registered nurse

customer service representative

Angels Care Home Health

This has been my favorite nursing job in an almost 30 year career. It breaks my heart to have to leave, but the increasing demands of corporate to attend meetings & be on required phone conferences, with no consideration for our workload, meant 50+ hr weeks. I can do almost anything for a short period of time, but when I looked back at my journal I saw that a year ago I was feeling the same sense of being overwhelmed with no support from management. A standard workweek means nurses must get 28 points, from seeing patients and, at that time, for attending required meetings & phone conferences. 

Last summer I had several MONTHS of 35-40 & even 40+ point weeks. When I complained to management about that & weeks of driving 500+ miles, I was told by EVERY manager & higher-up that I worked with, that they had worked even harder & it was part of the job. We were continually promised more nurses to help, but it never happened. 

My breaking point came a few weeks ago. Our census is down, and we were continually pressured to do more marketing--going into businesses to tell them about Angels to get more patients, helping w/marketing "events" and so on. There was NO CONSIDERATION for our schedules of seeing patients or what time worked for them; we were told that this marketing was required and we were told to be at events on various days & at various time, again with no consideration or input from the nurses. 

At a "team building" exercise several weeks ago, this was pounded into us again. Again we were told that we had to go out & market. When I questioned how to fit that in with urgent visits, or starts of new patients, I was told to fit it in--around marketing. When I voiced that patient care was supposed to come first, I was told "not really". The nurses were also told that it was their fault that we didn't have more patients. (Yes, this really happened!) 

As part of the same "team building" exercise I was told that I charted in too much detail & was "too technical". I had been working very hard to improve my charting to raise our points & get more payment from Medicare (we were NEVER encouraged to do anything illegal) & I had NEVER been told this about my charting. The time I was spending with "too much" documentation was then turned around to blame me for being overwhelmed. Other nurses' "negatives" were things like being OCD about patient care & expecting others to do what they were supposed to do. 

We were also told by the same marketing person that "no one" in the office had had their production points for many weeks, & that's why we should have time for marketing. In reviewing my hours & points, on our company-provided tablet, it shows that I have had an average of 29 production points & 46 hours over the last 4 months. And I discovered that the required meetings & phone calls did not even count towards production points, & some late charting (late because admission & recertification paperwork had not been completed by higher-ups---sometimes for WEEKS)  was not even counted in hours worked (the tablet automatically tracks the time we spend charting). 

This is a long post in hopes that someone on the corporate level will read it and realize how many very good nurses are quitting because of these frustrations (2 of 3 full time RNs in our office in one week-and at least 2 in other branch offices in NE the last 10 days). No one on the state or regional level has responded other than "too bad--it's part of the job--I worked even harder". 

I am discouraged, frustrated & bitter; I planned to stay in this job until I retired. I gave my ALL to this job. I have another job, & during my interview I was happy to hear that I will be expected to work a 40 hr week, maybe a little more, but they understand the necessity of family time & having time off for family & to avoid burnout. 

Unfortunately the patients are the biggest losers here, by the continual turnover of caregivers.

Prepare for burnout. “Work-Life Balance” is mentioned a lot from administration, but if you’re hired full time, it’s a joke. You will be working on your charting for hours after you return home. And it’s all on your provided tablet - no opportunity for a bigger screen at home.

The time expectation for you to fully complete an OASIS “start of care”, (SOC’s) resumption of care (ROC’s), recertification (recerts), or revisit is based off of a perfect patient with no issues - which we all know doesn’t exist in the home health world. 

Be prepared also for the expectation of at least one SOC every day, along with ROC’s, recerts, and revisits with a total pt. load of 5 to 6 pts/day. You will eat, sleep, and breathe this job, and it’ll never be enough because the average RN cannot meet that expectation without cutting corners and/or giving up on accurate charting.

Their EMR system, “PointCare”, is a nightmare. I’d be surprised if it was created for and by RN’s - it’s clearly geared towards administration.

They’ll inform you of taking “call”, and they’ll downplay it as a rarity you’ll have to do, but the reality is, “call” is the expectation for a Thurs.-Sat. or a Sun.-Wed. period (broken up within a month) spanning hundreds of miles (for my office, when you are on call, you cover your office territory, and a sister territory at least an hour away). If RN staffing is low, you will have it at least twice/month.

It’s the norm - not an exception - to have at least 1 - if not more - OASIS SOC scheduled on “call” weekends. So, it’s not really “call”, is it, within the definition we RN’s have known as “call” since you WILL be putting in driving and visit hours the weekends you are assigned call.

You will be expected to work holidays without shift differential, but according to the powers-that-be, they got you covered by allegedly averaging all that out with more PTO. But it’s not well-defined; who has time to sit down and figure all that out? You’re too busy making sure you are at the Monday and Wednesday morning meetings before your 5+ patients/day if you’re FT status (letting you know to hustle faster because they’ve got quotas to meet on the business side).

And you better get all visits in before 5. They say they want you home safe, but again - it all comes down to the dollar bills - they pay more with after-hours differential, so that’s why they want you to get it done before.

Ordering supplies is inefficient using their PointCare system, and what makes it more time-consuming is you have to notify the administrative supervisor of any special requests. And that’s the thing - there numerous quirky oddities you’ll need to learn and remember.

It’s absolutely overwhelming and utterly exhausting.

This is a corporation. It’s all about making a profit. And they won’t ever let you forget that.

Positives: Excellent healthcare insurance, salary I received is competitive. I enjoyed working with the other RN’s and most of the office staff. And I really enjoyed my patients.

They have RN reviewers who complete “soft-audits” to help you find and understand your OASIS charting inconsistencies before it’s sent through, which I really learned from and appreciated.

I’m also grateful for the extra time they took with “Extensive Training”.

But I still could not do it. I realized my personal happiness and “work-life balance” would have been part-time with just revisits.

I still love home health. Lots of opportunities and options out there. And I will definitely be more specific about “call”, weekend, holiday, and EMR expectations/inquiries with the next position. Onward and upward!

07/21/2023

Constant turnover of staff means you have no job security for yourself and no long term relationships with coworkers/managers. 

Constant staffing issues become the problem of the case managers - management is known to fire people or run them off with their rudeness and then just expect the remaining employees to pick up the slack - working 7 days a week, constant on-call, late nights, no OT pay available. 

There are constant promises of how things will get better. "Just give it two more weeks." They tell you that 50 times and before you know it you've been living in heck for months. 

Their territory is far too large. The company doesn't have the census to support it. What that means is very few nurses driving 1000+ miles a week/pp, but still being expected to meet some invented "productivity quota" and not being reimbursed per mile. The car allowance given barely covers the gas, much less the wear and tear on your vehicle. Bigger (better) companies have a higher census so while you may spend a lot of time driving, you're able to see most of your patients in the same area on a given day. Here? You may be in Livingston, then Conroe, then Tomball, then The Woodlands, then Houston, all in one day. 

The one great thing about home health is autonomy. There is none here. The scheduler creates your days, even if he/she doesn't know where exactly the visits are and pt's time preferences/commitments. Changing the schedule requires "manager approval."

Awful branch. Awful, awful branch.

This company is the most unprofessional company I have ever worked for, yet they have the audacity to want above the call of duty from their workers. I was only their for 11 months and from the time I started there till I left, there was only 3 original people left that was there when I started. I have watched an entire staff of people either leave or get fired in this period of time. I was also informed that the office staff prior to us, all walked in one day at the same time. I soon realized why. Their was always unprofessional profanity loudly used almost daily. Yet, I was harassed about my music I played in my office with my doors closed. People were able to bring their animals to the job and they were allowed to roam free and make unsanitary messes in the office. Nothing was never communicated with the entire staff professionally. My immediate manager whom I report to was fired and no one felt the need to report that to me. I found that out from someone that didn't even work there. I have never been on a job where I have never ever been told anything. Not even how the phone system works. They never show you anything, they never fully train you anything, but as soon as they feel corporate is barking down their necks, someone had to pay for it with their job.

What is the best part of working at the company?
They were very welcoming and I did love working there.  I felt like I was learning the position and training was going well, but the work load expectations, plus invoicing, PLUS answering phone calls (which I was told that I would not have time to do) was humanly impossible, especially with my minor disability after my spinal cord surgery (I had to learn to walk and write all over again).

What is the most stressful part about working at the company?
The work load expectations and the meetings that I really did not need to be a apart of, which made less time to get the huge work load done was the main stress focal point.  I already felt inadequate because of my hands not performing as prior to my surgery so the stress of keeping everything done while having meetings and answering phone was too much.   

What is the work environment and culture like at the company?
It's ok....I didn't appreciate the indoor smoking though.

What is a typical day like for you at the company?
Verifying PT, OT and speech therapy visits, waiting on authorizations to plot further visits, running audits on outstanding visits, answering phones, signing for deliveries.  I really loved this job, but feel like I was not given the six months to a year to truly show my worth and to find my groove in the position, which is unfortunate.

Pros is that you schedule appointment times. This allows for breaks throughout your day. Cons: lots of driving that is not compensated appropriately, poor training, poor oversight, management model for the company is “lean” which means they always do not have enough staff to perform required tasks even when fully staffed, which I never saw fully staffed beyond a few weeks. 

Management is nice, but too busy to help. Admin is great at her job, but company pushes nurses into the field. The training program is piece of paper outlining your requirements by dates not actual training. This is corp structured so hands are tied by local office. 


I recommend if you want out of hospital, I don’t recommend if have kids, fixed schedule, are not willing to accept more duties. You cannot refuse additional tasks even if asked at 4 pm. 

Pay raises are minimal, no negotiations on PTO/ no bonuses/ no paid sick leave. / no paid holidays. You get a PTO bank of 6.77 hours per two weeks which sounds good, but must use PTO if take off at all including illness, holidays, anything. Unable to take time without pay. Medical benefits are expensive for what they are for a single person and outrageous if covering a spouse, so ensure a spouse has their own insurance. 



I worked for Angmar form the very beginning of this companies existence. I have seen the good, bad, and ugly. The corporate management are hard working and eager to grow the company. As a Regional Marketing Director my job was very fulfilling. Training, hiring, and maintaining a territory within the company. Management was always interested in listening to my ideas on how to grow a office and develop a territory. Money is great. They start you out at a lower salary and dangle the carrot. Bonus structure is the top in the industry. You work for the extra money. An it was worth it. As a Regional I had a base at $65K and the last year I left I made over 100K. I am a young female. So no discrimination with this company. If you can do the job, it doesn't matter who you are. Co-Workers were great in the marketing department, clinical side at the time needed were difficult, but what clinical and marketing dept get along perfectly.  

I enjoyed the travel at 1st but after 4 years I was ready for a change and wanted to stay at home more. This company took a chance on a eager, young, and bright girl. They gave me opportunities no other company would have given me in the industry. I owe my career to this company and the owners. 

I have just completed six months on the job with AngMar at the corporate office in Mansfield and I couldn't be happier with my decision to take this position.

With my work, I have clear goals and objectives and do not have someone breathing down my neck all the time. Senior management makes it very clear what they expect and then let me use my skills and talents to get the job done. I'm not "meeting-ed to death" either with more time spent in meetings instead of working.

Also, the work/life balance is wonderful here. The corporate office shuts down at 5:00 PM and HR starts to lock external doors and shuts off secondary hallway lights by 5:15.

That sends a strong signal that employees are expected to show up ready to work, but don't work so much that your family life has to suffer. (I do work until about 6:00 PM at least once or twice per week though, but that's my call.)

There is a good deal of diversity here including women in management positions and employees are encouraged to pitch new and interesting ideas to solve problems.

The only negatives include the fact that IT has been way behind the times and there has been no formal marketing ethos here, but both of those issues are changing in the company.

I performed standard office support duties, like ordering marketing supplies for the [home health] marketers, I coordinated training meetings for the marketers, booked airline flights for my VP boss and marketers, ordered catered meals.

I also had the responsibility of signing Banquet Event Orders with hotels, created informational slide show presentations for patients, assisted the Marketing Director with large scale party and meeting events.

As time progressed and I had proven my communication skills, I was given the task of negotiating salaries for new hire marketers.

Awesome job and loved my co-workers!

My biggest challenge was hanging on for dear life with a stern and demanding boss who had a history of going through support staff.  When I was hired, I was her third admin in less than 2 years.

What I loved about working there was all the interesting stuff that I was learning about the world of outside sales and marketing, the field of home healthcare, as well as the opportunity to use my creativity to write and create presentations.

I worked as the chaplain, and enjoyed providing spiritual care to the patients. Many of our staff are talented and hard working, but do not stick around. Angels care hospice has more turnover than a pancake house. Seriously! A hospice should not lose employees faster than it does patients. Hospice work can be challenging, but the constant loss of employees, was the most bothersome thing about this place. Management DEFINITELY needs some education when it comes to employee retention. As a former employee, I would suggest, better pay, more respect for employees, and company vehicles. I had to make thousands of dollars of repairs on my car because many patients are rural and there is a lot of driving involved. It was sad to see the patients and employees suffer because we were NEVER fully staffed. On several occasions I witnessed my coworkers in tears because of stress. I enjoyed my job, but too many restrictions, low pay, and overall employee discontent caused me to quit. The vibes are just not good here. Angels Care Hospice doesn’t need a Chaplain, they need an Exorcist.

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Registered nurse 1 salary reported	$86,089 per year
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