Is there a cap on maximum amount of patients per day

[Roxxyruns]

Is there a regulation or law for the maximum amount of patients a home health nurse can see in one day? I posted a reply to another post describing my typical day and week.

The RN's may do 7-8 visits per day, including recerts, admits, etc. I'm part time and am committed to 4-8 hour days, but if I already have 7 people to see, and a medicare referral comes in at 4pm, I have to do the admission. I often do not see the patients I'm responsible for case managing, and they do not follow my schedule. I usually do the equivalent of a 12 hour day, and I'm trying to get out of this mess by getting a new job before I leave this one, but I have no time or energy left!

We also have no computers, no technology, and we're all swimming in paperwork.

The LPN's are paid hourly, and see from 7-9 patients per day. They case manage their patients, also.

Is any of this even legal? I would like to find the information online to find out if there is a cap on the amount of patients home health nurses can see in one day, and case manage, also.

If anyone has any info, please reply. Thank you.

Roxxy

[AnnemRN]

i have worked over 13 years in home health and it is my experience that the agencies don't want you to work overtime. i have always had excellent annual evaluations that mentioned my time efficiency. i rarely had overtime and my patients were well cared for.

on the other hand, lately with the daily patient load creeping up to 7, i do not get done in 8 hours. of course, management is not happy as they still want you to finish in 8 hours.

[berube]

pay per visit, even tho full time, therefore corporate way of saying NO overtime!!!

[tewdles, RN]

I have been in home care for about 6 months now...previously in hospice. BIG difference! I had a long talk with my immed supervisor and her director yesterday about expectations for an inexperienced home care RN. Basically what I have been told is that I am expected to see 2 starts of care and 2 routine visits in an 8 hour day. (I did 4 OASIS visits in one day last week, 3 the next). They acknowledge that it takes an average of 4 hours for even the most experienced RNs to complete the OASIS however, they are NOT going to pay me to accomplish that task. I must get it done within 24 hours and it must be done on my time. Needless to say, I am not happy about this discovery. Currently I am "donating" 5-15 hrs per week to this company in order to meet their productivity expectations and I am exhausted and overwhelmed. Not to mention the fact that it works out to about $18/hr in the end! I am sick to death of working at night, in the morning 0600 to 0700 before I start my day, and on my days off...all without compensation. The director's comment was, "home care always involves work at home, maybe this is not the right job for you". Given that I work in the greater Detroit area, in unsafe neighborhoods, often have travel time in excess of 30 min between patients, have many patients with significant medical and mental health issues that have been sorely neglected for years, I cannot imagine how I can possibly meet anyone's needs in this job, including my own. I am currently looking for other employment. My questions are this: How much work do CHC RNs do at home? Is it common for CHC agencies to refuse to pay for that documentation time? Thanks so much for your input, and THANK YOU for the great work you guys do out there in the jungle...these people NEED you!!

[tewdles, RN]

Oh, PS...I am case managing 47-50 pts covering 15 Urban zip codes with an excellent LPN/GN. I have no idea what that case management model looks like, and I asked my management to show me how that works...I am familiar with case managing 12-20 hospice pts in a similar setting. Any thoughts on this? Is this pretty much standard in CHC?