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Withholding Pay

Posted

I am brand new to home health and have a question for the experienced home health nurses. I started a job 5 weeks ago and should have received my first paycheck one week ago. They are withholding my paycheck because at one point I became very behind in completing paperwork. Right now I am pretty much caught up except for a few minor details. For example, they have asked that I redo an email to a physician because I did not open with " Dear Doctor.....". Is this a common practice in home health? I realize it is important to submit the paperwork within the designated time frames. I am going to check with the Texas labor board on Monday. HAs this happened to anyone else?

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

Redoing the email, no, withholding pay for delinquent paperwork, yes. How do you "redo" an email? It's already been sent.

NurseCard, ADN

Specializes in Med/Surge, Psych, LTC, Home Health. Has 13 years experience.

Yes, if paperwork is not completed and sent through, I don't get paid for the visit.

The email issue that you describe is pretty dumb. One of the reasons I quit my first hospital job is because the doctors there were treated like gods

and I got sick of it.

It is common practice for home health agencies to withhold paychecks because they don't like how you did their paperwork. In my state, the labor commissioner has a page on their website that states in black and white that the employer can not legally do this. Work performed, work paid. Paperwork is an issue of "how" you do your work, not "if" you have done your work. You earn your paycheck by performing the patient care. At least in my state.

Hi Silver 2,

I guess I miscategorized it as an email when it is actually an electronic communication to a PCP to inform them their pt is receiving home health services.

KelRN215, BSN, RN

Specializes in Pedi. Has 10 years experience.

It is common practice for home health agencies to withhold paychecks because they don't like how you did their paperwork. In my state, the labor commissioner has a page on their website that states in black and white that the employer can not legally do this. Work performed, work paid. Paperwork is an issue of "how" you do your work, not "if" you have done your work. You earn your paycheck by performing the patient care. At least in my state.

I dunno, I think it goes back to Nursing 101- if you didn't document it, you didn't do it. If you don't do your paperwork in the hospital, at least other people saw you there and know you worked that shift. Most of us who've been in homecare for a while have seen at least one nurse commit fraud. If I don't have your note, how do I know you actually cared for the patient? I wasn't there with you. And, often, agencies are not paid without documentation.

Well, it's not really a case of not documenting. What happens is the nurses see the patient, submit documentation which is scrutinized by a coder, someone with no clinical background who will request that the nurses alter the documentation. I imagine the goal is to optimize reimbursement.

Well, it's not really a case of not documenting. What happens is the nurses see the patient, submit documentation which is scrutinized by a coder, someone with no clinical background who will request that the nurses alter the documentation. I imagine the goal is to optimize reimbursement.

If the employer has possession of the documentation they have no grounds to hold your pay. The accuracy and completeness of the documentation are another issue that can be addressed through behavior mod or discipline.

SDALPN

Specializes in Peds(PICU, NICU float), PDN, ICU.

The law in my state is if you do the work, you are to be paid on your scheduled payday. Of course companies find ways around that. If its under $50, my state won't investigate. They also have to be given a certain amount of time before the state investigates. Then if you are bold enough to make a complaint, have another job lined up. My company swears that their policy trumps state law. I have it in writing from my state that says different. My best advice is approach this cautiously and discuss it anonymously with your state labor board.

I started working for a home health agency a month ago and just found out that they are withholding 12 hrs of overtime pay that I desperately needed on this wks check because my employer says they did not receive my nursing notes from a patient on Tues. I worked 5 days in a row and dropped off all of the notes in person. They told me that someone should have called to inform me of the missing doc but no one did before the deadline to enter time. I told them per Florida law, it is illegal to withhold pay for this reason. They said it was illegal for me to withhold a doc. I wasn't withholding a doc as I dropped it off and they admitted that they fired their billing person last week and things have been hectic (obviously paperwork lost) They have my time sheet with the parents signature on it proving I worked. My week totaled 58 hours but I am only getting paid for 46. They said they will pay me the OT when I redo the note and turn it in. Isn't this illegal? They had all of my signed time sheets. Don't we get paid for service rendered and not be allowed to hold pay for missing patient? I learned last night that they with help pay from another nurse because she wrote her notes on the wrong forms. How are they getting away with this?

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

I started working for a home health agency a month ago and just found out that they are withholding 12 hrs of overtime pay that I desperately needed on this wks check because my employer says they did not receive my nursing notes from a patient on Tues. I worked 5 days in a row and dropped off all of the notes in person. They told me that someone should have called to inform me of the missing doc but no one did before the deadline to enter time. I told them per Florida law, it is illegal to withhold pay for this reason. They said it was illegal for me to withhold a doc. I wasn't withholding a doc as I dropped it off and they admitted that they fired their billing person last week and things have been hectic (obviously paperwork lost) They have my time sheet with the parents signature on it proving I worked. My week totaled 58 hours but I am only getting paid for 46. They said they will pay me the OT when I redo the note and turn it in. Isn't this illegal? They had all of my signed time sheets. Don't we get paid for service rendered and not be allowed to hold pay for missing patient? I learned last night that they with help pay from another nurse because she wrote her notes on the wrong forms. How are they getting away with this?

Call your state labor board for assistance

We don't accept a time sheet without the associated visit* notes. No time sheet, no pay. HOWEVER we do everything we can to get those time sheets and visit notes turned in, we do everything we can to support our staff to complete their essential paperwork and we don't withhold pay for imperfect paperwork. *visit notes, not emails or anything other than a visit note

As far as coding requesting corrections based on the patient's clinical picture, which is gleaned from the entire medical record not just the nurse's assessment, if home health staff would consider that they should have a comprehensive understanding of Oasis which is a huge component of home health instead of turning in work representing a lacking understanding, agencies wouldn't have to rely on coders to proof the clinician's work.

We have great staff but we have provided class after class and umpteen resources to explain how to perform a comprehensive assessment and properly answer the oasis questions based on clinical guidelines. If you can explain why after years of this a college educated licensed nurse fails to connect the complete clinical picture, well you win the $64,000 question. It's a mystery.

In the meantime, we all might want to appreciate the efforts coders make to ensure the cost to provide care is covered.

I have to add, I worked for an agency years ago, back in the fee for service/pre oasis days. There was a nurse who was a personal mess who would have her paycheck held because she got so far behind. Back then our visit note was a half sheet of paper, one sided. She still got weeks behind. I'm sure it wasn't legal to hold her paycheck but I could never understand how she could get so far behind. That was back in the *gravy days* of home health.

Speaking of gravy days, nurses complained about the paperwork back then. I was getting done by noon after making 5 simple visits on the same patients in a condensed area. I would literally see 3 patients in the same mobile home park doing some simple dressing change and then a couple stops a few minutes away. I was making 45K working less than 8 hrs/day back in 1990. Our rent for a house on horse property was $400/month. It was so easy back then but heck if nurses didn't complain about it.

Labor law or no labor law, the agencies do as they please as long as their employees don't call them on it. It is up to you to decide whether or not you are going to put up with it. If you leave an employer over illegally withheld pay, or because you don't like their policies, you can rest assured that chances are high you will find your next home health employer does the same thing. Just like how they flaunt refusing to pay legally earned overtime with phony "there was an election 20 years ago, blah, blah, blah." Sign this so we can cheat you. Do you really think employees would agree to forego legally earned overtime pay? Let's get real.

In a similar boat right now I sent in all of my paperwork, even a signed verification sheet that the parents signed with all of my times on it. Somehow my timesheet was cut off, no idea how this happened bc it's in my original files. No one at my company even made me aware that I left my "official" timesheet off, and I submitted my paperwork says before the deadline. I found out when I didn't get paid a week later. I submitted my old timesheet but no one has responded yet. I'm brand new to the company, a new nurse and wasn't trained to write notes. I've researched a bunch of pdn notes to make sure my notes are up to par but zero feedback.

19 hours ago, bellaxcrunner27 said:

In a similar boat right now I sent in all of my paperwork, even a signed verification sheet that the parents signed with all of my times on it. Somehow my timesheet was cut off, no idea how this happened bc it's in my original files. No one at my company even made me aware that I left my "official" timesheet off, and I submitted my paperwork says before the deadline. I found out when I didn't get paid a week later. I submitted my old timesheet but no one has responded yet. I'm brand new to the company, a new nurse and wasn't trained to write notes. I've researched a bunch of pdn notes to make sure my notes are up to par but zero feedback.

You need to call the agency and speak to the person who handles payroll to straighten this out. That counts as your employer contact should you be forced to file a wages owed claim with the Labor Board. Quality of your nurses notes has nothing to do with the employer paying you for work you performed.

lpn954

Has 1 years experience.

Wow that sucks! Yes for not turning in your notes they can withhold pay. This is because they dont get paid. Im pretty sure its illigal to withhold pay for not doing notes the way they want. I would do that so so you get that check, and then run! You deserve better. I have had 2 companies not pay on time for no reason and I had to quit then get my money back eventually, It took months and I was owed thousands. One I had to take to court then won. But dont let it go that far. They perhaps told you you wont get paid until notes were to their liking as a way to stall you because they didnt have the money, or are just shady and dont want to pay. Thats why I would do what it takes to get that one check then run!

My wife and I just bought a home care two years ago. All the nurses there got paid by the hours and we changed that to a point system. However, for all the new hired nurses don't want the point system and so we end up adopting the per visit as an additional system in our agency. For some of the new nurses and LPN that choose the pay per visit fail to complete their charting. We have to put in place policies that if charting is not complete we won't pay them.

One bad apple ruin the whole.