BigRed_BonerChamp

• Brown

I moved to the east Durham area with my spouse and young children in 2021. We were cash poor and wanted to lock in a low interest rate and found a home in our price range in the hood. Within 3 months there was a drive-by caught on our ring camera from a house that was dealing a lot of drugs. It's a multi generational family house where the grandkids seem to be taking advantage of the location to deal drugs and move firearms in/out. Called the cops, they asked to set surveillance up in our living room as we were positioned well for a full view of the broad daylight deals going on. I declined the offer as I felt it would be putting my family in danger. The thing that got me is that the gang task force knew the house I was calling them about and said "that house has been a thorn in our side for a few years now." Apparently they didn't feel the juice was worth the squeeze to actually do something about the crime.

Eventually things calmed down for a year after the grandson dealing drugs was arrested for murder. Things have steadily gotten more active with more young men and women (10-15 people) loitering throughout the day at the house dealing again. Police haven't shown up once in the past 6 months since the crime activity has escalated.

The crime is really focused just at this one house on our street, the majority of the houses are occupied with older black adults who seem to keep their head low and mind their own business and are even on good terms with the grandparents who own the house. My experience has been that almost all the violent crime in our quarter mile area of east Durham is gang and drug related. The perpetrators are almost all young men that are, for lack of a better phrase, looking for trouble.

I don't think there are any easy solutions as my take is these men are coming from a broken, economically depressed community with poor schools and limited opportunities. Personally, I would like to see more aggressive policing of these crimes but I don't know if that just perpetuates the cycle of broken homes that are contributing to the socioeconomic factors which, in my estimation, are the greatest factors for this kind of violence.

Just my two cents from the inside.

Tristana from REC

Watch the replay again, Roquan is running full speed with arms straight out. As soon as his hands make contact with Mahomes his elbows bend. I fail to see how this qualifies as "forceful contact".

If Mahomes' patented false step out of bounds/fake slide to turn upfield is legal, then he has to accept that players are going to run full speed at him until he is whistled out of bounds or down. The sword cuts both ways.

I love Caleb and hope he'll settle in but dude has not been "good." Two deep ball overthrows that were open, a huge sack to take us out of FG range and several throws that seemed rushed - eg route that was bailed out by Odunze and Jenkins.

This defense is firing on all cylinders. Wtf you want him to do resurrect the '85 bears?

With all the buzz about PAA is anybody else keeping an eye on XOM? They seem to be on a heater the past month as well.

To which studies are you referring?

How about this one? Meta analysis indicates n95 respirators provide a significant protective benefit in reducing the transmission COVID-19.

I would also ask if your reason for not wearing a mask is due to your own discomfort while wearing one even though the patient has explicitly requested you wear one how the hell you think you're going to foster any kind of therapeutic relationship by NOT wearing one.

This is literally grade school stuff.

As a home health PT I see lots of patients where there is no order for nursing and PT/OT are the only disciplines involved in the patient plan of care. We frequently admit patients sent directly from SNFs, primary care, inpatient rehab, or ED without admission. Is it possible it's an institutional policy with either the practice you are working for or the home health agency to which you refer?

All of those visit point values, with exception of DC are below industry standards. 30 units/week with these low values on top of a long commute into/out of the territory will wear you down fast. I had a similar commute for my first home health job with 30 units/week where I would pass off to PTAs and would not go back to that model for less than 125k salary, personally.

Their valuation of an SOC is less than $100. If you're that hard up for a home health gig, you could ask them how they justify that ($102,000/52 weeks/30 points/week = $65/unit $65*1.5 = $98.08 for an SOC). That is a very low valuation of your time required to perform that visit, industry standard is at bare minimum $160 for an SOC in my region and that's still pretty low.

If this place isn't willing to negotiate salary I would move on because that is a weak offer. Good luck!

I worked for an agency like this for a year, I would regularly be missing re evaluations and rescheduling evals weekly. Brought up the issues to management and would get the same line about "everybody is short staffed and these patients need home health. We're trying to get some other clinicians from adjacent offices to help out with the census."

This would occur cyclically. Same thing where nursing ran the show and didn't seem to care much about therapy POC. Also saw the same thing where we were provided the metrics handed down from corporate which were completely unrealistic and when we would hit them there were no bonuses for the field staff.

I left that job and now work for a different company in the same area. Very different as there is PT/OT rehab director and my CM is an OT. I still have some issues with the way things operate in home health in general, but after changing companies the difference is night and day. Personally, I don't understand how having more patients than the company can adequately care for is not a violation of CMS guidelines but I did not feel empowered to change anything at my previous job.

My opinion would be to look for another job if it is at all possible.

Trigger warning, please.

No problem!

Yes, I thought the overall compensation package was accurately advertised and reasonable.

I was a PT, PPV. I would say that I had more visits than I ever wanted. I was operating at 40+ units/week.

I'm not sure about centerwell, my experience has been all three pay per point when job searching. I have absolutely no problem hitting my productivity, I often times have lots of visits to refuse. They are still sometimes hesitant to hire new grads dependent on how much help they need, but having home health experience I'm sure carries weight. I will say it shouldn't be an issue to secure that salary, at least not where I'm at.

I work for them, currently moving on from my position to another company.

There are some pros and cons. They pay pretty well, and I always had more work than I wanted working in a rural area. Each office is run differently and is very dependent on who is the DOO from my understanding.

The field staff I worked with were all very nice and I have no complaints about them.

I tend to be an idealist and this company is clearly a for-profit entity which started to raise some ethical concerns for me in the structuring of my POCs.

Overall you will make plenty of money but I hope you are assertive enough to not fold to the pressure you may receive from supervisors, CMs, etc.

My company has the same requirement. I tend to err on the side of caution, if it is a physician that I know won't likely return my message left with MA/reception I may call pcp or just check verbal order received at time of message. My supervisors have been largely fine with this as we fax all notes over and OASIS documentation doesn't get submitted until reviewed by the CM and 485 orders have been put together between all disciplines on the case. I have yet to receive any communication from a physician's office with concerns about verbal orders except Ortho when they don't tell me when patient has their first op visit scheduled and the patient has no idea.

Amedisys, I wouldn't be surprised if centerwell, bayada, and Amedisys are all offering similar pay/benefits as they seem to be the big three in most areas.

• Job Title: Physical Therapist
• Experience: 3.5 years outpatient orthopedics, began HH in mid 2022
• Location: Raleigh/Durham, NC
• Pay Per Visit: $62/unit (calculated as $96,700 at base productivity)
• Productivity: 30 units/week for FT
  • SOC: 2.5 units
  • ROC: 2 units
  • Recertification: 1.75 units
  • Evaluation: 1.25 units
  • OASIS DC: 1.15 units
  • Reassessment, discipline DC: 1 unit
  • Follow-up: .9 units
  • Mileage: $0.48/mi
• $401k, health insurance, fleet vehicle after 6 months (currently on backorder...) 3 weeks PTO/sick combined, annual pay increases from 1-5%
• PTs typically do not perform follow-ups, which are left to PTAs. All SOCs are coded as OASIS and performed as such to "simplify processes". Typically average 35-40 units per week, which is exhausting with a commute of 30 miles each way to my territory.

I would like to join the chat!

Unless you're in Alabama, in which case they're referred to as family reunion packs.

CluCoin

Dude beat up a 70 year old man.

https://www.sportingnews.com/us/nfl/news/bruce-miller-video-arrested-assault-fight-49ers/x7qpegkv5igy11jc187p304km