Home Health Admission Time

renerian, BSN, RN · Mar 5, 2003

2hours to 4 hours depending on complexity. I have done home health for 11 years. I find many people are unrealistic about the time it takes to do OASIS, the rest of the assessment, the care plan, any referrals, call the docs, teach your immediate needed items on visit 1 and any other issues. What is your company saying about the time?

renerian

Home Health Columnist / Guide · Mar 5, 2003

Originally posted by renerian
2hours to 4 hours depending on complexity. I have done home health for 11 years. I find many people are unrealistic about the time it takes to do OASIS, the rest of the assessment, the care plan, any referrals, call the docs, teach your immediate needed items on visit 1 and any other issues.

Ditto. 17 + years in homecare. Usual in home time for an admit for me to do it right the first time is 1 1/4 to 1 1/2 hrs (many elderly complex, poor patients with minimal support). Rare for me to be in clients home for 1 hr or less unless readmit and client known to me. Paperwork takes 45min-1hr to complete. Coordinating calls to docs/DME/Supervisor/family add another 15-30 minutes. I'd say three hrs for entirity is my average.

In my agency 1 admit=1 visit; 2 admits =3 visits for the day.

Hope that helps.

renerian, BSN, RN · Mar 5, 2003

Karen I said this before and I will say it again. I want to come work with you! In the agency I left it was not uncommon to have two to three admits per day as well as two to four visits. I worked six months without a day off.........................you have a good agency!

renerian

hoolahan, ASN, RN · Mar 5, 2003

In my agency 1 admit = 2 visits.

I agree w Karen's timeframes exactly to the number. But, if I need to do a lot of referrals, like to MSW or PT/OT/ST/RD, each of those is a form to the respective dept, so a lot of duplication there, and more time for paperwork.

In 2000, my other agency subscribed to VNAA.org and got a regular fax newsletter, which came on the weekend, so I always got to read it, and they did a survey which had concluded the avergae time for a new admit is 3.2 hours for all of it.

There have been times where I have been in the home for 2-3 hours, is a pt w new trach, peg tube, newly bedbound and eight decubs to assess, dress, and Instruct family in care of. But those are truly exceptional, and if I got a referral like that, I would make them take away 2 visits.

The trouble is, no one ever says no. If you are being given unreasonable caseloads/daily visits, refuse!

I put in for 7 hours today to do a new, a resume, and a revisit, with a student. (Yay! Finally they gave me a student!!)

renerian, BSN, RN · Mar 6, 2003

I always value hoolahans and karens thoughts.

renerian

sphinx, BSN, RN · Mar 8, 2003

It would take me around 3 hours average too, on CHHA patients. MY OB patients, with less paperwork, were a bit less time, unless they were a new hyperemesis pt who needed a PIV and a complete IV teach-that takes time.

When we give a nurse an opening, we usually give no more than 4 other visits, lately things have been SO bad, it's been worse....5 revisist, an opening, phone visits. (things might be looking up...even if only a little though, soon). The thing is, as far as productivity goes, a visit is a visit as far as openings or revisists are concerned. We were going to try weighted productivity, but it never took off. Not sure why.....

expatrn · Mar 15, 2003

I get $ 70 per admit , $50 rcert, $25 visit. Mileage is on me.

wenron · Apr 21, 2003

It takes me 1-2 hours in the home (21 page oasis) and then 2 hours of paperwork. 1 admit = 2 visits. If we casemanage, we only have 4 visits everyday. My boss also will try not to give us an oasis or Recert but every other day. As I read other posts, I see we have it pretty darn good.

Maerzie · Apr 21, 2003

wenron-

This is more like the times it is taking our nurses also. I suppose a person can do a sloppy job a lot faster, but a good assessment plus all that paperwork takes a LOT of time. Most bosses arrived at their positions BEFORE OASIS days, and don't have a clue how long any of those take.

Yes, you have a GOOD boss. Most bosses in this business are paid to make you cringe and do sloppy, hurried work so the company makes more profit under the guise of good nursing care.

Instead it should more honestly be called "profitable piece-work", with the words "nursing" and "CARE" eliminated.

wenron · Apr 21, 2003

NursieMe,

you said it well...I agree