registered nurse - admissions

hospice nurse

registered nurse case manager

registered nurse

licensed practical nurse

Chapters Health System

During the interview, I was told that my position is a 40 hours a week salaried position and I would rarely be working any extra hours.  Management told me that if I ever have to work any significant time past my assigned hours, I'd receive a $200-$300 pay bonus to make up for it.  After starting, I found out that my coworkers have never received the pay bonus for extra hours despite working an extra two to fours hours a day past their scheduled time multiple days per week for several years.  When you include the actual hours worked vs the annual salary, the actual hourly rate is abysmally low.  Employees who have been working there for a long time told me that many of the salaried positions outside of the main office use to be hourly positions.  However, the company changed many salaried positions because they were paying out too much in overtime.  Now the salaried positions are based on what the hourly rate was with no overtime pay included.  

Overall, the work/life balance is poor.  I've been asked to do extra work work on my days off without pay because I still have to do my regular scheduled 40+ hours a week in addition to putting in time on my scheduled days off.  Despite the claims that you will be givent iem to do manditory company education, the company/management doesn't give you extra time to do manditory company education, so you end up doing it unpaid on your days off.  In addition to that I'm expected to work in excess or my 40 hours per week on a regular basis with usually putting in 48-54 hours per week to complete what I was assigned.

Many of the mid level managers usually quit their positions after 6 months to a year because they are expected to work 50-60 hours a week, but are paid based on 40 hours a week.  The managers salary is low compared to similar management positions in the area.  In addition to that, mid level management is often given unreasonable expectations and goals to complete in short time periods.

The initial education and training people do a great job.  However, at least half the educators and preceptors I've had after the initial orientation period seem to not care about training employees and put in minimal effort.  When errors are pointed out in education and training, the educators say its not their problem and they will tell another department to correct it, but they don't know when it will be corrected.  Some of my preceptors basically did next to nothing to train me and sent me off on my own with minimal training, then told me I was doing things incorrectly and expected me to redo my work on my days off.

Your vacation/PTO time is used up for company holidays, so you actually don't get any real PTO until you have been there for at least several years.  I never received extra pay for working holidays.

What positive things can I say?  The health insurance plans average and not too expensive if you are only covering yourself.  Most of my coworkers and the other employees I have met are friendly and helpful when I have questions or need assistance.  The work can be rewarding at times.

Do NOT fall for the tricks from anyone at this company.  They entice you into an amazing orientation program where all these promises happen than as quickly as orientation is over, the reality hits and you quickly realize the lack of morals within the company.  Management and all the higher ups are only after dollar signs for themselves and although they say they care about the people, they do not and they will make you miserable, questioning your every decision.  You will spend many days trying to keep up with the demands that are counterproductive and against everything within the hospice standards.  You will spend many nights crying and reach burnout faster than ever before.  You will not get paid a favorable rate and will be expected to work off the clock to meet the demands, although they will deny it.  They will constantly contact you when you are off and expect for you to respond immediately and at all times.  For holidays, you must use your PTO and you must put in for the day off even when it is a holiday or you will not be allowed to be off or get paid for it.  If you are into a high stress, micromanagement, no respect job than this is the place for you.  The entire culture of the company is wrong on every level, guarantee within your first 90 days or less you are ready to quit, yet they trick you to stay with promises of it will get better and providing a bonus (which by the way they promise you, but you have to beg for it to be allowed to get it).  If you didn't have anxiety, trust issues, or uncertainty in your direction or your profession, this company will guarantee you will have it in no time at all.  Oh and forget it if you have personal issues going on or need to use bereavement or counseling services for yourself....It is available but you get frowned upon using it and there is no such thing as confidentiality.  When you express your thoughts or concerns, if you are experiencing burnout or you offer suggestions, you will not receive credit for it and you will be looked down upon as a trouble maker and reprimand you for speaking up.  Ever wonder why the turnover rate is so high yet nobody talks about it?!  You will see instantly and hear grumbles all the way around, once management gets wind of the grumbles they shut everything down and do not let you talk amongst each other because if you are talking you are not working.  Only reason most people stay is because they feel trapped and unable to find another job quickly.

A typical day at work begins with dread.  Nausea boils up while  reviewing emails from angry threatening leadership and evolves into drive for the day failing.   Team members reach out to support one another which is great.  Kudos and encouragement are the name of the game as we move through the day.  Constantly on our guard for short accusatory chat messages from leadership scouring the work day for any sign of  breach.  Often we are met with a lack of follow through from middle management with accusations of missing material.  This is a whole other kind of problem.    I have learned that the best worker is one who is not afraid, who is respected on the daily for contribution or met with for  constructive collaboration.  ALL  professionals deserve to be treated with respect.   This company has lacked the ability to  make even the smallest effort of respect for any staff member at any level. Former colleagues used to say that Life Path was the definition of cycling insanity. They would walk a person out and 6 months later hire them back;  they'd dissolve policies only to reintroduce them years later with old employees in new roles.  A huge sweep of ALL leadership roles from the team leads to the CEO needs to be done to change the environment of this dysfunctional company.  And an investigation of admission policies should be of special concern.  We are no longer JAHCO affiliated and we self  monitor at this time.  Not a good thing.     The BEST part of my job are the patients families and people I meet outside of this company . Why I stay? We were met with a new Executive  Director who was inspired to share a dedication to making  a change of culture.  I allowed that to override my better judgement.  

Facility SSC’s are assigned several facilities a piece. You are expected to follow up on every hospice referral received from those facilities, check the status of hospice pre-admits that are discharged to your facilities for rehab weekly, hand deliver patient mail and charting history to each facility to update physical charts weekly, attend and serve as the facilitator at facility and interdisciplinary care plan meetings on a weekly and biweekly basis, cover the hospice house now two weekend days a month, along with up to two weeks a year of oncall rotation from 5pm until start of your shift at 8am the next day. It’s paid if you’re paged or must make a visit but you will be on call for the entire region. With the expectation that you still work some part of your regular shift the next day. There is a staffing shortage all over. So you will often serve as hospice liaisons and nursing case manager if your facility does not have one. Policy is 1x/month and as needed visits per patient however they Will encourage you to make two visits/month. Familiarize yourself with the policies for they will try to manipulate you. There is also a census of facility bridges patients that you are also expected to follow up on monthly in addition to active hospice patient. These patients are those that may have been referred for hospice services but did not meet the criteria or declined admission, or were on hospice services but were discharged for no longer being terminally ill. You will need to use your PTO in order to get paid for company observed holidays. The benefits are not as good as they once were before Chapters affiliation.

Sadly this is the most dysfunctional employer and company ever!  Having worked in a variety of positions as a nurse which included case management and home health there are  major problems with the company.  Either the head managers don't know what lower level managers are doing or they do not care.  
The bright spot of the nursing position is the patients and family.  The nurses are overworked sometimes having over 120 patients with 2 nurses!  It is cruel to tell patients and family that "we're here for you" and not have the staff to work.
No back up, no calling anyone in it is ridiculous.

If you want to work 60-90 hours or more a week and earn 40 hours and at a lower rate than the average RN.....This is the job for you!

There is no excuse to not hire more RN's.  These patients need help and there is no way they can receive it with no help.

Most of the nurses etc that you work directly are a great bunch but the managers have serious issues.  

Run away don't walk if you even think of working for this organization.  The best thing I ever did was having the courage to leave many months ago.  You are treated like an expendable commodity and not a Professional.  Their turnover rate is probably over 70%.  Constantly orienting new nurses because they quit all the time.  They wear you down and almost kill you.  No breaks at all.  Scheduled 9 hours a day supposedly with a hour for lunch and really, no one takes a break.We would get new nurses and they would be gone in a few months because it was the most disorganized of any company around.

Since the company is a not for profit, treatments tend to be patient driven vs revenue driven. With PDGM changes, most home health agencies cut therapy visits and use algorithms to determine how many visits a patient needs. Chapters allows the clinicians to make the decision, which is refreshing. One of the only home health agencies that still offer home aide visits and social worker visits.  It is evident to see that Chapters is Hospice focused, and the home health division is slowly being adopted. Education and professional awareness is focused more towards nursing and hospice, therapy services seem to be forgotten from corporate. With that said, the division I work for appreciates the therapy profession and give us autonomy with treatments. My immediate supervisors are extremely accommodating for personal time and encourage clinicians to limit your work day to 8 hours, including patient care and documentation. The productivity expectations are appropriate, however due to short staffing, some clinicians have a larger territory with no adjustments in productivity. I believe this is a company that will soon be a leader in Home Health in Florida in terms of patient care and employee satisfaction, just need to work out a few kinks on the corporate level. 

Leadership talks about providing excellent patient care but they do not provide the staff to make that happen. The pay for field workers seeing patients is low salary and the work that is demanded on a daily basis far exceeds the compensated hours. Meanwhile, patients suffer because there aren't enough nurses and other care staff to provide timely care. This hospice has recently taken over a lot of smaller hospices and have not made consistent processes across the board. The right hand doesn't know what the left is doing. Staff get verbal talking-to about something they did wrong when they were doing what they were trained to do. Leadership does not value employees' knowledge and frequently lie about the reason for a process for example. Mandated reporters have to go through risk management to report abuse to make sure  it doesn't affect the company's reputation. There is a ridiculous amount of micromanagement. Staff are talked down to and not valued as employees or human beings. You can never plan anything because you don't know how long your day is going to be. Across the board field workers say they don't have time to take a lunch break and must eat while driving. 

I returned to this company to fulfill a need for job satisfaction it once allowed. Boy, was I wrong.  The company is so much worse than ever.  RNS are overloaded with patients and paperwork,. They are constantly overworked both physically and emotionally.  Supposed to be max of 18 pts to manage per nurse, but typically 25 to 30. If the census dips to those acceptable numbers, it won't last. You'll be told to locate possible referrals or they will have to lose a nurse, or no longer be abe to hire another nurse. It's a game.  Leaving at 5pm is also a joke, and even management will tell you that.  Pay and benefits are deplorable for what they ask of you. 3 out of 4 nurses spends hours on the weekend to either complete their work requirements, or like me, to complete the 5 or 6  recertification that have to be presented weekly.  Things would be changed rather quickly if the patients and families ever knew what the company required of their nurses,  but like the  true caring nurses who love end of life care, we protect our dying patients and families from the truth. I think the company capitalizes on this. I also believe upper management and leadership is AWARE.  Hospice nursing is in my heart, but I'll never make the mistake of Lifepath again.

Coworkers are good & hard working people, but management is uncaring, unsupportive, and incompetent.  They literally don’t care if you die.  We had a pharmacist pass away recently from a heart attack, very likely directly related to the ever increasing stress level, and leadership did absolutely nothing in his remembrance except immediately scramble to get his next shifts covered.  Management structure is redundant, with a director who doesn’t do much of anything and is so detached he honestly couldn’t even work a shift if he had to.  Staff is constantly in danger of not even having the resources necessary to take care of our patients.  We run dangerously low on IV infusion pumps/supplies to the point where we are forced to make tough decisions as to which patients get what they are ordered. Staff is progressively overworked and management asks for more and more, as that is the secure/easy way out for them.  Rather than taking tough/meaningful stances when direly needed, management caves in to pressure from other departments to maintain their security over the well being of the pharmacy staff/department.  Thankfully, coworkers step up to organize small tokens of appreciation for one another (birthdays, graduations, etc) since management does not.

Working as a chaplain for Good Shepherd Hospice (GSH), an affiliate of Chapters Health System, has been incredibly rewarding but also quite frustrating. Working with patients and families are the best part of the job. If you have a passion and calling for chaplaincy, this is the best part of the job. Furthermore, I greatly appreciated the camaraderie between the chaplains and others staff members; I truly felt as though we all supported each other and helped each other to succeed. However, chaplains (like all positions at GSH/Chapters) are underpaid and overworked. The gas stipend when I left the company was only 54 cents a mile, which is 4.5 cents below the 2022 federal standard, and certainly not enough to offset the spiking gas prices in 2022. Furthermore, once you become a full-time chaplain at GSH/Chapters, there is no more upward mobility. If you want to advance or get a substantial raise, you have to leave the company or change fields. This is disappointing since the work with patients is so rewarding. However, I did enjoy my time with the company and will look back on my time with GSH/Chapters with fondness.

Top Job Titles	Average Salary
Registered nurse - admissions 328 salaries reported	$90,781 per year
Hospice nurse 190 salaries reported	$40.45 per hour
Registered nurse case manager 255 salaries reported	$80,291 per year
Registered nurse 135 salaries reported	$44.58 per hour
Licensed practical nurse 144 salaries reported	$28.39 per hour

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