What would be a fair pay system?

[Care Plus]

I recently got into the Home Care business and so I started going online to find information that might help me understand the business better. After a few weeks I found this site and I have been reading lots of the comment online here since.

I don't see business owner post their comments here so I don't know if I will get any answer from this post. I hope I would.

There are 3 pay methods that I came to know; hourly, per visit, or points. Currently I pay my employees by the hours and I think it is probably the best option since I am not the kind of guy who likes to push people to the edge to work for me. But what I found with 'pay by the hours' is that some of the RN or LPN would put their (non-billable hours) so much. Sometimes their visit hours are less than their office hours that they use to complete the charts or scheduling, etc...

So with that, I plan to move toward pay per visit or points.

What is your thoughts and advise to me?

I think that if I can find a reasonable ground that an RN or LPN need to use to chart of do his or her things, I would love to stay with the hourly.

[OldDude]

Paying by the hour does tease those that aren't self motivated into a bit of laziness. I can see you're point. I think the best deal between employee and employer in home care is the pay-per-visit scale. The predominant problem with this system is if you can't keep enough patients to generate the income for your employees. I think a combination of "salaried, points, and pay per visit" scale is the answer. You'd calculate the number of SOCs, ROCs, D/Cs, visits, etc., and associated documentation/communication that could be reasonably done in 8 hours and set your per visit rate on that in an amount that would equal the industry salary standard for your area. This is how you would determine your "points" system and would set the mark for the median pay scale and productivity expectation, i.e., xyz point per day requirement. Of course you would have to adjust your productivity requirement according to geography if the clinicians are driving significant distances between visits...unless you could employ a Mr. Scott and beam your clinicians from patient to patient.

This system would be best for the employer in that there would be no risk on your part; your employee gets paid out of what you get paid. The flip-side is if you can't keep enough patients to "provide" your employees with enough visits to obtain the median salary. In other words, your employees would take the hit if your work load drops. This is where the "salaried" part comes in. You could guarantee your employee a base rate, based on fulfilling the productivity requirement. If they saw more patients than the base requirement, it would be a win win for both of you. If there wasn't enough patients for them to see, you'd take the hit. If an employee didn't fulfill the productivity requirement, if the visits were available to them, their paycheck for that period would reflect the deficit according to the pay per visit rate.

Of course you'd have to factor your non-productive requirements into the mix such as case conference, scheduling meeting, trainings, etc. I hope this has been somewhat helpful. Best of luck!!

[Care Plus]

Thanks for the advise.

[Care Plus]

OldDude, RN Guide,

Thanks to your advice. I looked through the hourly pay carefully and found one thing that I like to call it a See-Saw Pay Model. At the center is the bucket of 80 hours. When one end (visit) is down, the other (office hours) is up, vise versa. The goal is to fill the bucket at the center to 80 hours.

This See-Saw Model does not set the bar for employees.

Once again, thank you for the advice.