Tired of unpaid OT

Specialties Private Duty

Published

My client (an adult) stays up all night on computer and wants to sleep all day. He requires a liot of care but refuses to allow me to begin until the last minute. No nurse follows me. Mom says all work has to be done before leaving. She will never voluntarily take over. I am often stuck there 1 1/2 hrs late. One nurse on the case can finish on time and the other stays over for hours. I mentioned iit to supervisor but she says i am not assertive enough. I dont mind staying to chart but 1 1/2. -2 hours is crazy.

Uh oh,you might have been duped!

You might be entitled to some time and a half.

Not according to Medicaid. I only get the hourly rate for as many hours as the patient has been authorized to received RN care. This case was a 24/7 approval. Medicaid providers will only get the rate pay per hour for RNs. In NY it's $24.74 (give or take a few cents). If you deal with medically fragile children the rate jumps up to something over $30/hr and you get a little more for overnight work with medically fragile children. If I remember correctly, it required that you apply for a special approval to care for medically fragile children, which I am not sure of the criteria. If you are in NY you can see the rules for PDNs on http://www.EMEDNY.org.

The pt. I had was actually really kind and always offered more, but I never took anything beyond my billable rate of pay. Taking more struck me as one of those grey ethical areas.

However, I believe that the executive order by Pres. Obama is a game changer for all of this. We shall see how it plays out. At this point I just want more hours! LOL!

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

There is a difference whether you're an independent provider or working through an agency.

An independent provider isn't an "employee" of any entity, so they are not entitled to receive OT pay under the law. That would be like a plumber who owns his own plumbing service being required to pay himself OT.... he's his own boss, and if he doesn't want to work extra hours, he doesn't have to, so there is no requirement to pay him 1.5 times the going rate.

If you're working through an agency, however, you are then an actual employee and entitled to OT pay for any hours over 40 per week. The agency isn't allowed to bill Medicaid for more money for the hours that you were getting OT -- they still get their flat rate per hour of nursing service provided. That's why a lot of agencies will work like heck to make sure you don't get scheduled for OT -- they have to make up the difference in your pay out of their own pockets.

There is a difference whether you're an independent provider or working through an agency.

An independent provider isn't an "employee" of any entity, so they are not entitled to receive OT pay under the law. That would be like a plumber who owns his own plumbing service being required to pay himself OT.... he's his own boss, and if he doesn't want to work extra hours, he doesn't have to, so there is no requirement to pay him 1.5 times the going rate.

If you're working through an agency, however, you are then an actual employee and entitled to OT pay for any hours over 40 per week. The agency isn't allowed to bill Medicaid for more money for the hours that you were getting OT -- they still get their flat rate per hour of nursing service provided. That's why a lot of agencies will work like heck to make sure you don't get scheduled for OT -- they have to make up the difference in your pay out of their own pockets.

What about nurses who work for an agency but receive a 1099? i used to receive one from this agency 2 yrs ago,and i paid my own taxes.

i also see nurses on this board who work for agencies but bill Medicaid.

How is that possible?

I thought the agency bills Medicaid?

Specializes in Pediatrics, Emergency, Trauma.
What about nurses who work for an agency but receive a 1099? i used to receive one from this agency 2 yrs ago,and i paid my own taxes.

i also see nurses on this board who work for agencies but bill Medicaid.

How is that possible?

I thought the agency bills Medicaid?

Yes, independent contractors get 1099s.

CMS can directly bill nurses (That's including Medicaid) that have a Medicaid number; there are nurses that apply and receive a Medicai number for billing.

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
What about nurses who work for an agency but receive a 1099? i used to receive one from this agency 2 yrs ago,and i paid my own taxes.

Gets a tiny bit trickier when you are a 1099er... then you are considered to be "self-employed" and exempt, but then there are also situations where OT rules still apply to 1099ers (prevailing wage jobs in the construction industry, for example, require payment of OT to 1099 workers).

i also see nurses on this board who work for agencies but bill Medicaid.

How is that possible?

I thought the agency bills Medicaid?

Is that maybe a situation where they work more than one job? As in, direct bill for some clients and agency-paid for others?

Gets a tiny bit trickier when you are a 1099er... then you are considered to be "self-employed" and exempt, but then there are also situations where OT rules still apply to 1099ers (prevailing wage jobs in the construction industry, for example, require payment of OT to 1099 workers).

Is that maybe a situation where they work more than one job? As in, direct bill for some clients and agency-paid for others?

No. There is a thread about falsifying notes and she implies she works for an agency and bills Medicaid herself.

Specializes in Complex pedi to LTC/SA & now a manager.
No. There is a thread about falsifying notes and she implies she works for an agency and bills Medicaid herself.

Then why not ask her directly for clarification if you are referring to a particular member?

Specializes in Emergency Department.
What about nurses who work for an agency but receive a 1099? i used to receive one from this agency 2 yrs ago,and i paid my own taxes.

i also see nurses on this board who work for agencies but bill Medicaid.

How is that possible?

I thought the agency bills Medicaid?

If you're in that situation, be very careful about your employment with agencies that hire "independent contractors." It's possible that you're actually an employee and not a 1099 Independent Contractor. If you go that route, just make sure that you meet whatever requirements are necessary to actually ensure that you're truly a 1099 and not an employee.

Specializes in Emergency Department.

I guess homecare nurses who get paid a flat fee for each pt are exempt?

I actually wanted to try Homecare(hourly) visits,but it seems the nurses actually work more than Pdn nurses,esp with all that driving.

No, I said they might be exempt. Same goes for salaried folks too. You have to meet all the requirements/exemptions/tests necessary to actually be considered OT Exempt.

I suspect that nurses that are able to bill directly for services, as opposed to being paid for services (probably a subtle but important distinction) might be what triggers the OT exemption.

If you're in that situation, be very careful about your employment with agencies that hire "independent contractors." It's possible that you're actually an employee and not a 1099 Independent Contractor. If you go that route, just make sure that you meet whatever requirements are necessary to actually ensure that you're truly a 1099 and not an employee.

Even the IRS acknowledges that most employees are in fact, employees, and not independent contractors. If you have any doubts, contact the IRS for clarification.

Then why not ask her directly for clarification if you are referring to a particular member?

I consider it rude to derail her thread when her main issue is false charting.

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