home health productivity - opinion - page 2

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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,... Read More

Mar 14, '08
Occupation: med surg nursing Joined: Jan '04; Posts: 16

I would first talk administration. Where are they getting their case load/ productivity standards from? Maybe suggest someone shadow you for a day to see what you could do different so you can meet the productivity standards that someone who is obviously not a nurse is establishing. A 1/2 hour with a pt might be on a perfect day with a pt who is about to be discharged because goals are met, family is attentive and educated, and it is a perfect world. You need to speak out loud and clear that quality patient care does not happen in 30 minutes, that you will not continue to take on unreasonable assignments. Share the load with the per visits nurses. All nurses need to unite for quality care for the patients we serve in all areas and we also need to fight for quality care for ourselves too. Most of us are getting older, do you want a nurse coming in to your home at the end of her 50 hour week? Who will be taking care of whom? Be fair to yourself.
Mar 14, '08
Joined: Aug '05; Posts: 64; Likes: 12

Since this thread was started in May of 2000, the payment rules were different. Home Health Agencies were being transitioned from Fee for Service to PPS via IPS. Though this is a little high for that period of time, this agency must have survived the transition period with thoes productivity standards in place. This was prior to PPS implementation which occurred in October of 2000. Productivity standards from then cannot be compared to productivity standards today. You are looking at apples and oranges.
Jun 26, '10
Occupation: Postpartum/gyn nurse Joined: Feb '02; Posts: 110; Likes: 81

Quote from 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?

This was an old post (2000) but I had to reply. It sounds like your agency was really taking advantage of yo. I say 'was', because I hope you have moved on by now. For full time RN in my agency, the productivity goal is 30 'points' per week. You get one point for one visit. 2 points per Start of Care.

What are doing now?
Jun 27, '10
Joined: Apr '09; Posts: 118; Likes: 38

OMG 7-10 visits a day?!! I have been in home health for 19yrs and have never heard of expecting that many visits a day. I would say 5-7 visits a day (averaging 5-6) is the norm. I wish I could say I don't bring work home, I do 1-3hrs a night of paperwork (on a PDA actually). My average is 30-45min for a revisit and 90-120min for a SOC.
Aug 27, '10
Joined: Jul '08; Posts: 126; Likes: 107

[quote=lyndy_p;22314]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.

Wow!!!!! 50 miles a day? Try 160 and average 650 or more miles per week! I was sent to see ONE patient who was a 45 mile drive one way ( 90 round trip) then called while doing visit to go see another patient 50 miles north ASAP. The company quickly lost this full time RN...there was no consideration for time spent doing all this driving and the expectation was 5-6 visits per day. Each routine visit was rewarded with 1 point a nurse was expected to get 30-32 points a week...if it took 2 hours travel for one patient then another hours drive to the next you still had to have your 5-6 visits in each day ( keep going till u drop dead in other words). Forget about no mans land I was in HH Hell!
Aug 28, '10
Occupation: home health Specialty: med-surg,ltc,home health ; Joined: Feb '07; Posts: 34; Likes: 3

Patty Rn you should definitely find a better agency, that is just wrong!! To the nurses and the patients both! That company doesn't care about either it seems. Sad.
Aug 28, '10
Joined: Jul '08; Posts: 126; Likes: 107

[quote=caliotter3;2705514]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 I didn't notice the date of this thread and how surprised I was to look back and find that the productivity requirements have not changed in 2010. As I said in my post the expectation is 32 vists per week with the company I currently work with . Driving 80 miles one way for one patient is also an expectation. Do they get what they expect ? No they do not and currently have no full time nurse on staff other than the two "clinical supervisors" who are sent to do the visits and the administrative work required.