Horizon Homecare MobileCare-GPS TRACKING

carwin · Nov 22, 2010

People in homecare know that nurses chart, eat, etc in their parked cars and stop to go to the bathroom so that's how you explain gaps. But you can't have all these paperwork-in-the-parking lot stops and yet paperwork is always late. You are by allowed by law to take a break. If the labor board ever came to audit, they need to see a break on your logs. I think we homecare nurses will keep pushing so that we can stay ahead of rush hour traffic or finish before dark. Honestly, I don't care if people know where I am because I won't be anywhere I would be embarassed about including picking the hot Christmas toy for my child at Target.

cathrn64 · Dec 3, 2010

I don't know about the GPS part. I can tell you about charting on a PDA. It is small. Plan on having blurry vision by the end of the day! (we use the HCHB system)

caliotter3 · Dec 3, 2010

Although I don't do anything dishonest when doing my timesheets, I am opposed to the idea of being "tracked". As soon as I learned that my employer was moving to such a system, I would actively seek employment elsewhere. When all the local hh employers have moved to that activity, I would have to decide how much I want to remain in the specialty.

RN1263 · Dec 4, 2010

I'm not dishonest with my time sheets either, but I'm not comfortable with being tracked. I'm just not....

Carwin said:

*****You are by allowed by law to take a break. If the labor board ever came to audit, they need to see a break on your logs.********

Actually, In the state of Ohio, breaks and lunch times are NOT mandatory by Ohio law. Federal law states that IF you are permitted to take a break and it is 20 min or less, then an employer must pay for that time. So, no they would not audit for break time in the state of Ohio.

Carwin said:

******But you can't have all these paperwork-in-the-parking lot stops and yet paperwork is always late.*******

Ummm, My paperwork is done the same day as the visit, even an admission, so your assumption is not correct.

Cathrn64said:

****Plan on having blurry vision by the end of the day!****

Yeah, ugh, I don't think my eyes will take kindly to typing on a PDA all day, especially admissions. What do they want all their nurses to go blind! Why does your company use PDA ?

caliotter3, thanks for understanding!

RubyRN,CHPN · Dec 4, 2010

We use Mckesson software on our mini laptops which have I believe about a 10 inch screen. Because is it is an intergrated assessment tools for SOC's, ROC's, RC's it looks like their paper forms if you have used them before. It is a very tedious, mechanical program. I wouldn't envision using anything less than a 10 inch screen to do the assessment on and I had our IT guy make my font larger so I could see it with my reading glasses. It also helps to have a touch screen device as well as it speeds up answering OASIS. Yes, there will probably be eyestrain.

As for smartphones with tracking devices in them, I'm not sure if I would like that. I suppose if your boss wanted to know badly enough about how many miles it took to go from point a to point b they could use Google maps. Now it gives you every concievable route to your destinaiton down to the 10th of the mile. Sounds like a big waste of money to me. I would rather have them get me a GPS with the premise it would assist me with time management, get me to my patient's home safely and on time. That's way better PR for an agency than an agency having a reputation for not trusting their employees.

As a sidebar to the above, I did ask when we were shopping new laptops earlier this year to use with our McKesson software why we weren't considering an I-Pad, I was told they weren't powerful enough to run our encryption software. Will this PDA/Smartphone setup be secure enough for your ageny's data?

carwin · Dec 4, 2010

Honestly guys there is no time in the office to sit and track nurses all day long. Agency owners who hate to pay up may have time to watch the tracking screen all day. There's not enough time to do what's needed!! If you are hired full time, that is how an agency could verify that you are putting in your time. If you are contingent, why do you need to be tracked?

As a manager myself who was once in the field, I would only use tracking (if we had it) to help explain why things aren't going the usual path or patterns of consistently late paperwork or patients always calling looking for the nurse. Spouses ALWAYS call the office! I've told some nurses, I think your hubby is checking up on you. The funny thing is that I eventually found those same things out anyway without those devices. It might take longer but you find out.

There are people who just don't like being "watched" so they should move on. I would have loved to have been tracked when I was in the field. I would always think if I ran into a deep ditch who would find me.

RN1263 · Dec 4, 2010

This is just a tid bit from Mckesson's Horizon mobile care website, re: smartphone technology:

"Alerts field staff in real-time of schedule changes

Reduces staff mileage with accurate turn-by-turn directions to each visit or stop

Eliminates the need to manually log, track and verify mileage

Automates staff tracking and late-arrival alerts

Provides real-time updates of completed visit documentation, including vital signs, based on the task-based care plan"

******************************

The office will know if I follow the directions the GPS told me to go to reduce mileage it will be recorded (therefore having to explain, detours, accidents, ect). They will be able to see where I am and give me another visit by PDA alert instead of calling. My mileage will be tracked automatically, but unfortunately if the gps doesn't recognize the address and I used a map, then the mileage won't be accurate-so I've heard.

There may not be time in the office for managers to sit and watch the tracking, but they don't have to, because the tracking, mileage, idle times, time in the home and the documentation that was done in the home is recorded in the smartphone system w/ locations and times done, then transmitted via satellite to the office in "real time". This is a "smartphone", not a regular GPS device. They'll probably be able to make graphs w/ the information and have something else to complain about.

I am paid hourly, so they are not satisfied with the fact that you did your job and did it well, as fast as you could, accurately and had your charting turned in on time. There is ALWAYS something they are complaining about that could have been done better. For example: Now they're saying our "outcomes" need to be better and that our admissions must not be being done correctly and we are going to have the Quality assurance "LPN" go w/ us to make sure we are documenting correctly. I had a FIT!!! I was insulted. Also, LPN's can't even do admissions or oasis in home care, yet she's going to critique my work....

Rubyrn said:

****Will this PDA/Smartphone setup be secure enough for your ageny's data?****

I have know idea, they are keeping a lot of things under wraps and not answering questions that will **** everyone off. So, I went on their site myself to find out all the lovely details. I have yet to bring up my concerns to management, because I'm told it's already a done deal. So, either I will hang in there for awhile and see how it goes or find another job. We are suppose to be getting trained in January with McKesson software and the smartphone.

cathrn64 · Dec 5, 2010

dijmart,

We use use PDA's because, I'm told, that HCHB was designed for use with them and other window's based products. I'm told we will be getting net books with 10" screens in the spring. I can't wait!

tewdles, RN · Dec 5, 2010

charting on a PDA will be brutal and takes a toll over time.

they can and will track you using the GPS feature...if not at first they will eventually.

good luck...

RubyRN,CHPN · Dec 5, 2010

Honestly guys there is no time in the office to sit and track nurses all day long. Agency owners who hate to pay up may have time to watch the tracking screen all day. There's not enough time to do what's needed!! If you are hired full time, that is how an agency could verify that you are putting in your time. If you are contingent, why do you need to be tracked?
As a manager myself who was once in the field, I would only use tracking (if we had it) to help explain why things aren't going the usual path or patterns of consistently late paperwork or patients always calling looking for the nurse. Spouses ALWAYS call the office! I've told some nurses, I think your hubby is checking up on you. The funny thing is that I eventually found those same things out anyway without those devices. It might take longer but you find out.
There are people who just don't like being "watched" so they should move on. I would have loved to have been tracked when I was in the field. I would always think if I ran into a deep ditch who would find me.

Carwin, being an exemplary employee you probably aren't being one watched. Therefore, they probably wouldn't be looking for you in the ditch. It would probably be the snow plow in the spring that would find you. One of those ironies of nursing where the weak ones are the ones that are rescued.

Still I not in favor of tracking devices on employees. It doesn't show a great amount of respect for them. To OP, sorry your agency is having to make an uncomfortable decision to track their employees. Hopefully you will be able to find some good and peace in this transition.

carwin · Dec 6, 2010

Although a new software system or a form may be put in place in our respective agencies, they are only tools. Tracking software could prove to an FBI agent that you did make a visit and the fraud in the agency lies with the sweet little biller in the finance office. That's where we are in home health these days because of fraud. I'm in a high-fraud area and many of my posts run along that vein. After reading many entries in this forum, I've wondered (I hope erroneously) if my fellow nurses know what's happening in our industry and how we are impacted. Depending on the management team to inform staff might be laughable in some cases. Medicare fraud is big, RACS and P4P are here and AS MANAGERS WE NEED TO INFORM STAFF of their roles in all of this. Too often people are told what to do without a reason why. Grown people want to know why.

The office QA person should be there for you and I'm sorry not an LPN. QA needs to be all over these sites so they can interpret to staff what is needed.

To expand your knowledge on what YOU NEED to know, Google some of the following terms: home health compare, home health fraud, pay for performance in home health care, etc.

Pay for performance (P4P) is why you need to complete the OASIS to best of your ability. So yes, we all need to do it better. The link below explains in a nutshell home health agencies being paid incentives for good outcomes. The Home Health Compare compares SOC OASIS to D/C OASIS. The public is advised to look at this site to see how well an agency provides care for its patients. Are you willing to do it better so your agency is chosen over another?

Centers for Medicare Medicaid Services then search home health-all you ever need to know is here

Medicares Home Health Pay for Performance Demonstration Year 1 Incentive Payments Issued

Medicare.gov â€" the Official U.S. Government Site for Medicare

OASIS Answers, Inc.

The fraud in home care is ridiculous. Seven cities are being targeted by the feds. There are things some of you may be doing and not realize it's fraudulent. Are you making corrections the right way or should you touch that documentation at all?!?!? Your management team may not know either. Public service announcements are running on TV and radio stations to inform the public to say no to people offering gift cards, house cleaning, etc.

Stop Medicare Fraud

Recovery Audit Contractors (RACS) These guys have mining software (tracking the agency) that arbitrarily pulls records for review is you bill m-caid or m-care. These guys are to identify and recover overpayments made by Medicare Advantage plans, Part D and Medicaid. Agencies must self-report and return the overpayment in 60 days. Now if there is charting that does not support the plan of care, they will say you didn't do what you were paid to do. US gov takes the money back. Of course the RACs get a percentage of what they recover so you know how fine-toothed their combs are. What if they want money back on 20 cases? That amount could equate to hundreds of thousands of dollars and close an agency immediately. Private insurance companies have always done this.

Overview Recovery Audit Contractor

Take care of yourself by informing yourself. Ruby and Dijmart tracking sucks but never do you want an unscrupulous manager blaming you for visits not made to cover themselves for what they aren't doing. I've seen it happen. When I've talked to nurses and other clinicians who have sat with FBI agents, they were happy to have proof they were in the home.