Working a Make a Wish trip indepentandly (no agency)

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I was recently contacted by the family of a former pediatric client of mine. The client is being given a Make-A-Wish trip to Disney World in Orlando. Their current agency has no nursing coverage for the client in the home, so they do not have a nurse available to make the trip with them either. They invited me to go on the trip with them to provide nursing care for the trip. I am comfortable going, it's a family I have an established care relationship with.

My questions are mostly surrounding the fact that, since I no longer work for an agency, I will essentially be working directly for the family. Has anyone ever done a short term assignment for a client outside of working for an agency? Any advice on what I need to do, other than fill out Florida's form for nurses taking care of patients temporarily residing in the state?

I know the travel expenses and accommodations are paid for by MAW, I have asked the family to clarify whether I am working for the family or if MAW is arranging my payment for hours worked. Is there any special tracking of this income I need to do for tax reporting purposes?

Thanks for any information.

Cross posting to the general questions forum.

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Specializes in Complex pedi to LTC/SA & now a manager.

Are you an RN or LPN?

Is there a physician signed plan of care?

Do you have professional that covers you as an independent contractor?

If you are an LPN who will be the RN signing the plan of care and providing clinical oversight?

Are you credentialed for independent practice by Medicaid?

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I am an RN, I do not currently have personal , nor am I credentialed for independant practice. What type of credentialing is required for independant contracting?

As far as I know there is now (I've asked the family, no response yet), and while I previously worked with this client, there always was an MD signed POC in the home.

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Specializes in Complex pedi to LTC/SA & now a manager.

Depends on the state Medicaid rules as far as independent credentialing. Not sure if MAW needs it all nurses I know went as an agency employee. Maybe their agency can hire you for the trip since it's paid by MAW? Then you have an employer and signed POC

A POC for an agency you don't work for is not for you to use. You would need to write your own and secure your own orders/signed 485.

FL offers temp licenses for this nurses traveling with patients as long as they have signed physician orders. Details on BoN website .

Independent contractor rates are often 5-10x higher than a nurse employed by a company. (Mine was $104 as an employee if I worked independent the premium was $780, & $1100 if independent home care.

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I think I will get in contact with the MAW coordinator directly and see if they can give me more information. The family did already send me a copy of the FL temp license form.

I was able to find a downloadable CMS 485 form which I could fill out and have the family get signed by the physician prior to the trip, if need be.

The rates you mentioned, what units of time worked are those reflecting? What were your hourly rates as an independent contractor in home vs. as an employee?

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Specializes in Complex pedi to LTC/SA & now a manager.

Do you mean the insurance rates? I didn't take the independent contractor job as the insurance premiums are out of my budget.

Almost no one in my area works independent PDN or HH the liability risks are too high. Much more cost efficient and better protection of license if employed by agency. Then agency is responsible for compliance & ensuring signatures in place and all the billing.

One nurse did get hired by her former patient's agency strictly to accompany on a MAW and vacations as no other agency employee was willing. So it was win/win for the nurse. Expenses paid trips and minimal obligation to agency but same protection as an employee. She just needed to do their mandated inservices (infection control & privacy) and PPD testing. Only works agency client's family vacations.

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Oooh those are the insurance rates, got it! That makes more sense. I did an online quote and since I am employed full time at my regular hospital job (this trip would be a one time only special arrangement) and have my own medical insurance the rate quote was $109 I believe. Which is not bad considering I'll be getting the expenses paid trip, and paid for time worked!

It sounds like it could work to be hired as a temporary employee with their new agency, I think I will look into that option, after talking to the family again and the MAW coordinator. Thank you so much for your input, its very helpful. :)

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Specializes in Complex pedi to LTC/SA & now a manager.

If you go as an independent you need to let the carrier know otherwise you aren't covered. Have the parents ask the agency they have more pull especially if the agency isn't capable of staffing the patient's needs. Win win

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

Being an independent contractor with Medicaid is a non-issue .... Medicaid isn't paying for the nursing coverage during this trip.

Having professional IS a necessity, though, IMO. If you don't get hired as a temporary employee by their current agency, you can check to see if MAW is willing to cover your expense for professional liability insurance, as it's technically a cost of providing nursing care for the trip.

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Specializes in Complex pedi to LTC/SA & now a manager.
Being an independent contractor with Medicaid is a non-issue .... Medicaid isn't paying for the nursing coverage during this trip.

Having professional liability insurance IS a necessity, though, IMO. If you don't get hired as a temporary employee by their current agency, you can check to see if MAW is willing to cover your expense for professional liability insurance, as it's technically a cost of providing nursing care for the trip.

That would be an unprecedented request as I've known some who tried and the cost was too high. But if you don't ask you never know

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Specializes in Psych, HIV/AIDS.

You need to obtain your own Professional . If you rely on an Employer's insurance you'll be the first to be thrown under the bus when things get testy...NOT the employer. It is in your best interest to maintain your own personal policy throughout your career.

Hope you have a good time on the trip, even though you'll be on-duty.

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