For those that are working in the healthcare industry, you know that it can be very lucrative and rewarding, and can provide lots of opportunities for growth and development. As the healthcare industry continues to change, there is an ever-pressing need for home healthcare providers.

 Most therapists that I have spoken with, have shown an interest in in-home healthcare services, but for one reason or another have decided not to get involved. Most of the time, it is due to fear and rumors involving the home healthcare industry, both true and false. Perhaps some of you are looking to get into the industry but would like to weigh the pros and cons before taking the leap of faith.

I personally have decided to take up home health as a side hustle, to learn more about the industry, and to hopefully bridge the gap between a patient’s discharge from hospital to home. Using my personal experience in home healthcare services, I have developed a list of the top (5) pros and the top (5) cons of working in this setting.

Property of rehaballey.com

THE PROS

#1 FREEDOM TO CREATE YOUR OWN SCHEDULE

As an independent contractor providing physical therapy services, I have found that I have a lot more freedom and flexibility to create my own schedule. By having the freedom to create your own schedule, you get the opportunity to work around your life schedule instead of living around your work schedule.

For example, if you need to take Tuesday off because family is coming into town, you can schedule your home health visits for different days in the week. If you are not a morning person, you can schedule your visits for later in the morning or afternoon.

You also have the freedom to schedule your visits around traffic hours, lunch breaks, errands, and even holidays. Now, you will also have to schedule your visits around your patient’s availability as well, but you do have a lot more room to decide. I personally enjoy being able to run errands during the day, rather than waiting until the evenings or weekends to complete my tasks.

#2 PATIENT ONE-ON-ONE TIME

After having worked in the Inpatient Rehabilitation Facility for (6) years before working in the home health services, I have discovered that there is a correlation between the demand for productivity, and the number of patients you are expected to see.

In some cases, you may have to see multiple patients in a group or concurrent session. As you may have already figured, treating (2) patients at once may lead to a decline in the quality of care for your patients.

Property of rehaballey.com

In a home healthcare setting, every patient you treat not only gets the benefit of one-on-one treatment sessions, but you also do not have to deal with interruptions from other clinicians.

For example, you do not have the nurses giving medications, or doctors checking on patient progress in the middle of your session. Not to say that other clinicians do not have an important role, but fewer interruptions help to deliver better quality to our patients.

#3 HOME ATMOSPHERE

After working in both a hospital setting and home healthcare services, I have seen that some patients tend to behave and progress better in their own home environment.

While at home, patients are in an environment that they are familiar with, and have more control of. Patients tend to get better sleep, be in a better mood and are more willing to participate in their therapy sessions.

From a clinician’s standpoint, this also helps to get out of the hustle and bustle of the hospital environment. You also get the opportunity to work in a place that is comfortable for you and the patient, which sets you up to deliver better quality and achieve better outcomes.

#4 BENEFITS

This usually pertains to clinicians that are working either full-time or part-time in the home healthcare services. The benefits that they receive are typically similar to those received in a hospital setting, with the addition of being compensated for mileage or a company car. Most of the time, PRNs and independent contract workers are not eligible to receive these benefits.

It is important to note, however, that your mileage and any equipment that you buy relating to home health can be written off on your taxes. So hang on to those receipts!! In addition, you can use apps such as QuickBooks Self-Employed (LINK) or MileIQ (LINK) to track your miles and/or expenses throughout the year.

#5 MORE AUTONOMY

Working in home healthcare services, especially as an independent contractor gives you more autonomy to establish a patient’s need for therapy, discharge, and Plan of Care (POC). After completing the evaluation assessment, you can decide whether the patient is appropriate for home healthcare services, and whether to proceed with services or not.

You also have more autonomy to determine whether to discharge a patient if they can no longer benefit from services. In all honesty, you do not always get the opportunity to make these quick decisions in a hospital environment, as you have more entities involved with admitting and discharging patients. Most of the time all a clinician can do is make suggestions, and wait for the suggestions to be considered.

THE CONS

#1 DRIVING

Unless you are using a company car, you’ll likely develop some wear and tear on your car from having to drive back & forth from patient visits. Not to mention, you can rack up high mileage on your vehicle.

If you are working full-time or part-time, you may not get the opportunity to avoid those high traffic situations or inclement weather situations. Furthermore, you may even get assigned to patients that are outside of your preferred area.

Those that work PRN or independent contractors may not get compensated for their drive time. One way to offset this issue is to schedule visits in the same area together to avoid long drives back & forth between patients. If you are working as a PRN or independent contractor, you may have more freedom to choose visits that are within your area.

#2 WORKING OFF OF THE CLOCK

This is a BIG one for me, especially with being an independent contractor and getting paid for the visit. However, even with hourly/salary employees working home health, most of them can relate to having to complete work off of the clock.

Most of this extra work comes in the form of documentation, and other paperwork. Documentation paperwork usually has a deadline to be completed by the end of the day. This sometimes involves completing paperwork in the evenings, after your visits have already been completed.

Property of rehaballey.com

In other cases, you may have to communicate concerns with other home health clinicians, patients, family members, and complete inquiries such as checking email outside of treatment times.

One way to offset this issue is to bring a small laptop or pad with you to your patient visits and complete as much documentation as possible either during or immediately following your visit. As mentioned in the previous section, keep your receipts for tax-related purposes.

Property of rehaballey.com

#3 COMMUNICATION WITH COWORKERS

Since other clinicians in the home healthcare services are not readily available, communication can often be very tedious and difficult. This usually involves sending emails, text messages, or phone calls, and waiting longer for feedback and correspondence. It can also be very difficult to get all disciplines on the same page. This can cause delays and setbacks when relaying information to your coworkers.

#4 INDEPENDENT CONTRACT LIABILITY

As the title implies, this is usually only an issue for those working as independent contractors. Independent contractors and PRNs typically do not receive any benefits from the company, and therefore do not receive any liability protections. As with any business owner, if a mishap were to occur, this leaves you vulnerable to lawsuits.

Property of rehaballey.com

Most companies that hire independent contract workers or PRNs, require them to carry liability insurance at all times while they’re involved in inpatient care. I will not go into detail about the different liability coverages, however, the most popular one used by healthcare professionals is HPSO Malpractice Insurance for Healthcare Professionals (LINK).

Limits and coverages for HPSO malpractice insurance depend on your particular state and plan. HPSO also provides coverage for both individuals and businesses.

Not only are independent contract clinicians liable in the case of malpractice, but you will also be responsible for your own taxes. One method that helps me to keep track is to take out a certain percentage of my paycheck and transfer it immediately to a separate account that I save only for my taxes. It is important, however, to talk with your CPA or tax lawyer regarding your specific needs.

#5 EQUIPMENT

Lastly, I want to touch on equipment as being the last major con for working in a home healthcare environment. As you may have already figured, working inside of a patient’s home limits your access to equipment that would’ve been available to you in a hospital or clinic setting. At most, you are limited to what can be stored in your backpack, briefcase, or car.

Most of the time clinicians do not get reimbursed for the equipment they purchase, so as previously stated it is important to save your receipts!! The limited supply of equipment may also limit your interventions. Therefore, you will have to get creative with the items that you purchase, or use around the patient’s home to achieve similar results.

Property of rehaballey.com

Hopefully, this brief article helps to clarify some of the pros & cons surrounding home healthcare services. With the proper information and preparation, home healthcare can provide wonderful opportunities for both you and your patients. GOD BLESS YOUR ENDEAVORS!!