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Wanting to cut our On-Call Pay

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becca-roo becca-roo (New) New

Agency is looking to cut expenses and scrutinizing our On-Call pay. Meanwhile, our main Physical Therapist (and PTA's under her employ) is contracted (paid per visit) and recommends a frequency of 3xweek x9weeks on every referral/diagnosis PT evaluates. I'm new with a non-profit agency and not up with the office politics...but it seems to me that PT is getting a heaping helping of our PPS pie. I'm wondering what PT frequencies other agencies have. Shouldn't they be instructing the patient and caregiver on their HomeExercisePrograms and getting out ASAP? I've worked for other agencies where it was more the norm for PT to be in and out in under 10 visits to where we couldn't get the extra $$$....and now to see PT go 27visits for each Recert period?!? I'm curious too about wether or not therapists do OASIS at other facilities...ours doesn't.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

Therapy only cases do admits; occasionally they will admit if Sn unable to get out timely due to vacation/illness and does OASIS whenever they admit.

PT visit pattern is 1-3wk/9. However, only 47% time are more than 10 Therapy visits made: Mostly CVA, Brain injury, multiple fracture type cases. We do strive to provide 10 PT with all Medicare patients.

Agency goal for Medicare patients is average of 15 combined visits; above this

visit pattern is discussed with Clinical Mgr. Daily wound care heavily reassessed to see if newer product with every other day visit patten available. Above diagnosis understood higher 20-25 total with one recert usual. Your CHF/COPD/Amb Dysfunction patient averages 5-8 visits.

No PTA aides permitted in PA. Our PT are in and out due to backlog of cases---76 were unassigned on Friday. AND they do discharge OASIS too. OT is assigned if HHA is requested. Staff is combination 40% FT, 60 % perdiem/independent contractors. Have about 50 therapists in 4 branches.

~1500 New admits/month.

Your agency needs to have a meeting with realistic goals and staff understanding profit/Loss with these cases. Our CFO runs MO825 report weekly to see how were are doing.

National average is now less than 20 MC visits per patient all diagnosis.

Our PT usually does not do any Oasis. We usually find that even if PT is ordered there usually is a need for some nursing visits anyway. We usually do 12 PT visits (if 1 or 2 are denied) and more if needed by never 27! For a high acuity patient we try to keep max. visits between all disciplines under 30. What are they scrutinizing about your on-call pay?

our pt usually does not do any oasis. we usually find that even if pt is ordered there usually is a need for some nursing visits anyway. we usually do 12 pt visits (if 1 or 2 are denied) and more if needed by never 27! for a high acuity patient we try to keep max. visits between all disciplines under 30. what are they scrutinizing about your on-call pay?

they are looking at reducing our on-call pay to save money since we are a non-profit organization that is operating in the red. i'm curious as to how other agencies pay employees for being on-call. i have almost 13 years home health experience and my starting hourly wage (as a senior nurse) is 15.50. needless to say, i signed on for the benefits. now they want to take some benefits away. we take call for 24/7, a week at a time. we get paid for 8.5 hours and get a 7.5 hour day off with pay. that figures up to me making $248 for being on-call. care to share with me what your agency does?

they are looking at reducing our on-call pay to save money since we are a non-profit organization that is operating in the red. i'm curious as to how other agencies pay employees for being on-call. i have almost 13 years home health experience and my starting hourly wage (as a senior nurse) is 15.50. needless to say, i signed on for the benefits. now they want to take some benefits away. we take call for 24/7, a week at a time. we get paid for 8.5 hours and get a 7.5 hour day off with pay. that figures up to me making $248 for being on-call. care to share with me what your agency does?

i work for a small for-profit agency that has been in business only 3 or 4 years. we have about 50 patients. i have to take call every other week since there are only 2 rns. there are a few more lvns so they don't take call quite as often. we don't get any on-call pay. we get paid during nonbusiness hours only if we have to go see a patient; but it's not often we have to actually see a patient. usually speaking to the patient or family on the phone will suffice. also, we don't have much in the way of benefits. no health insurance, just aflac dental and supplemental insurance.

renerian, BSN, RN

Specializes in MS Home Health.

Both the agencies I work for do not get paid anything for call.

renerian

I take call a week at a time. I am paid a per visit rate if I have to go out and get $10 weeknight and $45 each weekend day. Most of the patients are long distance call for me. I just eat the phone charges usually. My cell phone doesn't work at my house.

I would take call 1-2x/month--$5.00 per hour if not called otherwise regular rate of pay for any telephone time or actual visit time (includes travel time). Regarding your physical therapy question--how does your agency justify all the PT tx's, our PT's had to show patient progress otherwise would have to dc if patient had plateau'd.

We get $2.00 an hour for having the beeper on...paid hourly rate for any time worked.

Doing on call duty was the biggest reason I quit home health. I did home health for about 9 years and all our benefits kept getting taken from us. Home health was a great job before the 1997 Balanced Budget Act. We only got .50 cents an hour for being on call plus regular hourly wage if we had to see anyone after hours. Also, time and a half over 40 hours per week.

renerian, BSN, RN

Specializes in MS Home Health.

You got that right...............I know.....home health is very different...

renerian

I talked to friend last evening, HH nurse, she is quiting, said she cannot afford to work HH anymore. Milage pay is way too low for price of gas and call pay has not raised in 2 years. Said they raised her medical insurance and she cannot afford it now. She has already talked to boss and given her notice. She says her boss just said she would be missed. After almost 5 years there. She said she feels so silly for not leaving sooner. She was doing the work of 2 nurses, they can't get nurses to stay, so another sad story about HH and nurse abuse .

they are looking at reducing our on-call pay to save money since we are a non-profit organization that is operating in the red. i'm curious as to how other agencies pay employees for being on-call. i have almost 13 years home health experience and my starting hourly wage (as a senior nurse) is 15.50. needless to say, i signed on for the benefits. now they want to take some benefits away. we take call for 24/7, a week at a time. we get paid for 8.5 hours and get a 7.5 hour day off with pay. that figures up to me making $248 for being on-call. care to share with me what your agency does?

becca- you get paid what??! for 13 years experience? boy they are getting a good deal. i am in upstate ny-we get over $20 ish/hr for fairly new rn's. on-call is $2.50/hr, time and a half on weekends. also time and a half on weekends/holidays if we choose to work some extra.(there is always extra time available). i work part time during the week (20 hours) and then i try to work most weekends by choice, because of the pay.

CseMgr1, ASN, RN

Specializes in Case Management, Home Health, UM. Has 39 years experience.

Doing on call duty was the biggest reason I quit home health. I did home health for about 9 years and all our benefits kept getting taken from us. Home health was a great job before the 1997 Balanced Budget Act. We only got .50 cents an hour for being on call plus regular hourly wage if we had to see anyone after hours. Also, time and a half over 40 hours per week.

Tell me about it! I worked for one home health agency back in the late 80's and early 90's whose owners took themselves and their managers on lavish excursions to NYC...all expenses paid, while we were left toiling in the fields and eating their dust. Those days came to a screeching halt in 1993, when these same owners were indicted on 101 counts of Medicare fraud. They were later led away to Federal Prison kicking and screaming that they didn't do anything wrong (yeah, right!). Now we and our patients are reaping the rewards of all those years of excesses and fraud by those crooked owners...with little or nothing left to nurse with. What a tragedy! :angryfire

renerian, BSN, RN

Specializes in MS Home Health.

Our nurses get no on call pay or mileage. I am sure they won't be around long.

renerian :o

renerian, BSN, RN

Specializes in MS Home Health.

Jack and Margie died in a plane crash. I have to say they did push the envelope but they were good to the people in our office in the 90s..

We were treated great.

renerian

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