I work in a county agency in a rural area. The nurses may travel 50-100 miles per day. Average caseload is expected to be 20 - 25 with 4-5 visits being made a day. The agency tells us that other agencies are making 25 caseload a norm with 5 visits per day. Well then I'd like to ask you who are doing this....when do you get your paperwork done? For any start of care the paperwork can take up to 2 hours to complete. I guess because we are rural the mileage thing is the issue.