experience as of now, but I feel as if I should leave soon to protect my license and in hopes that an acute-care facility would hire me in the near future.

fsudmbRN, ASN · Mar 20, 2019

On 9/8/2018 at 1:36 AM, sunnysideRN said:
Non-billable discharge- nothing, not a penny (curious if other agencies reimburse for this)

I think we get $7

ShelleyFl · Jun 23, 2020

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