clinical
Who is considered a novice nurse? 🩺
An LVN/RN with under a year of working experience.
What is the difference between a ROM and BDM?
ROMs manage current business BDM’s go out and get new business.
What does speed to READY measure?
Speed to READY measures the amount of days it takes to make a caregiver active from point of i9/comps to activation
Nurse Aundria had been an lvn since 2020 but just received her RN license this month. She will be onboarding with Maxim as a novice nurse.
False
Name 1 example of a Medicaid payer
WellPoint, UHC star/star plus, Molina, Superior
What is the purpose of an in home observation?
The purpose of an in home observation is for a clinical supervisor to evaluate a nurse on shift to ensure doctors orders and plan of care are being followed, confirm the nurse is using proper technique, and to address any safety, patient, or family concerns.
What is the formula for calculating spread?
Revenue minus direct labor and burden.
What does speed to MARKET measure? 🏎️
Speed to market measures the amount of days it takes to get a caregiver from i9/comps to bedside.
Nurse Terrence received his lvn license in 2023 but Maxim will be his first time working as a nurse. He will onboard with Maxim as a novice nurse.
True
Name 1 example of a commercial payer
Aetna, Cigna, BCBBS
How long does a clinical supervisor have to complete a R.O.C after knowledge of a patient returning home?
48 hours.
Define direct labor and burden 💁♀️
Direct labor: The wages that are paid to caregivers who provide services to our patient.
Burden: All the extra costs associated with employing someone (but not their wages) ex: benefits, pto, admin costs, etc
What is DPS?
Part of the backgrounds process (usually the part that takes longest to come back) searches Texas state criminal records, convictions, info from law enforcement. This is different from federal background checks.
A novice nurse must complete 16 hours of in home training
False
Which of these is correct?
A. Spread = gross profit
B. Spread = revenue
A. Spread = GP
After how many hours of a patient hospitalization is a resumption of care required?
48
What does M.C.O stand for and what is it’s purpose?
An MCO stands for managed care organization. An M.C.O plays the middle man between the state/federal government and healthcare providers, M.C.O’s vary by state because each state runs it’s own Medicaid program.
What are examples of reasons for on holds?
Missing signatures/documentation, 485’s, client loggings, authorizations
If a patient has a commercial plan and a Medicaid plan commercial is always listed as their primary.
True
Define Bill Rate
The rate at which Maxim is reimbursed for services
How many hours of training is required for a novice nurse?
Up to clinical discretion
What are 3 types of payers we work with?
V.A, Medicaid, Commercial
How many days should speed to ready be and how many days should speed to market be?
Speed to ready: 7 days
Speed to Market: 15
All home-care agencies have the same reimbursement rate in the same state since we work with the same MCOs
False
After how many days of not working should a nurse be put on hold/made inactive and after how many days of not working should a nurse be termed?
30 days inactive, 90 days termed