Re: Home Health Salaries-Help -Negotiating

[Guest guest]

In a message dated 1/1/2007 7:10:17 A.M. Mountain Standard Time,

tnlybrand@... writes:

Good Morning,

I am a new member and am starting a new chapter in my career,part of

which involves doing some home health. I will have to negotiate pay

in afew days and am desperate to see what is the going rate. Mentioned

are two different hourly wages:1) in office chart reviews and 2)home

health visits. I am in South Carolina, does anyone have any ideas?

Thanks,

Tina

Best wishes Tina!

A couple quick comments before I head out snowshoeing!

1. I LOVED doing home care. Enjoy it! You learn so much more about a person,

and their spending habits, by doing homecare. Somebody may dress " poor " but

you see a well-appointed home with a ton of " disposable " income items in the

home, showing the money is there, it's just channeling spending onto good

food.

Or, you see a well-dressed woman, that insists she's " fine " in an office

visit, and you may assume she has money - but in her home, you realize that she

" used to " have money, and that now, there is no food in the house, and no

longer enough income to support her. . . etc, etc.

I remember the 8 year old severely DD kid. Lots of asthma, runny nose,

illness, irritability etc. ONLY on canned formula feedings (Ensure or some other

stupid corn syrup/vitamin junk.) Mom wanted " healthier " so we started adding

REAL veggie and fruit juices that she made in her juicer (esp. spinach/kale)

to his tube feedings. (Duh, think people need real antioxidants?) Within a

month, significantly less respiratory crap to deal with, less illness, less

irritability and less stress on their marriage, which was HUGE for Mom and Dad.

Small changes we help with can make such big differences.

2. I haven't done significant homecare for over 10 years, but in 1995, the

going rate was $60/home visit, which included drive time. (Actually, varied

from agency to agency - I think I worked for 5 different agencies at one

point.) Some visits took 10 minutes. Some took 2 hours. Sometimes you had one

visit with a 30 mile drive. Other days, you could book 3 short visits within a

few blocks of each other.

Find out the range/distance you'll be driving. Be sure to negotiate for

drive time as well. Help the agency get reimbursement for your visits if

possible, and that will encourage referrals. (I'm NOT the person to ask here.)

Schedule inservices for the nursing/PT staff if you can. Get on the

inservice schedule twice a year if you can. Physical therapists need reminders

that a

person won't " gain strength and balance " if their protein intake or vit B-12

or Vit D levels are deficient! And, over 60%-80% of the time, they will be

deficient in one or more. If a person isn't improving with PT, that should

trigger a nutrition consult! (But, that's the simple version - in an

inservice, it might take 20 minutes to truly demonstrate the science/health so

they

" get it. " )

3. Even if your visits aren't reimbursed, I had one smart HHA Administrator

that admitted/realized that " MY " visits " made " the agency money. How? Often,

they'd have a patient that nurses and aides would visit daily or 3x/week

(reimbursed visits) -but the patient was " going downhill rapidly " and was about

to get admitted to a nursing home or hospital if " something " didn't change.

(Thus, they'd lose revenue.) Well, many times, they'd send me out for ONE

unreimbursed visit, and I'd find out the reason for the " downhill slide " -

nutritionally related of course - the " eats well " comments by the aide would

mean

1/2 a sandwich with a 1/2 cup of chicken noodle soup . . . duh. Anyway, I'd

turn them around nutritionally (often were protein or B-12/b-vitamin deficient),

and the client would STAY with the agency. My " cost " was negligible compared

to " losing the client " to a NH or hospital.

Use that as a negotiating point! You are NOT just an " expense required by

law " person!

If you'd like me to send you a copy of an article I wrote for the Home

Health Care Management and Practice Journal, let me know, or click here.

_www.hhc.sagepub.com/cgi/content/abstract/9/1/29_

(http://www.hhc.sagepub.com/cgi/content/abstract/9/1/29)

4. Chart review. I think my rate, 10 years ago, was $45per hour. Hopefully

more now.

5. I also taught the Nutrition and Food Safety/Sanitation (3 hours each)

segments of their Home Health Aide Certification courses (New Jersey) then too.

After the RNs heard me present that segment once, they refused to teach it.

They realized that they didn't really adequately know what the RD knew. (Go

figure!)

6. Is this a consulting position only? Thus, no benefits. Be sure you don't

ask the local " salaried " rate.

7. Finally, a good goal for 2007 for any RD. IMPROVE your negotiating

skills. I learned a LOT from " Dawson " tapes. Get together with 5 other RDs

and purchase a set of his programs.

Check it out here for FREE audio samples of various negotiating " gambits " .

.. . listen to all of them! Practice at garage sales.

Priceless! I know his tapes have earned/saved me $1000s over the years! Not

bad for a $70 investment! (Actually, a friend gave them to me. My investment

was time.)

If you have only a few days before your meeting, listen to ALL these FREE

audio gambits. They alone will give you words/skills that you didn't know you

had!

_http://nightingale.com/pa~product~Secrets_Power_Negotiating~audio~2048.asp_

(http://nightingale.com/pa~product~Secrets_Power_Negotiating~audio~2048.asp)

_http://nightingale.com/pa~product~Power_Negotiating_For_Sales_People~audio~20

23.asp_

(http://nightingale.com/pa~product~Power_Negotiating_For_Sales_People~audio~2023\

..asp)

GO FOR IT! It truly is rewarding work (most of the time!)

Happy New Year!

Jan

Aging (Milano). 2000 Dec;12(6):455-60. Links

Comment in:

Aging (Milano). 2000 Dec;12(6):405-6.

Muscle strength, functional mobility and vitamin D in older women.Verhaar

HJ, Samson MM, Jansen PA, de Vreede PL, Manten JW, Duursma SA.

Department of Geriatrics, University Medical Center, Utrecht, The

Netherlands. _h.j.j.verhaar@..._ (mailto:h.j.j.verhaar@...)

Vitamin D deficiency may lead to loss of type II muscle fibres, and thereby

to atrophy of proximal muscles with an increased risk of falling and bone

fractures. The aim of the study was to determine if six months of vitamin D

treatment (0.5 microg alphacalcidol) could positively influence values for

muscle

strength and functional mobility in vitamin D-deficient older women.

Twenty-seven women entered the study which took place at a teaching hospital

outpatient department. Ten vitamin D-deficient (serum 25(OH)D3 <20 nmol/L)

older

(>70 years) women and 13 age-matched female subjects with normal vitamin D

levels (serum 25(OH)D3 >30 nmol/L) completed the study. Preand post-treatment

data

were obtained for isometric knee extensor strength, handgrip strength and

functional mobility (walking distance over 2 minutes and the timed i'Up & Go "

test). Six months of treatment with alphacalcidol led to significant

improvements (compared to the controls) in values of isometric knee extensor

strength

(left leg: 14.6% +/- 5.7%. p=0.03; right leg: 11.5% +/- 5.0%, p=0.02) (mean

+/- SEM). The achievements in the timed " Up & Go " test and 2-minute walking

test did not improve in the alphacalcidol group compared to the controls after

6 months. However, within the vitamin D-deficient group, 6 months of

alphacalcidol treatment led to a significant increase in the walking distance

over 2

minutes (increase from 137.6 +/- 12.6 to 151.3 +/- 11.2 meters, p=0.03). The

controls, with normal vitamin D levels, did not exhibit improvements in

performance of any of the tests over a period of 6 months. Summarized,

alphacalcidol seems to improve muscle strength and walking distance over 2

minutes in

vitamin D-deficient older women.

Jan Patenaude, RD

Director of Medical Nutrition

Signet Diagnostic Corporation

_www.nowleap.com_ (http://www.nowleap.com/)

(Mountain Time)

(toll free)

Fax:

DineRight4@...

Mediator Release Testing and LEAP Diet Protocol for Irritable Bowel

Syndrome, Migraine, Fibromyalgia and more, caused by food sensitivity

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