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Thread: Private Pay Nursing Rates

  1. #1

    Private Pay Nursing Rates

    Hello everyone.

    Hopefully I haven't posted this in the wrong place, but I've got a question that I can't seem to find the answer to anywhere.

    Due to some limitations and a lengthy story I'd rather not get into, I am in need of assistance with my morning bowel routine. I do my BP (bowel program) every other day, and have a nurse that's been visiting me. This has gone on for almost a year and a half now, but my nurse is from another country and enjoys haggling on price. We started out at $60 per visit. A visit entails roughly but almost never exceeding 2 hours of time. I'm up and ready to go when they arrive, and once out of the shower, I handle all dressing, getting back into bed, etc, etc.. We are now at $75 per visit, and she's pushing for $100. Personally, that kind of increase in just down right insane and grounds for completely being replaced, but I don't know what the going rate is and so maybe I'm totally screwing her over at $75. To be clear, she is performing digital stimulation for the duration of my program, roughly 45 minutes.

    We came to this rate after she and one other nurse started moonlighting for me directly away from the nursing agency that connected us which was charging $110 per visit. She had a longer drive than the other nurse, and so I gave her $60, and the other nurse was at $50. But I've stopped seeing the other nurse.

    Can anyone help me figure out what a good rate would be? I've temporarily bumped the pay to $85 to keep her from murdering me during the program. Ok, I kid, but she seemed very unhappy that I turned down her request for $100. And I like her and want to continue, but I'm not loaded. She points out all the benefits to having her as a single nurse and knowing what I'm getting, but seems to totally ignore the benefits of having me as a client. Like, she sees me before her normal routine, so it's an extra $1200 a month along side her regular job. I'm very easy to get along with, and want to do everything I can to make her job easy and quick.

    Alternatively, can anyone point me in the direction of a directory for nurses/CNA's of this sort?

    Thank you in advance!

  2. #2
    Is this current caregiver an Registered Nurse with fully recognized credentials in the United States?

  3. #3
    Yes, she is a registered nurse, and had to be in order to work for the agency. But I'm not sure what kind of nurse. ie: RN, LPN, etc, etc.. But to that point, maybe I need to be seeking a CNA instead.

  4. #4
    Quote Originally Posted by Platypus View Post
    Yes, she is a registered nurse, and had to be in order to work for the agency. But I'm not sure what kind of nurse. ie: RN, LPN, etc, etc.. But to that point, maybe I need to be seeking a CNA instead.
    RN = Registered Nurse
    The basic requirement for registered nurse status education in the state of Georgia is an Associate’s degree or higher.
    In many jurisdictions no one but an RN=Registered Nurse (hired for pay) can do a bowel program with digital stimulation and inserting a suppository.

    If you hire from an agency, in many states, the only certification that can do a complete bowel program is an RN=registered nurse.

    In some states a registered nurse has to have a minimum of a 4 year bachelor of science degree to certify for board exams to be a RN=registered nurse.
    Last edited by gjnl; 01-25-2017 at 12:37 AM.

  5. #5
    I don't know of any states that require that someone be an RN to do digital stimulation and insert a suppository. In most states, an LPN/LVN (licensed vocational or practical nurse) can also do this. In most states, an unlicensed assistive personnel (UAP) such as a CNA or HHA (certified nursing assistant or home health aide) cannot be delegated such care by an RN or LPN/LVN (which would include being assigned by an nursing agency, since such agencies must have all care provided under the direction of an RN).

    Regardless, in most states, including my state (CA), a person with a disability may hire anyone they wish to do care for them that includes such things as suppository insertion, digital stimulation, catheterization, suctioning, etc. etc. that they would be able to do for themselves if not for the disability. So if you are private hiring (not through an agency), it is likely you could hire such a person (without a nursing license) to provide the care you are describing.

    It is also possible that this nurse is in violation of her contract with the agency working for you privately. It would be common for her contract to state that she cannot do this, within a certain period of time after working for you through the agency, or before the agency has billed a certain number of visits our hours to your case first.

    Some insurances that provide payment for such care (workers comp for example) may also require that you obtain such care through an agency (and therefore only from a licensed RN or LPN/LVN) but if you are actually paying out of your own pocket completely, you are not obligated to hire only an RN or LPN/LVN for this type of care.


  6. #6
    I was able to confirm this morning, she is an LPN. But I do believe that a CNA could perform this task as well. Either way, I'm just trying to figure out what a good hourly rate is or since it's 2 hours, what a per visit should be. The agency charged $110, but only gave the nurses $25/hr ($50).

    Btw, neither of the nurses work for the agency anymore, so there aren't any issues with moonlighting now.

  7. #7
    In my opinion, I would try to figure out a rate that you both can live with (if you want her to continue) and then also build in to it, an increase annually (keep it reasonable). I would do a simple contract that spells out both of your responsibilities and rights. That way, you know what to expect as does she. Rate wise, not sure what to tell you. I think that 100/visit is a big increase in one swoop. Maybe you could spread it out over time if you find that you can't do anything else.


  8. #8
    Senior Member
    Join Date
    Aug 2001
    Melbourne, FL USA
    Two excellent caregivers from first one was $15 an hour and the second one is $20 for an hour and a half, 7 AM to 8:30 AM.

    The best way to find and retain reliable help is to have it in writing. Be specific and make sure all parties understand what is needed and how it is going to be delivered.

    Don't need a caregiver as much as I need someone to run my house. Keep things stocked, laundry and cleaning. Basically I need a Mr. French from the 60s sitcom "Family Affair".

    As was pointed out above, once I it 50 it was rough enough have to wonder what 65 is going to be like.

  9. #9
    Senior Member dnvrdave's Avatar
    Join Date
    Feb 2002
    Denver, Colorado USA ---- C5/6 Complete 1985
    Quote Originally Posted by Platypus View Post
    I was able to confirm this morning, she is an LPN. But I do believe that a CNA could perform this task as well. Either way, I'm just trying to figure out what a good hourly rate is or since it's 2 hours, what a per visit should be. The agency charged $110, but only gave the nurses $25/hr ($50).
    Thanks for starting this thread. I think the discussion is important, but I also wonder whether it is in the right place. I seem to recall in the past that caregivers got upset because we were "bashing" them, or vice versa.

    I currently have a CNA (privately hired) that I pay $28 for a 1 hour visit, and $70 for a 4-5 hour visit. When I hired from Craigs List and, I advertised $14 per hour. She has been with me for a few years, and I like her a lot. She doesn't do dig stim, but she irrigates a colostomy (and changes the wafer) once every 9 days and changes a supra pubic catheter once a month (which I pay $21 extra for). She is good at these things (which I know are "advanced") but she has started complaining about being the only CNA of mine who does them. And she wants more money.

    I've never given her a raise, even though I am reimbursed by insurance, mostly because they have daily limits and I have a lifetime maximum benefit. Also because I know I can go out and hire someone else to do her job. That is probably what I will do, because I have found (after 32 years of this) that once a nurse starts complaining they will never really be happy again. She is burned out. I openly appreciate her sometimes, but not enough. Once a nurse gets a bad attitude, I just want them to go away. We both stop talking to each other.

    It is probably difficult to find a nurse (CNA) willing to do dig stim for 45 minutes at a time, but I think $25/hr is more than enough for a CNA, and I'd use or Craigs List to find new help if I were you. LPNs should get more than CNAs, but I think you are paying enough already. This is a supply and demand market. It's up to you whether you want to stay attached to her, but I have found that there are a lot of great people out there. Change is usually good.

    Update: I let go of some of my anger today, and asked my CNA (she has refused to speak to me for 2 days, due to her anger), "What do you need from me?" She immediately replied, "Eighteen dollars per hour!" I said ok. What this means is that I will have to pay two dollars per hour out of my own pocket. My insurance pays $16 maximum. I am relieved that I don't have to go hire someone else right now. And I realize I've got a much easier situation than you, Platypus. Good luck!
    Last edited by dnvrdave; 02-26-2017 at 08:52 PM. Reason: Added update
    "The primary cause of unhappiness is never the situation but thought about it. Be aware of the thoughts you are thinking. Separate them from the situation, which is always neutral. It is as it is."
    --Eckhart Tolle

  10. #10
    There is always a trade-off of paying more versus letting another stranger into your house to compromise your security. One needs to do a little amateur actuarial work and determine whether your cash "burn rate" is sustainable based upon your financial assets, age and level of care. If the increase is absorbable then it is probably best to give it unless there are other confounding factors, such as personality issues. One always has to keep in mind the ceiling for wages one is willing to pay.

    Then, if there is a possibility of your "burn rate" causing a literal bankrupting of one's assets then the choice will be to find other employees at a lower rate or perform some legal/financial maneuvers to go on Medicaid home care assistance. It may be possible to shield some assets and use these supplement the Medicaid provided wages.

    All in all sobering possibilities. They say money can't buy happiness, but it can sure buy some peace of mind in knowing that our personal health care needs will be met for the duration of our natural lives without requiring us to go to a nursing home or concede all independence overly restrictive agencies.

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