RN supervising a pdn

[mdflores]

hey everyone. I am currently new to the whole independent nursing which some people refer to as a PDN. I want to be a independent contract nurse and work for myself and get reimbursed by med-cal, medicaid. I applied for my national provider identification number and got approved and got my number. So what do I do now? what is the next step? And i currently work for an agency doing home health and I have a RN supervising me, but who supervises me if I become a PDN as I plan. I currently have a patient that wants me to become their PDN but just waiting for me to get everything together with the whole process. any comments will help, thanks.

[jadelpn, LPN, EMT-B]

PDN as in "private duty nurse"? I am not sure what that is, however, be really, really careful in becoming a private person for a patient who is currently on agency.

It could get you in some hot water if you are getting your private patients from your relationship with an agency that you currently work for. It, for most, is a could be considered a conflict of interest.

I would contact med-cal and medicare and find out what you need to do, how you need to do it, and what the requirements are. That way, going in (and you could advertise for patients) you are prepared to bill accordingly, have the correct liability and malpractice insurances, and have a clear idea on what the procedures are.

Best wishes!

[Altra, BSN, RN]

Agree with the previous poster -- any clients of the agency you currently work for will likely be off limits to your new organization for some period of time.

As you have applied for provider status, I assume that you have investigated avenues of referral to obtain clients, as well as the administrative time requirements to satisfy documentation of care, billing, and regulatory compliance. And that you understand the reimbursement process, including the lead time you can expect between billing and collection, and the tax implications of being self-employed.

Good luck with your new venture!

[mdflores]

Forgot to mention. I wanted to pursue this type of work because my current patient is leaving the agency but wants me to still be his nurse and told me about being a private contracted nurse and don't need an agency. I don't think I will be technically stealing a patient from a agency right?

[dishes, BSN, RN]

What does your BON say is within your scope of practice? Are you licensed to function independently? Or are you required to practice under the direction of a physician or RN?

[dishes, BSN, RN]

Forgot to mention. I wanted to pursue this type of work because my current patient is leaving the agency but wants me to still be his nurse and told me about being a private contracted nurse and don't need an agency. I don't think I will be technically stealing a patient from a agency right?

What does your contract with the agency say, sometimes there is a no compete clause, with conditions that say you cannot work for a client within six months of leaving the agency.

[JustBeachyNurse, LPN]

If you are an RN you create your own care plans signed by the physician. Don't take on clients currently working with your agency unless you want a legal & ethical battle that can be very costly. Follow up with MediCal & medicare as far as client referral procedures

[JustBeachyNurse, LPN]

Forgot to mention. I wanted to pursue this type of work because my current patient is leaving the agency but wants me to still be his nurse and told me about being a private contracted nurse and don't need an agency. I don't think I will be technically stealing a patient from a agency right?

Not exactly. Most agencies have you sign a document that you will not work for a former or current agency client for 6 months after your leaving the agency. Many agencies are vigorously enforcing this non-compete clause. The patients/clients may be subject to paying wages to the agency of the client hires a current or former agency employee with in 6 months of the client discharging from the agency.

Since the only reason you know this patient is a direct result of being employed by the agency, yes this is "stealing" a patient from the agency.

[JustBeachyNurse, LPN]

If you are an LVN you need to contract and pay an RN to supervise your work, develop and sign your plan of care, and whatever other regulatory requirements. Generally LPN/LVN can assist in the development and data collection for a plan of care but cannot initiate or authorize a plan of care

[klone, MSN, RN]

I think a non-compete is completely dependent upon the state. My husband's company just took on a private duty client, who had grown fond of the nurses who worked for him, so my husband's company hired those nurses from the previous agency they had worked for, so they could continue to work for this patient. According to my husband, companies try to get employees to sign non-compete agreements, but they're not legally binding in this state. I imagine that may be the case elsewhere.

For instance, according to Wikipedia, non-compete clauses are not valid in California unless you're an equity stakeholder in the company.

[Esme12, ASN, BSN, RN]

moved to private duty nursing for best response

[caliotter3]

My former supervisor who obtained a provider number and started working directly for MediCal is an RN. She supervises herself. Her client did most of the legwork. That is why I advised you before to inquire with your client/responsible family member. If they can't give you any information, then a call to the MediCal office would be in order.