Thinking of going into HH

[jnb1740, BSN]

I am a 30yr RN veteran who is about to retire from my State nursing job at a hospital (Cardiology stepdown unit) with a decent pension. The pension will pay about 80% of my expenses, so I need to keep working elsewhere to pay off some debt (house, car, kids college, etc) for a few years.  I am seriously considering doing HH.  I did a little HH back in 1996 on a part-time, per-diem basis.  A HH nurse just saw my mom at home. It was a quick 20 min visit to change her PICC line dressing.  I asked how much his HH agency pays for a revisit like this.  He said $72.  I was doing the math in my head thinking to myself that I could do this for 8-9 re-visits/day that would take me 8-9hrs.  Am I correct in my assumptions here?

[jayni]

Hey!

It really depends on the agency. A lot of agencies utilize PRN RNs for SOC's (Start of Cares)/Admissions and routine visits are done by LPNs. One company I worked at paid $50 for routine visits and $120 for SOCs, another paid $70 for routine visits and $100 for SOCs. It all really depends on the company, but the majority of the pay is negotiable. Most of the HH agencies I have worked for pay salary for full time employees, and some of them will work you to death. Always ask a lot of questions in interviews!! Hope this helps!

[jnb1740, BSN]

Thanks.  I will ask a lot of questions.  If all they wanted me to do is SOC, that would be fine, but I'd need like 120/visit for all the work that is involved. It would probably take like almost 2 hours at first, but maybe faster after I've done a bunch.

[jayni]

Everyone is different, but keep in mind for a lot of nurses the SOC visit itself takes 1-1.5 hours in-person, then another 1-2 hours of charting depending on how much you manage to do in the home. (Just to consider!) 

[Peachpit]

Documentation for HH has changed expoentially since you were last in the field in the 1990's. I too worked HH in the mid 90's and it was all paper charting and mostly post ops or new diabetics. Patients now are sicker and require more care, many have wound vacs, multiple wounds, trachs, IV, etc. It is RARELY a 30 min visit. Documenation is on a tablet or laptop via HCHC usually and it's a difficult system. OASIS is mandatory for HH (not hospice) and there are productivity points based on the type of visit you perform. So you may be paid salary or hourly but both depend on the points. Visits can be anywhere from 30 min to several hours depending on what service code is assigned. Documenation after the visit is not paid as it's considered part of the visit.

Unless they agency is willing to assign you 1 or 2 visits I don't see how you would be able to work just 2 hrs. You have to account for the drive time, in home time and documentation time after the visit.

HH agencies where I live don't normally have a dedicated SOC nurse, many hospices do though but if there aren't SOC then other visits are assigned. 

Set your boundaries from the beginning where you decide to work HH or you will be burnt out in short order.

 

 

[jnb1740, BSN]

I wasn't saying that I'd only work 2 hours/day.  I was saying that the SOC would be probably that long.  I would want the re-visit to be no more than 1 hour (including charting), otherwise it would not be worth it with the driving.  I just know that the HH nurse who saw both my mom and mother-in-law was in/out in less than 30 min tops.