Thoughts?

[dreamriderRN]

Hello, I have recently interviewed for a full time hospice case manager position. It would be a 40hr week with a case load of 12-15pts but is paid per visit at $47:50 plus mileage. Can anyone give me some input as to whether this is the norm, good, bad? So I have an idea whether to go forward if it offered to me.

I would appreciate any input.

[AtlantaRn1]

First question-what is the territory? Coverage area? If you are in an urban area and are stationed at a facility you could see 6-8 pts a day based on their acuity. But if you are seeing Home patients you may only see 3-4 in a day. In my experience at a previous hospice south of Atlanta $50/routine visit (30 min), $75 extended visit (45min), admission $100 plus mileage. That was when I did case mgt 2008-2014

[pmabraham, BSN, RN]

Good day:

I work as an RN Case Manager with a caseload of 10 to 15 patients (but this varies based on various factors including when people are on vacation or call off sick; we have a lot of good teamwork -- best I've ever seen in my life). I typically make four to six visits per day, less if I'm going to be doing an admission.

Admissions take 3 to 6 hours to complete (1 to 2 hours with the patient and the party who can sign consents, and the rest in the office or home). Routine visits take anywhere from 30 to 120 minutes with the average being 45 minutes.

I get paid hourly plus mileage though I'm not paid from my home to the first visit and from the last visit to my home. Personally, I would not take a paid-per-visit position. Why not? 1) Hmmm, that 3 to 6-hour admission at $47.5 per visit means I'm getting paid $7.92 per hour. 2) If during a regular visit, there is a lot of teaching to be done (this happens for the first few visits as well as when the patient is transitioning to actively dying or when there are medication changes) and the family really needs 2 hours that particular visit, would I (the RN) feel pressure to cut things short with the visit so I get paid a fair wage? 3) What about the x to-y hours of driving per day? Unless you are going to one facility and all of your visits are at that facility, sometimes half or close to half of your day can be driving.

To be fair, if you can get in six visits in an 8-hour day and you only work 8-hours then $47.50 per visit would be higher than a lot of hourly rates with $285 for the day. But if you have a day with 4 visits in an 8-hour period (due to driving, family needs, etc) then those who get paid hourly will make close to 50% more than the person getting paid $47.50 per visit.

BTW, in addition to asking if there are different pay-for-visits for admissions, ask for the pay for an eval visit, and informational visit, a discharge visit, a going-to-respite visit, a prn visit and what oncall looks like.

Thank you.

[vampiregirl, BSN, RN]

Another consideration would be to inquire what the hourly rate for inservice etc is.

[CrochetNurse154]

Currently, I work as a salaried case manager, however when we pick up extra shifts overnight/weekends/etc, we get paid per visit. Our visit pay is as follows: $50/visit, $60/death visit, $130/admission. I think if you can be efficient and can make many visits in one week, you can really make bank working per visit. However, hospice is very "feast or famine" as I've found over the last 2.5yrs. I've had weeks where I've done > 25 visits, and I've had weeks where I've been lucky to do 15. I would be asking if you're full time how you'd be paid for those times when you may only do 3 visits in a day, or not put in a full 8hr day. Good luck! :)