Published Aug 23, 2014
Tigerlily8
119 Posts
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
1 Article; 7,349 Posts
Redoing the email, no, withholding pay for delinquent paperwork, yes. How do you "redo" an email? It's already been sent.
NurseCard, ADN
2,850 Posts
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.
caliotter3
38,333 Posts
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.
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.
toomuchbaloney
14,939 Posts
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
997 Posts
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.
LPNDebbie
89 Posts
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, LPN
13,957 Posts
Call your state labor board for assistance
Libby1987
3,726 Posts
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.