Archive for June, 2014

New Minimum Wage Regulations Impact Home Care Agencies

Friday, June 27th, 2014

Home Care Minimum WageA pending extension of the Fair Labor Standards Act has significant potential implications for home care agencies.

Starting January 1, 2015, the U.S. Department of Labor will require all direct care workers employed by home care agencies and other third parties to be covered by minimum wage and overtime protections.  Caregivers will be limited to 40 hours a week without overtime, which must be at least one and one-half times the standard hourly rate. In addition, agencies must offer a minimum wage of $7.25 per hour (the current federal rate) or the current minimum wage in their state, whichever is higher.

A particular element of the Department of Labor’s final rule, published in September of 2013, will also narrow the application of the “companionship services” designation and prohibit “third-party employers, such as home care agencies, from claiming the companionship and live-in exemptions.”

What could this rule change mean for agencies, caregivers, and patients?

Agencies

Home care agencies face an almost guaranteed increase in operating costs: in the first place, if they do not already pay their caregivers at minimum wage they will have to meet that standard. Second, agencies will have to either allow overtime at a higher rate for their nurses to continue working more than 40 hours or hire additional staff to close coverage gaps from a limited 40-hour work week.

Many agencies will have to increase their rates to match their rising costs.

Caregivers

While caregivers will be earning more for the hours they work, many agencies will likely choose to restrict their weeks to 40 hours. Many caregivers typically work as many as 80 hours in a week, meaning that such a restriction would effectively cut their paychecks in half. Another concern: if agencies lose patients due to increased prices, there may be even less work for a caregiver to perform.

Caregivers who face losing a substantial portion of their pay may be forced to take a second job to supplement their income.

Patients

While most of the coverage of this rule change so far has centered on home care agencies and caregivers, there are also meaningful potential consequences for patients who rely on home care. As mentioned above, home care agencies may be forced to raise their prices for care or, alternately, provide fewer services to current and future clients. Patients who pay out of pocket or from a trust for their services may quickly be priced out, as would those who have long-term care insurance. Nonmedical home care is not covered by Medicare.

Case Study

There is already an indication of how this rule will impact home care agencies, based on new legislation enacted in California earlier this year.  The California guidelines set a threshold of 45 hours for regular work time and feature a $9 minimum wage as of July 1.

The New York Times profiled one California home care agency, Select Home Care, and highlighted the owners’ options for continuing to operate. In addition to the options presented earlier in this article, co-owner Dylan Hull also presented the option to turn their employees into independent contractors. This option would almost certainly reduce operating costs for Select Home Care, even when factoring in the additional caregivers they would need to recruit.

However, the contractor path opens Select up to periodic audits from the government to ensure that they are in compliance with the IRS definition of an independent contractor. To meet that description, Select would lose the ability to dictate the quality of care they expect and to hold their employees to that standard. According to feedback from other industry professionals not affiliated with Select, the most promising option is to charge more for services and hire additional staff to accommodate a new shift structure.

The Good News

Fortunately, home care agencies do not have to struggle with increased operating costs alone. Factoring for home care agencies can provide immediate working capital to cover the hiring, training, and payroll costs associated with bringing on new staff. Home care factoring also offers additional benefits that can help home care agencies structure their businesses for continued success. PRN Funding has nearly 15 years of experience providing outstanding service to home care agencies across the country – could you be our next success story? Apply online today to get started!

Which State is the Best for Nurses?

Monday, June 23rd, 2014

That the nursing industry is changing is indisputable. Social and economic pressures are transforming the industry and will have a continuing impact on new nurses looking to establish themselves in the industry. Where are the nursing jobs? What state offers the best standard of living for its nurses?

WalletHub released a recent analysis of the industry nationwide (including the District of Columbia) with a breakdown of the best – and worst – states for nurses along a variety of criteria. Depending on your area of focus and your career goals, below you will find out which states to pursue…and which to avoid.

Jobs

Nursing is an overall high-demand field, particularly given the impact of the Affordable Care Act on the insured population. However, some states have more openings than others and provide a more ideal destination for the newly minted nurse in search of a job.

Most job openings: District of Columbia

Least job openings: Alabama

Most healthcare facilities per capita: Oregon

Least healthcare facilities per capita: Delaware

Salary

Even the most rewarding position should come with a salary that covers the cost of living and, hopefully, allows an experienced nurse to invest in the future. What kind of price tag comes on your dream job? Find out where you’re likely to get it, and where you may need to pass. (Salary rankings are adjusted for cost of living.)

Highest annual salaries: Texas

Lowest annual salaries: Hawaii

Demographics

A nurse’s dream job location also depends on his or her specialty. Many specialties – including pediatrics, labor & delivery, and elderly care – are concentrated in a single age group, and choosing a location with low numbers of patients in that demographic means finding the right job will prove difficult. WalletHub projected the concentration of patients over 65 in each state by 2030.

Highest percentage of population over 65: Florida

Lowest percentage of population over 65: Utah

This is just a sample of the data and perspectives available in WalletHub’s survey. For more information, visit their site.

Many nurses choose to start their own nurse staffing agencies to serve hospitals and other healthcare facilities. If you are starting a nurse staffing agency and need working capital to get off the ground, contact PRN Funding to start nurse staffing factoring today.

Bundled Payments May Be the Future of Hospital Billing

Monday, June 16th, 2014

If you reside firmly in the 21st century you are likely very familiar with bundling. You can bundle your car insurance with your home and life insurance policies, your cable with internet and phone services – even your soda with your pizza. Hospital billing is picking up on the trend, and soon bundled hospital bills may become the norm.

Typical hospital billing involves individual charges for each element of a given stay or procedure, down to individual doses of ibuprofen. Provider services are billed separately. In a bundled billing plan, however, hospitals would consolidate these charges to a single fee for everything involved in a typical procedure.

Not only do bundled payments offer savings to patients, but they also provide an incentive to hospitals to provide efficient, high-quality care. Hospitals would keep the net funds remaining after a procedure completed under cost, but would be required to absorb any additional costs for extra care or complications.

Medicare is working with more than 300 health care organizations to provide bundled hospital payments for large-scale procedures such as heart surgeries, and other facilities are expected to follow. In the future bundled payments may include those for chronic conditions as well. Rob Lazerow of Advisory Board Co. points out bundled price tags can help hospitals “compete on cost and quality” for patients shopping around.

Hospitals that shift toward bundled payments will need to work with high-quality vendors to provide the best care to their patients. If you want to expand your healthcare company to work with these hospitals, PRN Funding’s healthcare factoring programs can provide the working capital you need to get everything in order. Contact PRN Funding to learn more about healthcare factoring in every sector and to get started today!

Healthcare Sector Adds Jobs in May

Friday, June 6th, 2014

Despite nationwide reports of healthcare systems eliminating jobs, the sector added 34,000 jobs last month according to the Bureau of Labor Statistics.

The healthcare sector has added jobs for 131 consecutive months, or nearly 11 straight years, despite the recession and fears that the Affordable Care Act would cause the sector to shrink. Last month’s growth was twice the standard rate at nearly three percent, most of which was concentrated in ambulatory services.

One element of continuing job growth is the increase in demand for services created by larger numbers of insured patients. At the same time, the decrease in uninsured patients due to marketplace policies and Medicaid expansion has reduced healthcare spending for charity care and covering self-pay patients.

Year over year spending has dropped significantly from 2007-2008 levels, but has remained consistent over the last several years.

PRN Funding offers healthcare factoring solutions to a variety of companies in the healthcare sector. If a lack of working capital is keeping your company from hiring the staff you need, learn how healthcare factoring can transform your cash flow and help your healthcare company compete. Contact us today to get started!

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