home health patient accuity system

Specialties Home Health

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I am wondering if anyone is currently using or is aware of an accuity type system for home health patients to determine staffing and visit expectations. Our agency has several branches in different parts of the state. Each branch has individual characteristics that influence the ease with which patients are seen. One branch is very rural with alot of driving involved and often includes inclement weather (snow, ice, etc). The corporate branch is located in city limits and may involve several visits within blocks of each other. Yet, the expected number of visits to maintain FT status is the same across the board with no consideration for driving conditions or accuity of patients. Is there a system out there I can access so that I can suggest to administration we look at accuity level and travel time/distance rather that just number of visits. I also do not want this to not be an additional piece of paper for the visit nurse to complete. Just info for management when reviewing productivity quarterly. Any suggestions....

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I have never seen a tool like this. In all my years of HH, I have never seen a referral turned down because we couldn't manage it without killing the staff. I have seen "points" systems in which a SOC is worth 2 points, RC 1.5, etc, but nothing that takes into account the different conditions you describe.

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I too have worked in home health for years and the only thing that doesn't change is the fact that your day is NOT going to go as planned. I am ready to propose that every nurse manager should continue to do visits to stay in touch with reality. 1 SOC that I completed today took a total of 3 hours with travel time included - but I am not nearly done with the paperwork....

I don't have access to payroll information but also think that management should know what other staff is earning so that there is equity in pay among visit staff. We have some nurses paid per visit and some that are salaried but the 25-30 visit per week standard is pretty much across the board to determine if you are FT status and qualify for benefits.

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Specializes in ICU/CCU, Home Health, Case Management.

Salaried, too. 30-32 caseload, including IV' s even q 12hrs-1hr away 2 hr visit, all ROC's, SOC's and one follow-up before the LPN gets case, (minus IV), Recerts, Discharges, notice of d/c prior to d/c, sn ASSESSMENT IF BROUGHT IN by PT, on and on. Plus, I am supposed to complete job in 40hrs, no OT.!!! Daily visits for my agency require full assessment. ALSO, this is big, all Diversion (medicaid admits and superversion, intro of HHA. Longer visit cuz I don't speak Spanish, need to call interpreter. This does not factor in to my productivity!! AND, I have to go when HHA is there, which varies according to their schedule, which they all change!!!!! Visit could be an hour away because Diversion pts are in 4 county's. To make matters worse I get paid 28. hr, salary, take call qow, for $1.hr and asked to cover Clearwater office for free when I am on-call. I told them this was unsafe, don't know their census, pts who may call, etc, have to do all SOC's.reply, you won't get called, we help them out, because they are short-staffed!!!!, My office is in Tampa. I f I don't meet my 30 productivity,, Told company does not care about acuity, just numbers, by my sup. asked her what an iv visit ewualed, soc, roc, recert, emergency sisit, pm visit and she said this is a small company, i don't know. she's been working there a year. BEST, if I don't mmake 30-32 pts, even if they dont have them, d/t lo census, she told me I have to do weekend visits q wk, if i have to, to make productivity for the week!!!Every wk!! LPN is salary, non-exempt, but gets paid for weekend visits, when on call. LPN's should not take call at my agency, cuz they cannot do soc's, IV's, ROC's, etc. So, I have to cover her for RN visits for FREE. NO ON CALL pay. I have addressed this 3-4 times with my sup, she gets ******, (oh, well, that's HC. I did hc in MA for 5 years houly and never had to endur this insanity. Was not told any of this on interview, asked repeatedly for my RN job desciption, secretary gave it to me Friday, been there since June 1,2009. I need to put this in writing, what I AM WILLING TO DO, SAFELY, i WILL DO 32 PTS Q WK, IF THEY HAVE THEM, IF NOT THEN OH WELL, NOT MY PROBLEM THAT MY QUOTA IS NOT MET. i WILL NOT WK EVRY WKEND, COVER LPN QOW FOR FREE. AND i WILL GIVE THEM 45 HRS A WK WHATEVER DAYS NIGHTS ETC, BUT ONLY EVERY OTHER WKEND. tHEY HAVE PLAYED THE GUILT CARD WAY TOO MANY TIMES, AND MANIPULATED ME. aLSO, i JUST FOUND OUT, pOWERS TO BE ARE INCENTIVIZED IF THE OFFICE MEETS QUOTA AND A CERTAIN CHARGE, iS ALL OF THIS LEGAL, SOUNDS FISHY TO ME, ADJUSTING VISITS QWK BY SUPERVISOR FOR COST-EFFECTIVENESS. pLEASE HELP, I HAVE BEEN NURSE FOR 35 YRS, 22 IN ICU, NO SLOUCH HERE, ASSOCIATED WISH I HAD BSN. I AM THE ONLY RN WKING FOR MY OFFICE, ONE FT LPN, NO PERDIEMS. tHEY WON'T PAY THEM MILEAGE. i GET 45. CENTS PER MILE! bIG DEAL , THE TRAVEL TIME DOES NOT COUNT AND I PUT AVERAGE 150 MI/DAY. aLL pt'S, ot, sw, st, pta'S AND MOST hha ARE PERDIEM AND WORK FOR OTHER COMPANIES!! sOUNDS LIKE NEED TO LEAVE, ARE CONTRACT, NO WONDER!! THEY PICK AND CHOOSE.HELP!!

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Specializes in ICU/CCU, Home Health, Case Management.

No wonder my BP was 150/102 had emergency MRI, change in migraine since preesure was up elevatedlast week, was on vasotec for 20 yrs, controlled, no issues. whatchaneded in the past 3 wks, all the new things they don't put in writing, but reqiure me to do viditd.md changed med to benitar, no response stll high, azor is wkig but does drop it 77/55 occ,sorry this is long above reply.

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