Salary vs Per Visit?????

Specialties Home Health


Hi there........ I have a questions for my fellow home health nurses.........if you had the opportunity to take a salaried position or a per visit position....... which would it be???????

I have been offered 2 jobs in home health again.....

Salaried position........ 4 days a wk......10hrs. coverage area of 4 counties, great benefits, great salary, on call once every 5th wk. And the nurses take turns being the admissions nurse for the day. Case manager the other days. Has triage nurse that answers calls before the on call nurse gets called. And the week you work sat and sun you have the 3 days off before your weekend and the monday after.

Per visit position......... great per visit rate, coverage area of one county, benefits are great, case managing and doing admissions for my "territory" every day....... mon-fri 8-5 but no guarnteed amt of visits. On call once every 5th wk.

Any comments????????


839 Posts efficient are you? and what's the average visits per day for the per visit position?...unless it's low, personally i'd go with that one...also seems like the first one has the potential of too many cooks if you know what i mean...


38,333 Posts

I do extended care (8 hour shifts) home health and get paid by the hour. I prefer this option b/c I have always heard that salaried people are more prone to be taken advantage of when it comes to overtime situations. I can work as much as I want. Currently I am working 40 hrs for one agency and 56 hrs for a second agency w/stable cases that I love. I would recommend home health to almost everybody. Any time I want some time off my clients and agencies are agreeable. When my clients take a vacation I can too. It doesn't get much better than this!

renerian, BSN, RN

5,693 Posts

Specializes in MS Home Health.

Honey I have done it all and seen all. The home health paperwork is phenominal. So is the office time. If you are traveling four counties go with salary as when you are doing per visit your drive time and office time probably are not paid. I was working 10 to 12 hour days with no drive/office time pay and 6 of the day was in my car! If your salary at least you know your getting some pay for your time. I would have days when I worked eight hours for only 75 dollars since the patients were so far apart. If your working for an agency that will keep you in an area then go for per visit..........can make lots of money that way if your in one area of town. Find out what your hourly rate is for office time, team conference time and inservice time. Find out if they either give you a phone or reimburse for calls cause you will need a cell. Find out what their mileage reimbursement is. I put between 500 to 800 miles per week on my car. You also need to check with your auto insurance company because if you use your car for work and drive over 30 miles your rate goes up since your more at rise for auto accidents. I went through four cars in 11 yeasrs and put over 30,000 miles on my car a year. I spend lots of money in car repairs. Do you work in an area where it snows? Sometimes it would take me 3 hours to get to a place after it snows so remember if your driving alot or far apart go for salary. Does that help any?



Thanks for all the replies...........

I did a little further investigating for the per visit offer............

As I suspected........... only the "patient visits that you do will you be paid for" So basically, all the paperwork time and office time are my time.......other than a team conference which will count as 1 visit. The office is 25 miles from home..........The one county will be covered by 5 nurses with the average census of 100 patients. Oh and the "paperwork is on paper"

The salary position is 10 miles from home.......... And the "paperwork is on laptop HBOC system" I have used HBOC before and loved it. The 4 counties is covered by 8 nurses with the census running around 200, however they just picked up a contract with one of the private insurance co, so I see that increasing. I have done home health before both Medicare and Private Insurance off and on for 11 yrs........ so I am used to all the paperwork and very anal retentive about so the paperwork doesnt bother me. And I loved the idea of going back to case managing. That way I felt that I had some kind of control over what happened to the patients unlike in a hospital, if that makes sense..

Again thanks for all the replies......... I am supposed to call both of them today and tell them my decision........ i'll let yall know what happens............. Have a great day!!

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