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[Dysphagia] Options as dsphagia specialists
The high pay in nursing homes
> only thinly covers the fact that SLPs are responsible for pt
> deteriorations in so many areas and guess who has deep pockets in the
> lawyers eyes with our million dollar liability coverage
I havent responded to anything on this listserv for a very long time, but
this one really set me off!! I resent this statement! I have devoted 25
years of my career to SNF and have trained 15 CFs in this setting. I am a
manager for a large therapy company employing SLPs. To say that SLPS are
responsible for "pt deteriorations in so many area" is absurd and insulting
to our profession. We have many dedicated SLPS in SNF throughout this
country who give quality care to our residents. The "high pay" is due to the
fact that there is such a short supply of SLPs that wish to work in SNF.
Responsible for deteriorations? Here is an example of what my CF has done
just this week:
Screened the dining rooms in 4 facilities and identified 6 residents who are
in need of OT for feeding and ST for swallow.
Evaluated 5 residents 2 on GTs and 3 who are having difficulty w/solids and
losing wt.
Treated those 3 residents who are now eating >75% of their meals and already
looking stronger and gaining wt.
Provided excellent quality of services to 10 residents in the areas of
swallow, cognition and speech-language, improving their quality of life.
I could go on. It is unfortunate that this type of statement re: SNF therapy
services is why many of our colleagues don't want to practice in this
setting.
In the future, please retrain from ever saying that anyone in our profession
is responsible for deterioration of patients.
----- Original Message -----
From: "donna w" <lovdatsoap at gmail.com>
To: <dysphagia at dysphagia.com>
Sent: Saturday, August 25, 2007 7:52 AM
Subject: [Dysphagia] Options as dsphagia specialists
> To a CFY:
>
> To be blunt--don't go for contract work/high pay as yet It places
> you and your pts at risk and gives you no time to do the best job that
> they deserve
>
> Contract workers make the most because they are hired at the top rate
> because they can literally handle anything because they have seen
> it all and they can deal wtih it quickly and effectively They are
> worth the top pay They also have more risk and liablity because there
> is no layer between lawsuits and their license but the required skill
> level which
> gives the the subtle skills in those grey areas that come up so often
> in dysphagia Contract work is feast
> or famine and there are months when there is way to much to do and
> too many places to go to and it demands great time skills and
> organizational skills to pull it all off plus
> personality/salesmanship/PR skills to keep everyone ( MDs
> Administrators) convinced you are worth more than the new interviewee
> who will work for nothing
> They dont get paid for paper but they have done it for years and can do it
> fast
> Usually - they have 5-10 yrs exp or more
>
> Most contract workers demand flat minimums
> ie a 2 hour minimum or give options
> one rate for a 4 hr minimun day
> or a lesser rate for a min of an 8 hr day
> Most have a min of 4 hr or 2 hr min so you wont get there and the pt
> is ill or gone or off to a test or d/cd and you are NOT paid anything
>
> PRN/Float pool / resource pool-- have less pay but are called in
> more often because it is a bit cheaper for the facility They are
> actual employees ( pay in lieu of benefits) After one year and an avg
> of 20-24 hr week
> they are eligible for benefits-usually 401 or some type of pension
> option under the ERISHA law
> but on paper it could be building PTO time as well --pretty unheard
> of but possible.. Anything is negotiable
> PRN also can have minimums Some have a 10 hr week min Some have
> a 20 hr min for a week and balance it out over the week Most who have
> this
> arrangements cover 2-3 small hospitals and balance it carefully and have a
> small core of backup SLPs ( your friends) in case of illness or
> vacation so you wont get replaced because the place is without a SLP
> when you are ill or on a trip
> The minimums insure that you have core income that is steady so the
> higher paying contract work fluctuating places won't do your income in
> when the facilty which pays more has a low census ( no referrals for you)
> Neither of these options have medical and self pay medical is pricey
> unless you go for the cheap version that wont pay if you are really
> really hurt----
> better to have a
> spouse with medical coverage for you both if you go PRN
> There is NO job security and one
> can go off the call list without notice despite verbal promises or verbal
> plans--
> (Yes you can be co-manager in September so I can be home with my baby
> 3 days a week.. OOPs no I changed my mind and we wont need you after
> tomorrow until about 3-4 months from now...)
> So you have to really
> save up for the famine moments
> It is great for those with small kids who have a spouse who can
> subsidize benefits
>
>
> Do not let companies treat you with such lack of respect as to accept
> the job offer as they delivered to you
>
> All other professionals need paper time Carpenters need time to look at
> blueprints Even haristylists get to study new
> techniques on company time
> Stand tough and demand a job that will
> pay you for paper /prep and followup
>
> Non billables make a quality service-- period
>
> For now work on building
> your skill sets and there will be great ooportunities always for our
> field- dont go for high pay yet
> Dont let the appeal of money suck you into a position that puts your
> license at risk
> EX-
> Folks who hire on and find they are responsible for a huge caseload
> and are limited as to how many hrs they can work -leaving cases
> inadequately covered and increased risk for poor outcome and your
> license tangled in lawsuit The high pay in nursing homes
> only thinly covers the fact that SLPs are responsible for pt
> deteriorations in so many areas and guess who has deep pockets in the
> lawyers eyes with our million dollar liability coverage Read about
> FL SNF lawsuits --itis very sobering I stick to hospitals
> Be very careful and speak to those who worked at a place before you
> --before you hire on
> I told one place that I would work as PRN as I checked out a place
> (You dont know if management has good ethics--) I quit on the spot when
> I found out how they billed for my time an called ASHA and Medicare on
> them (Kept my reg 24 hr week job and only worked 6 hrs a week initially)
>
> Sometimes if it sounds too good to be true....
>
> Donna W
> PS sorry for my typing I have limited sensation in my fingertips
> and never was a very good typist :(
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