I was a home care administrator for a number of years. I left because two separate doctors told me that if I didn't the stress of that work environment would kill me. And while that seems dramatic, they weren't kidding. My BP was sky-high. It was actually one of the nurses who noticed I looked off and forced me to stop and seek immediate care. I'm so grateful I did.
It doesn't matter if they are an NP agency. They have to cover costs and what most states' Medicaid and commercial insurance pays for services doesn't cover costs for the services. They certainly don't cover what PT costs. That's why Medicare patients are the goose that laid the golden egg in home care for their episodic payment structure. If you don't have a large number of Medicare patients in your mix, it is incredibly difficult to cover costs/budget. Home care agencies operate very leanly with respect to staffing as a result. One person always does the work of multiple people. HR would be an "extra" that a manager could (theoretically) handle. In other words, they can't keep them because it's a stressful environment and they often just plain can't afford an HR person. Directors in those situations are often tough (which, in the wrong people bleeds into aggressive) because management above them has set near-impossible goals for sales and back office management.
SO...rather than try to fix this, which is not likely. I'd ramp up your efforts to find something else. That's absolutely what you should do. Wishing you much luck!
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