nurse practitioner

physician

primary care physician

outreach specialist

primary care nurse practitioner

HarmonyCares

When you first start, they make it soumd like your day literally will end at 2-3 PM and they will take you on a ride along for a shadow. They will take you to only  few nice stops or a group home. This is not reflective of a normal days work. A typical day at work was arriving at the office around 8/830 am, getting the assignment for the day ( 9-10 patients that are 15 min to 1.25 hrs long), leaving with the medical assistant that drives you around in the company car, going from patient to patient in a lot of bad neighborhoods and often unclean homes with bed bugs and roaches, arriving back at the office around 3pm, and work from then on up until 9pm or longer often times to respond to messages, finish notes on a poor EMR, and fill out paper work for patients. I literally got a lunch break 2 times during my employment there. Otherwise, I had to scarf down food in within a few minutes.

There was a meeting every Tuesday that was focused on finances of the company and software updates. I learned that there are so many patients out there that really need help because they cant leave their home. Management is tolerable, but they have people that have never worked in a clinical setting a day in their lives making the rules and they have LPN's and non healthcare people that are pushing the financial agendas of the company onto nurse practitioners and doctors that are trying to provide QUALITY of care. They have multiple people seeing your patient doing the same thing that you are doing, but they claim it is a different service. They do this behind your back and repeat tests that you already have done and are up to date like A1C screening on diabetics or microalbumin. 

 Work place culture is ok. There is a lot of drama at the office at times. it reminded me of high school.  Managers befriending staff to a fault, playing favoritism, doing personal care at the office, and using very unprofessional language. The group I worked with was overall decent. 

The hardest part of the job was working for a company that only cared about how many patients you were seeing and not the amount of hours you were working. For example, if you have 4 new patients which require 1 hr visit, and you have 5-6 established patients. this schedule equates to 9 established patients in a group home that will obviously take substantially less time  Also, it was hard working with a company that tries to make you order useless/repeat tests for patients for their financial gain ( I did not do). They call them protocols. For example, on a person with depression dx in the past that is on no medications, they want you to order a CBC and a CMP every 3 mos. When you ask why its indicated, they never get back to you. When you do not do it, your score card drops, you get less bonus money,  and then someone is in your face or emailing you asking you about why you aren't ordering more tests. There were changes literally at least 1 time per week to something. Before you could get used to one thing, boom! Then there is something else. Many times, changes were pointless. Also, they gave you barely any changes and expected you to perform without error. There is literally no room for advancement whatsoever. Everyone except for a few people above you has less education or is literally non health care related. No one actually reviews the quality of your work, they only review the quantity of your work. The reports they run for the quantity of your work are not in real time and are always inaccurate, but you get questioned or accused of not doing your job based on these skewed reports. Health benefits not that good. 

The most enjoyable part of the job was caring for the patients and getting to know them. They became like family to me. It was very difficult to leave them because we overcame so many issues with their chronic diseases that were plaguing them before.

Dear Fellow Physical Therapist, 

Pinnacle senior care is part of USMM, which includes Visiting Physician Association, Grace Hospice, The HomeDME, Homescripts, and Visitng podiatry. Their Primary source of referrals  are from Visiting Physician Association for therapy and nursing needs.  There is no variety in case load most of the patients you might see for generalized weakness or totally disabled.

The Case Mangers and Administrators are persistent with their request for therapy referrals from the physician.  Majority of therapy referrals are not appropriate for home health physical therapy. If you evaluate a patient and make clinical judgments regarding patient not in need of therapy or not appropriate for therapy be prepared to be questioned by the Administrator regarding this.  The Administrator who is a nurse always questions and tries to influence you clinical judgment. 

I had multiple scenarios where it was not safe for me to see the patient due to psychological impairment, as the patient was verbally and physically abusive but they are persistent with their request. They do not care about your safety.  Base don my experience working with them they have questionable ethics and operate in the grey area. 

They do not have patient confined in one area so be prepared to be driving in all four counties. On average I was driving 100-120 miles a day. 

The office staff is not supportive at all; there have been numerous occasions where they have lost my documentation. They still use paper documentation, which is redundant.  They have not figured out their workflow yet so be prepared for changes on weekly basis.  Office staff and management are not open to suggestions/recommendation and do not deliver any promises. They are not resourceful as a company you might have to pull a teeth or two to get theraband or so.  I have been using my personal resources to address my patient needs. 

There goal is to run this place by PRN staff so this place is an open door when it comes to staffing and everything gets done on paper and in reality nothing get done.  The do not care about their patients at all , none of there additional needs get addressed. 

The administrator is forgetful, inconsistent, always make attempts to change or influence your clinical judgment.  I would not trust this company for a penny numerous promises were made and undelivered.  

Bottom line this company has questionable ethics, poor management that does not support the staff and have no resources. 

I hope after reading this you get a good picture of this company and how they operate they do pay well but its not worth a penny due to hostile, unfriendly office environment, unrealistic expectation and stress related to this job. 

Here is what you can expect salary wise.

Annual Salary of 92,000-98, 000

PRN Staff 
Per visit PT: $ 80.00
ROC: $100.00
SOC:$ 120.00
PT Eval: $ 90.00

The compensation is very good for in-home IHA visits (Initial Health Assessment: comprehensive health assessment done annually). For telehealth IHA assessments, the use of audio and video are required. The EMR interface does not offer single window video and charting. The use of a smartphone for audio video and a laptop for charting is ideal. Telehealth compensation is 45% less per patient compared to in-home visits. Part time providers are eligible for health care benefits and receive a flat rate per patient. They use their own computer and car. A mini router for secure Internet access is provided by VPA. Some full time positions include the use of a car with a gas card and a company computer. The documentation training is weak. It is very helpful to have previous experience with IHA documentation.

Daily schedules can be grueling for in-home assessments. VPA schedulers tend to use the Loop method when scheduling patients instead of the Cluster method which is more efficient and easier on the providers. When employing the Loop method the daily mileage limit is used as the standard distance for daily routes. The Loop method allows schedulers to create multiple routes in a timely manner without the risk of exceeding mileage limits. The downside to the Loop method is an extensive amount of unnecessary driving. Providers waist a tremendous amount of time driving the same long routes day after day. By the end of the week the average provider has traveled 15 miles in direction X five times, 15 miles in direction Y five times, and 15 miles in direction Z five times. If the Cluster method were used to create the routes providers would visit each region on seperate days and have time left over to see additional patients.

When I started at Harmony Cares as a field nurse for Home Health I didn't really know what to expect. I came from the hospital on a very fast paced, high acuity unit that did NOT are about patients. I wanted to give up on nursing all together. I took a leap of faith and entered homecare and have to say it has been the best decision I have made regarding my career. In the beginning I was struggling with volume load, understanding CMS guidelines for charting but the 1:1 time with patients was exactly what I was looking for. I ACTUALLY made a difference in the patients lives. I was made part of their family, they actually looked forward to visits. That was what I was missing in my nursing career which I am thankful to get to experience. 
As for the work load. It comes and goes. Sometimes we are bursting at the seams and others are light. Salary based which is competitive from my understanding in other homecare agencies. Our Administrator actually listens to you, schedules 1:1s and tries to remedy situations and values your input to improve the work environment. 
Benefit packages are good, insurance policy is competitive in this market and much better than what I was offered in the hospital, 401k, PTO grows the longer your with the company but I still haven't ran out even with multiple illnesses with my children and myself. 
Flexible days to make appointments or school events for the kids. You get to control your schedule as long as you can see your patients and/or keep productivity. There is on call but usually you aren't having to go into the field.
Some days are harder than others but we have a great team and management. The patients and 1:1 time is my favorite aspect. Still get to keep my nursing skills and judgement while bettering patients lives in the long run. 10/10 would recommend this agency not only to family for care but to work at. 

As a home care nurse the workload was either so low I was afraid I’d get laid off or so high that I was drowning! Management and office staff always tried to help me out though! Typical day was between 3 and 8 patients but covered a huge territory (often times patients were over 40 miles from one another!) so driving time was excessive! On call obligations were terrible, however, you were well compensated for on call time and people were usually willing to swap! 

I did have plenty of good weeks at this company and if you’re single and don’t do much on the weekends  and you love to drive this is a good job! The pay was amazing for my area! My personal manager was amazing always listened to my concerns! 

It is a constant amount of work as well. You will be charting at home every night and every weekend trying to catch up! My position was salary and I think that was great! Getting paid by visit only would have been terrible some weeks! 

The paid time off was very generous. I had a sick kid several times and had no difficulty getting a day off and never ran out of pto. holidays are paid and you do not have to work unless you’re on call and a patient must be seen. 

The patients are so happy to have you in their home helping them. Totally different attitude from their home vs hospital setting. 

Corporate seems to listen to complaints and concerns. 

Ultimately I loved this job but the driving and on call got to be too much for me! I would have stayed forever if I could have just had 5 patients a day and not have to do all the excessive double charting!

I worked for VPA from 1/18 and finally resigned in 10/18 secondary to lack of work.  Communication from staff and management was poor or non-existent.  There was a shortage of scheduling staff to make our appointments and patients often cancelled (probably 50%) when I contacted them to confirm their appointments.  I made a total of $4400 in 9 months. They did cover the malpractice insurance and deducted taxes. Paid $145 per completed visit which was to take 1 hr.  I was never able to complete a visit in 1 hr and then the EMR had to be completed which would take another hour at home.  Plus you are using your own car.   The patients I did see were usually happy to see me, they were often older patients although I did see some who had health insurance through the ACA.  Your schedule had to be turned in for the month at least a week ahead.  Patients were so few I would often go weeks without a patient scheduled.  Unable to make any plans on scheduled days as the schedule would not come out until the afternoon before.  So I am scheduled to work on Tuesday but won't know until Monday afternoon if there are any scheduled patients which means I can't plan on anything (like lunch with a friend) because I may have to work.  The final straw was when other ARNPs reported problems with their pay and upon checking my meager earnings vs documented visits, I was shorted one visit.  Reported this twice to the new supervisor, his supervisor (vice president), and the scheduling supervisor via email.  Never heard one word back.  As I had not had any pts scheduled for over a month, I decided to resign which I did via email.  Never heard one word back from anyone.  So unprofessional.

A typical day involved calls, patient assessments, documentation, chart reviews, and coordinating care with providers. While the clinical work was meaningful, a lot of the tasks felt like redundant busy work, especially around “quality” duties despite having a dedicated quality department.

I learned a lot about remote patient management and handling complex cases over the phone, which strengthened my clinical judgment and communication skills. However, management and workplace culture were inconsistent. When hired, leadership presents as team players, but on certain shifts managers did not share the workload or provide consistent support. The company frequently used the “startup company” explanation for disorganization, constant process changes, and unclear expectations.

These frequent changes often confused patients, which led to staff being spoken to disrespectfully when patients became frustrated with shifting policies. The hardest part of the job was balancing high call volume, unclear workflows, and patient frustration caused by internal confusion.

The most enjoyable part was helping patients and families feel supported during vulnerable moments. Remote work flexibility and patient interaction were positives, but the internal culture and lack of structured leadership made the role stressful and difficult to sustain long-term.

A company with employee favorites is not a company worth keeping. Also there’s no way individuals with same licensure's are paid differ tot clearly based on race. 

This place has such a high turnover due to so many family members besides the outside mainstream runs this place. They promote only to the family members who has no type of degree on the job they are promoted to. This corporation has made many frauds as over pricing medicare patients in which they run tests which are not really required so than can increase revenue. The managers in which come and go just work like robots as whatever the CEO says to do as coming up with bogus ideas to make more money, the manager ends up doing it. You have to take test in order to get a raise, its not like other jobs as your seniority increases, then your pay does. They claim that they care about their employees, but that's BS. Like when they give Christmas parties, what they do is they only give $500 to each site company and figure that should take care of the staff in which each site is different, but at my site we have 30+ employees. Also, they have a Podiatry in which is run by folks who have no knowledge of the Podiatry setting as scheduling, billing etc, in which just last year they had to payback Medicare $90,000 back due to faulty billing. The people who work for this company, they are very cut throat as for themselves. Please do not apply to this company. I am not the only one that has bad reviews on this company. I see this company tanking itself soon. They already sold 68% of it and soon it will just can itself as seeing the lack of leadership and responsibility of themselves, and the poor, poor very poor treatment of the employees.  SO DO NOT APPLY!!!!!

What is the best part of working at the company?
Helping patient’s to get better by understanding how to manage their disease. 

What is the most stressful part about working at the company?
Driving more than 200 miles a day. Driving from areas like Conroe to Rosenberg in one day. 

What is the work environment and culture like at the company?
Not good. But I have years of experience. Good communication skills and do excellent charting. 

What is a typical day like for you at the company?
Check schedule for the day. I have already scheduled appointment times with the patient the last evening.
Look at the patient’s chart. Review the orders. Check orders for procedures. Review previous nurse notes. 
Check my work bag re stock if needed.
Check car stock if required. 
Call first patient and tell them I’m on my way. 
See patients as scheduled. 
Follow POC. If changes found tell patient and explain to them and caregiver what they need to do to help it get better, and what to report. Make sure the have our number to call. Tell them to call us first because we are there to help keep them from going to the hospital. Tell them the symptoms are of an emergency and when they should call 911 and what to tell them. 
Report any problems to the doctor, case manager, and clinical director. If new orders were given write them. 
Write in home chart.
Complete charting and get patient to sign.
When finished for the day. Go home look at patients scheduled for the next day. If new patients and I have not gotten report from RN I will call them. Then schedule appointments for the next day.

Prepare for never ending work. Your basically doing the job of like 4 people. They promise you bonuses that we have never got in all the years I was here. Too much favoritism, it’s like high school all over again. It’s hard to take PTO because we are always short staffed and people call off everyday. We are constantly covering for someone and taking on their duties plus whatever duties we already have. Management expects so much from you and they continue to add more duties to your already long list of duties. VPA does not care about patient health it’s all numbers for them. Different direction from admins and manager, never on the same page. Some doctors are nice and others are just rude and hard to work with. You will be doing whatever you were “hired” for but turn around and cross train you to cover an area where we have no help. No knowledge or nothing they just throw you in something your not even qualified for. This job will suck the life out of you. Too much micromanaging from the admins. There is absolutely no advancement unless your really good friends with the manager or area manager. Employees who have been here long term still are underpaid while the new hire are making way more. Do not work here it will drain you. They do not care about you they only care about meeting numbers. 

Top Job Titles	Average Salary
Nurse practitioner 241 salaries reported	$116 per day
Physician 47 salaries reported	$206,596 per year
Primary care physician 79 salaries reported	$208,866 per year
Outreach specialist 31 salaries reported	$19.23 per hour
Primary care nurse practitioner 35 salaries reported	$147,025 per year

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