Saturday, October 1, 2011


We have round-the-clock nursing for my beloved, quadriplegic wife. For seven years we have been doing this, having replaced the original nursing agency with nurses we hire ourselves. Our hiring the nurses directly costs our former employer less than the agency was charging and lets us pay the nurses substantially more than they were getting before.

We pay the nurses weekly, then fortnightly bill the insurance company my former employer, IBM, uses to handle retiree medical benefits. The last shift we were reimbursed for was July 31. Today is October 1. That means we have paid our nurses for 60 days of nursing without yet getting repaid. This delay is about twice the usual delay.

We pay the nurses a gross wage of $38 per hour, whether Registered Nurses (RNs) or Licensed Practical Nurses (LPNs), who have less training than RNs. The work is essentially the same for both types of nurses. The RN wage is about average for our area, from which most of our RNs come. The wage is high for LPNs, and we attract them from as far away as an hour’s drive, which we need to do in order to fill our ten-nurse roster here in the exurbs.

The $38/hour becomes $40/hour with employer-paid Social Security and Medicare taxes, and balloons to $43/hour after including 2-3% bonus pay given near Christmas plus state and federal unemployment taxes (SUTA and FUTA). So, 24 hours/day times $43/hour equals $1043/day, approximately $1000 per day.

Sixty days un-repaid means $60,000 out of our piggy bank. Earlier this year I cashed in my IRA to help cover this cash flow. We will eventually get paid, but the wait is inconvenient.

The title of a Robert Frost poem is “Provide, Provide.” Our situation is unusual, but it should alert our readers to the perils of aging.

If Obamacare is instituted and our ex-employer pushes us onto the public plan, as some companies have done already, we will not get such nursing reimbursed.

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