r/nursing • u/No_Wheel_6096 • Oct 09 '24

Nursing Hacks Home Health RN pay

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I’ve been a nurse for 8 years and have always worked in the hospital setting (travel nursing for the last 4 years).

Looking to transition to a nursing job outside the hospital and have been looking a lot into home health, clinic jobs, etc.

I got a job offer with a home health company and I’m wondering how these pay-rates (pay per visit) compare to others in the same area (Orange County, California)?

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u/Neither-Magazine9096 BSN, RN 🍕 Oct 09 '24

I was trained on how to revise oasis coding to maximize reimbursement and it just felt like some worthless game you play with insurance.

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u/[deleted] Oct 09 '24

You got it there. Oh and they have clinician “scorecards” now that track the improvement of each patient the nurse admits, discharges, or case manages. If patients end up hospitalized during their episode of care, it’s the admitting nurse and case manager nurse who get the blame.

And if I complained that I was charting all the time I would be told that it’s just me who’s having the problem. I could have just spoken to another case manager who complains about the same issue and spoke to their supervisor about it, but management would swear it was just a me issue. Complain about the house? “No one else has said anything, are you sure it’s that bad?”

Gaslighting was so common. It sucks because I really love it at the heart of it, it’s kind of the best form of nursing where you can really make a difference and work with that patient and see their progress. But the agencies care more about reimbursement than actual quality patient outcomes now.

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u/[deleted] Oct 09 '24

I'm the home health Medicare biller where I work. I live, breathe, eat and sleep this bullshit. I promise you were never the only one going back and revising and redoing. The amount of times I have to resubmit claims because QA decided to make the nurses go back and upgrade to the next level so we get paid $200 more for the month tells me just how often that happens. Those stupid OASIS are a beast. My A&P professor this semester is a home health PT and we had a whole bitchfest about them a few weeks ago. All the paperwork is crazy and then all the potentially scary stuff you get into, home health nurses should get paid sooooo much more.

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u/Mr_Fuzzo MSN-RN 🍕🍕🍕 Oct 09 '24

ALL RNs should get paid more.

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u/[deleted] Oct 10 '24

Well, yes, I thought that was common knowledge accepted on this sub. But there is an extra risk that you don't even have the potential to call for backup or security out at a patient's house. We've had nurses who have had guns pulled out on them.