home health productivity - opinion

  1. I have a question regarding productivity, my agency tries to have us see 7-10 patient a day, they tell us that if we have an oasis then they will bring it down to 6 visits which has not happened, they dont have a plan to give us overtime or per diem if we we dont get done within 8 hrs so they go thru and doc our drive time to get us down to 8 hours, one weekend I had 20 visits and 7 admits and was in trouble for not having it all done by 8am monday morning, it sometimes gets overwhelming, my mileage is about 50 miles a day with an average speed of 22 mph as calculated by my BMW, one thing good about them though is the health insurance is good, found out yeasterday I had severe tendonitis and possibly carpal tunnel syndrome, thankfully my insurance is covering it. If I ever go to the office to finish paperwork they tell me that I should not have to do paperwork in the office because I should have it all done in the home (they yell at me if my visits are over 30 minutes long) I am considered full time which is 37.5-40 hrs, my productivity averages 37 visits a week with about 6 oasis, and I get paid for 38 hrs/wk the drive time from the area where I do my am visits is about 45 min drive time from where I do my pm visits, and since lunch break and mileage are from the timed from finishing the last am to the 1st pm, lunch usually consists of rolling down my window and sniff the fries cooking at wendys as I drive by while I get docked for this time and this mileage, does everybody have this situation? our paperwork from the day before is due the next day so I usually get up at 5am and work on the from 5-7am, I am considered full time, the other nurses are not full time and they only accept 5-6 patients a day and end up taking the full 8 hours, your opinion?
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  2. 19 Comments

  3. by   mcrow
    Not a pretty picture you are painting there.
    Why not do what I did, and start a home based internet business. Set your own hours, even eat thoses fries instead of sniffing them. Just a thought.
  4. by   BethD
    patty,

    I would suggest checking out other agencies in your area.

    full time productivity at my agency is 32visits/wk. and that's pretty standard for around here ( mass)

    I personal chose to work in home care partly for the less stress environment. I wouldn't put up with what you have to go thru.

    BethD RN
  5. by   Rebecca Braune
    Dear Patty, I hope by now you've left that sweat shop! It's obvious that you're employer does not know that slavery has been banished and they could care less about you or the patients. It's sounds like this is an agency who doesn't have a clue about how much time it takes to assess a patient appropriately and to document it accurately on 10-16 pages of an OASIS plus all the other pieces of paper the employer has for you. It also sounds like they are trying to sqeeze every dollar out of Uncle Sam and Ins. Co.'s that they can at the exspense of your health and your nursing license. After you've recovered from your CP, and tendonitis I would scedaddle (that's TEXAN for hall buns) out of there and when you're all settled in with an employer who cares about you and can meet your needs then I would call that infamous little 1-800# and let Uncle Sam know what's taking place at this agency. You may actually save some lives in doing so. Good luck to you Miss Patty RN and God Bless you for hanging in there as long as you have. Becky RN (22 yrs in nursing 12 in HH).

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  6. by   Pal2Rn
    Productivity in my place of employment is 6 visits a day for an 8 hour shift. They are now expecting more than 30 minutes with the patients according to the pps coming effective. We do all case management including Oasis and chart keeping. I have learned after 6 months of homecare NOT to bring home work with me. Some days can be a bit stressful but nothing like the days I worked on the floor in the hospital. I will never return to hospital nursing. The amount of pleasure and accomplishment I get from teaching and spending quality time with the clients is well worth it. Oh we have admission nurses and the admission visit counts a 2.5 visit, so they do alternating 2 and 3 admits a day.
    Time for you to find a compassionate employer....look for them they are out there.
  7. by   Mijourney
    Hi Patty,
    Unfortunately, I have come close to been there and done that. I decided to just say no. Extreme back breaking work only leads to a broken back and spirit. Hard work is fine, but smart work is where it's at today. Increasingly, smart work is being reward positively. That 20 visit, 7 admission w/e...... Well, I don't believe in burning bridges, but when that assignment was presented to me, I would have laughed asking if they were joking if I was the only name attached to the list. If they weren't, then I would have asked if there were other nurses who were available to assist me with the clients on the list. If I was it, I would have taken my copy of the list and walked out, permanently, laughing and shaking my head. Curious, how long have you been in home health care? Is this your first agency? I'm in agreement with the other posters. Shop for a new HHA. I hope by this post, you've already found another one.
  8. by   lyndy_p
    Originally posted by PattyRN:
    I have a question regarding productivity, my agency tries to have us see 7-10 patient a day, they tell us that if we have an oasis then they will bring it down to 6 visits which has not happened, they dont have a plan to give us overtime or per diem if we we dont get done within 8 hrs so they go thru and doc our drive time to get us down to 8 hours, one weekend I had 20 visits and 7 admits and was in trouble for not having it all done by 8am monday morning, it sometimes gets overwhelming, my mileage is about 50 miles a day with an average speed of 22 mph as calculated by my BMW, one thing good about them though is the health insurance is good, found out yeasterday I had severe tendonitis and possibly carpal tunnel syndrome, thankfully my insurance is covering it. If I ever go to the office to finish paperwork they tell me that I should not have to do paperwork in the office because I should have it all done in the home (they yell at me if my visits are over 30 minutes long) I am considered full time which is 37.5-40 hrs, my productivity averages 37 visits a week with about 6 oasis, and I get paid for 38 hrs/wk the drive time from the area where I do my am visits is about 45 min drive time from where I do my pm visits, and since lunch break and mileage are from the timed from finishing the last am to the 1st pm, lunch usually consists of rolling down my window and sniff the fries cooking at wendys as I drive by while I get docked for this time and this mileage, does everybody have this situation? our paperwork from the day before is due the next day so I usually get up at 5am and work on the from 5-7am, I am considered full time, the other nurses are not full time and they only accept 5-6 patients a day and end up taking the full 8 hours, your opinion?
    I am appalled by your dilema, I manage a branch office for a Hospital based Home Care Agency. I would never dream of treating one of my nurses in this manner. Our productivity is between 5-6 visits per day with consideration taken for mileage. I have to admit my nurses would love to only put 50 miles a day on. We provide service in a very rural area. Average number of miles per visit is 27. I would never dream of expecting a nurse to work on their own time and not be paid nor would I alter their travel time to keep their hours down. If you really enjoy the challenges and rewards of Home care I would suggest you find another agency. I'm always looking for dedicated nurses. Would you consider relocation to no mans land.



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  9. by   nursemom30
    I work for an agency in a rural area. Average daily mileage of about 90miles. We also do 3 to 4 OASIS each day with an aide supervisory or routine visit in addition to those. I take work home daily to complete the documentation. Is this the average for home health care? I've been a nurse for 9 yrs but only in home health for 6 months.
  10. by   DutchgirlRN
    We get 6 hours worth of visits scheduled per day. Regular visits are worth 1 hour, Admits, DC's, Recerts, Resumps are all worth 2 hours. Then 2 hours charting time per day.

    Today I had 4 regular visits and one DC visit plus 2 hours worth of charting. I actually saw patients between 10:00 - 3:00

    We do get overtime as well as extra pay ($25.00) for a visit that is over 20 miles one way.
  11. by   cookie102
    we are all paid Per Visit---we all are hired on as either Full Time or PRN, only difference is FT gets benefits......quota is 6/day but that by no means that we only see 6/day....some days are rough, mileage up over 100 miles, yesterday i thought i had a pretty decent day scheduled, 7 revisits, then got called that a nurse had called out sick and we had no PRN help (frequently we hear this) so i ended up with 8, and 144 miles!!!! tired at the end of the day, then to tackle the paperwork,,,i find it hard to complete all the paperwork in the home with the number of visits and miles between etc. so something always carries into the evening,,,managememt says they understand!!!!!! but i think we must be speaking different languages as we have yet to see anything different
    not sure what the answer is , i have been in home health for 20 years and been a nurse for 33 years----think it is all just getting old!!!!!
    best of luck to everyone----hang in there and we will support each other!
  12. by   caliotter3
    Since this thread is eight years old, I would hope that the OP had the wherewithal to find another employer. I think the agency expectations were just a little too unreasonable and hope there were employment alternatives for the OP.
  13. by   jnette
    Quote from BethD
    patty,

    I would suggest checking out other agencies in your area.

    full time productivity at my agency is 32visits/wk. and that's pretty standard for around here ( mass)

    I personal chose to work in home care partly for the less stress environment. I wouldn't put up with what you have to go thru.

    BethD RN

    Ditto to all the above.

    Pati.. that's outrageous and totally unacceptable!!! :angryfire

    Get out while you still have your lisense and your sanity !!!
  14. by   jnette
    Quote from caliotter3
    Since this thread is eight years old, I would hope that the OP had the wherewithal to find another employer. I think the agency expectations were just a little too unreasonable and hope there were employment alternatives for the OP.

    LOL !!! Ha!

    Thanx for the outdated PO info!

    I just responded to it as well.. didn't see the original date, either!

    Guess she has moved on by now, eh?

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