Working PRN for two or three home health agencies gives you control of your week and usually a better per-visit rate. It also gives you two or three of everything: offices, EMRs, pay tables, ways of counting productivity, rules about when notes are due. The visits are the easy part. Keeping straight whose patient is whose, which system to chart in and what each visit pays is the work.
This guide is for the PRN or per-visit PT, OT, SLP, nurse or assistant who takes patients from more than one agency. It covers what to keep per agency, how to plan one week across all of them, and what to watch on pay, miles and patient privacy.
A note on who is writing. I'm an occupational therapist and the founder of Logicly, a home health scheduling app built for clinicians who plan their own visits, including across agencies. Nothing here is legal or tax advice.
The Short Answer
- Keep one card per agency: office phone, who assigns the visits, the EMR, the note deadline, the pay table, the unit table, mileage terms.
- Tag every patient with their agency, so you always know which system to chart in and who to call.
- Plan one week, not three. Your patients from every agency go on one schedule and one route.
- Count pay and units per agency, because the same visit can pay and count differently.
- Keep patient information in each agency's EMR and in one protected scheduling tool, not spread across texts, notes and calendars.
Before You Say Yes to a Second Agency
Read the agreement before the first visit. Look for:
- Non-compete or non-solicitation terms. Some agreements limit seeing the agency's patients for anyone else or working in the same territory.
- Employee or contractor. Federal hours-worked rules, including paid drive time between patients, protect employees. Our guide to mileage and travel-time pay lists the questions to ask before a per-visit job.
- What a missed or cancelled visit pays, and whether documentation time is paid.
- The note deadline. Agencies set their own: same day, 24 hours, 48 hours. Two agencies with different deadlines is the most common way PRN clinicians fall behind.
- What they need from you: license, CPR, TB screening, vaccination records, liability insurance, orientation and a competency check. Expect each agency to ask separately.
Pay rates vary widely by state and discipline. Home health pay per visit by state shows what agencies in each state spend per visit, from their Medicare cost reports.
Keep One Card per Agency
| What to keep | Why |
|---|---|
| Office phone and who assigns visits | The person you call when a patient cancels or goes to the hospital |
| The EMR and your login | Which system each patient's notes go in |
| Note deadline | The rule you'll miss first |
| Pay per visit type | Start of care, evaluation, routine, recert, resumption of care, discharge, missed visit |
| Productivity units per visit type | If the agency counts units, the same visit may count differently elsewhere |
| Mileage terms | Paid from home, from the first patient, or after a set number of miles |
Tag Every Patient With Their Agency
On each patient's record, put the agency at the top, before the address. It answers three questions you'll ask a dozen times a week: whose patient is this, which system do I chart in, and who do I call. It also stops the mistake that matters most: giving one agency's office information about another agency's patient.
Plan One Week Across Every Agency
The orders come from different offices, but you have one car and one week. Put every agency's patients on one schedule:
- List what is due for every patient, whatever the agency: recert windows, 30-day therapy visits, new starts of care, discharges. The clocks are the same rules at every agency; only the office reminding you differs.
- Place fixed visits, then spread the rest so each patient's visits are a day or two apart.
- Group by area, not by agency. Two patients on the same street from two agencies belong on the same day.
- Leave a slot most days. With several offices sending referrals, the new start of care is coming.
How to plan a week of home health visits works an example from orders to a finished week.
Warning
Do not let one agency's schedule decide the week. A coordinator who sees only their patients will book you for Tuesday morning without knowing Tuesday morning is another agency's recert. Tell each office your open days, and plan the week yourself.
Count Pay, Units and Miles per Agency
At the end of the week you want three numbers per agency: visits by type, units, and miles. Count them from your schedule, not from memory, and check them against each agency's pay statement.
- Pay. Multiply each visit type by that agency's rate. A start of care and a routine visit rarely pay the same, and a missed visit may pay nothing.
- Units. If an agency counts productivity in units, its table says what each visit is worth. Two units for a start of care and one for a routine visit are common starting values, but there is no standard.
- Miles. Each agency may count them differently: from home, from the first patient, or after a set number of miles each way.
If you are a contractor, you also keep these for taxes. The IRS generally expects estimated tax payments when you expect to owe $1,000 or more for the year, and the standard mileage rate applies to business miles a self-employed person drives. Ask a tax professional how this applies to you.
Keep Patient Information in Two Places, Not Ten
With several agencies, patient details end up everywhere: texts from coordinators, a photo of a referral, a notes app, a paper list on the passenger seat. Each is protected health information, and each agency is responsible for its own patients'.
Keep it in two places. Charting goes in each agency's EMR. Your own schedule, addresses and to-dos go in one tool whose company signs a Business Associate Agreement with you, locks when you put the phone down, and keeps an audit trail. Delete what the coordinator texted once it is in.
How Logicly Handles More Than One Agency
Logicly is a home health scheduling app for clinicians, and working for more than one agency is built in. In Settings, Agencies, you add each agency with its office phone and what it pays for each visit type; each starts with common unit values, such as 2 for a start of care, that you change to what that agency counts. Each patient belongs to an agency, and their record shows it at the top beside the phone and the address. Every agency's patients go on one schedule and one route, and the dashboard shows the day's, week's or month's visits, missed visits, recerts, miles and estimated pay. You can hide the pay with one switch.
One account holds every agency, and the plan is per clinician, not per agency. Your account is yours; agencies do not sign in to it. Logicly is not an EMR, so you keep charting in each agency's system. You sign the Business Associate Agreement in the app before you add a patient. You can try it on sample patients without signing up.
Every agency, one schedule
Give each patient an agency, keep each agency's pay and units, and see the week's visits, miles and pay on one dashboard.
Key Takeaways
- Read each agreement for non-compete terms, employee or contractor status, missed-visit pay and the note deadline.
- Keep one card per agency: phone, EMR, deadline, pay table, unit table, mileage terms.
- Tag every patient with their agency, and plan one week across all of them, grouped by area.
- Count visits, units and miles per agency every week, from the schedule.
- Keep patient information in each agency's EMR and one protected scheduling tool.
Frequently asked questions
Can I work PRN for more than one home health agency?
Usually, yes. Federal rules do not stop a clinician from seeing patients for several agencies. What can stop you is a contract: read each agency's agreement for a non-compete, a non-solicitation clause or a rule about seeing that agency's patients for another agency. Each agency will also want its own orientation, competency check and copies of your license and health records.
How do I keep track of pay from several home health agencies?
Write down each agency's rate for each visit type, such as a start of care, a routine visit, a recert and a discharge, and how it pays for missed visits and mileage. Then count each week's visits by agency and visit type. A home health scheduling app that keeps each patient's agency and each agency's rates can do the arithmetic for you.
What are productivity units in home health?
Points some agencies use to weigh visits by how much work they take, such as 2 units for a start of care and 1 for a routine visit. There is no federal standard; each agency sets its own weights and its own weekly target. If you work for more than one agency, keep each agency's table, because the same visit can count differently.
Do I need a separate HIPAA agreement with each agency?
Each agency is responsible for the protected health information of its own patients, and as a contractor you may be asked to sign that agency's confidentiality or business associate terms. What you control is where you keep patient information: in each agency's EMR for charting, and, for your own scheduling, in a tool whose company signs a Business Associate Agreement with you, not in a phone's notes app or a personal calendar.
Sources
- 29 CFR 785.38 (opens in a new tab): travel between job sites during the workday is hours worked (employees).
- IRS, Estimated taxes (opens in a new tab): who generally must make estimated tax payments.
- IRS, Standard mileage rates (opens in a new tab).
- HHS, Business associates (opens in a new tab) under the HIPAA Privacy Rule.
- Related on this site: mileage and travel-time pay, pay per visit by state, how to manage a home health caseload.