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subcontracting in home health


Hi everyone! This is my first post here. For months, I have been enjoying reading all the great questions and thoughtful responses.

I have been a nurse for almost 20 years. The last 5 years have been in home health. Here's my question. Have any of you tried subcontracting with home health agencies to perform visits and opens for agencies who, for whatever reason, do not have a nurse available to do it?? I suppose it's comparable to what staffing agencies do for hospitals and LTC, but in the home health arena??

I am aware that PTs and OTs often are entreprenuers in home health, but I'm not familiar with nurses doing the same. Why not???

I suppose it's disheartening to always be the "rainmaker" and watch administrators make lots of $$$$ while I'm out breaking my a**.

All responses/ thoughts are appreciated.

hoolahan, ASN, RN

Specializes in Home Health.

Hi KP, welcome.

Not a half bad idea. I see a few problems, in my area anyway.

The current beef with my agency is the CM's are not getting to see their own pt's. We have lost many RN's and replaced with LPN's, and now w/ medicare wanting an RN visit on a minimum basis, the RN's c/o the schedulers are rearranging their schedules and giving away the visits they need to make themselves. They are totally frustrated, and we have lost a large number of staff, and it seems like there are weekly resignations.

The paperwork is abominable, and it always has been, but now it's worse, couple that with the increasing frustration, and you have a lot of nurses ready to walk in a heartbeat. Many have returned to hospitals for major bonuses and amazing hourly rates. So, the situation is prime for recruiting nurses to an agency like you envision. BUT, if I were the owner or CEO of a home health agency, and decided to hire subs/agency HH supplemental staffing, I just know it would be the last straw for my loyal staff, and they would leave en mass.

Also, the 2 diff HH agencies I worked for always cry poor. With PPS, they truly do lose money on many cases, and I honestly can't see where the agencies could afford this financially, or emotionally as above.

I can only speak for my NJ experience. Not sure how other places are coping. If you start one in NJ, let me know where you are, I'll be your first one to sign up!!


Specializes in Vents, Telemetry, Home Care, Home infusion. Has 43 years experience.

HI, KP, and welcome.

Independent Contracting is no different than Agency A contracting with Agency XYZ to provide backup nursing staff. I have seen it occur, mostly in for-profit agencies due to cost factors.

My first agency worked as independent contractor to them getting $25.00 hr in 1985! I worked as much or as little as I wanted, paid my own taxes, malpractice; had husbands insurance, etc. Retirement Savings was in IRA plan. In return, I was last person called, often worked the evening cases, farthest cases from agency base that no one wanted--didn't mind though as kids young and worked when husband available. This agency's niche was being backup for ALL the infusion company's in my area so I might be seeing patients from 3 or 4 agency's with differing paperwork in one day: kept 7 agency's paper work in my car.

Yes, it is possible to do. Now, would recomend that you incorporate to protect yourself more from liabilities;own malpractice insurance. MUST be prompt with paperwork--in within 48 hrs and properly bill agency; have excellent communication and followup skills. Be careful that you have guarantee for prompt payment from agency---can take up to 30 days to get paid.

Home fax, mobile phone, COMPANY car, beeper, etc----all CORPORATION business deductions. Might not get a lot of work at first, but as reputation grows should be kept busy,

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