How long it took you to complete your first few admissions?

nicole109 · Jun 19, 2010

Hi there!! Welcome to the world of home health =) I assume, since your admission packets are 20 pages long, you are doing OASIS--you should check out the Home Health msg boards on here, there's some good info there! Anyhow, our admission packets are 36 pages long, plus a 4 page 485, so I feel your pain, and I'm still on paper, unlike the majority of my agency who has been transitioned to laptop. I will say this though, you will find your own way, and the more you do the more you will understand what the questions are asking and how to answer them, and they will happen much faster. I, like many others do not document admissions in the home, I do my basic assessment in the home, and provide the skill that I am there to provide, I ask any other questions that I need to ask and I reconcile their medications. I do take notes so that I can fill out my paperwork later when I get back to the office or when I get home that evening. Our agency policy is that we have 5 days to complete an admission packet, so if there is anything that I missed (which I sometimes do), then I can either call and ask the patient (if I'm not the nurse following) or I can ask on my next visit. I would say my very 1st admission packet probably took me a couple hours to complete, visit time not included. Now I can usually do one in about 20-30 minutes, depending on the complexity of the patients, again visit time not included. I have most of the questions pretty well memorized from reading through them so many times, so when I start to fill in check boxes, I just have to skim through the answers to find the correct one that applies for that particular patient. Best of luck =)

Davey Do · Jun 19, 2010

Time management is always a big consideration, isn't it, BHNurse?

It's been over ten years since I've worked Home Health. However, I can remember, in the beginning, the case opening was a time-consuming process. It seems to me that, in days gone by, it took about 1 to 1 1/2 hours. That's one reason why nurses made more money on case openings.

I believe it's like anything else: the more you do the admission process, the better you become at it. "Practise provides opportunity for possible improvement", so to speak.

One final point: I don't believe we were expected to complete ALL the paperwork while we were with the patient. (Which isn't a bad idea, really.) I believe we completed the necessary paperwork during the admission process. We were required to have the entire admissions packet completed when turned in our work at the agency.

Hope this helps. Good luck to you.

anticoagulationurse · Jun 22, 2010

I used to take about 4 hours start to finish, including the visit time to completed a computer based admission. Then, untold time correcting stupid little things weeks later after utilization review got their hands on it. Our agency requires them to be done in 24 hours after the visit. I always complete mine the same day, as the computer is date sensitive and I would rather not have to change the dates manually on each page if I were to wait to do it tomorrow. (I also hate having a bunch of junk looming on my back burner uncompleted). Now, my admissions take me 1.5-3 hours to complete, including the visit depending on the case. It took about 6 months to become this proficient.

twinpumpkin · Jun 22, 2010

When I first started in home health, it took me about 4-6 hours to complete a computer-based admission, which included visit time. This was due to the length of the admission "paperwork" and the learning curve of a new software system. Now I work for a smaller HHA, which uses paper and I find it takes me less time, approximately 2 hours, to do a 24-page admission. I ususally do the entire admission in the home since I know nothing about the patient prior to this visit. I let the patient know ahead of time that it will take 1.5 to 2 hours the first visit (only). They are usually very accomodating and cooperative. I find it is faster for me to do visits on paper than on the little hand-held PDA type computer that I used before. I have only been in HH for a year now and it is so much easier now that at the beginning. Time and practice will improve your charting time.

cathrn64 · Jun 24, 2010

I agree with others on this. When I did my first OASIS (at the very beginning of OASIS), it took me 2 1/2 hours in the home and many more hours afterwords! The agency I work for uses PDA's for charting. It takes a while to learn how to do everything. I find that when I orient new nurses I tell them to learn the OASIS as much as possible so that they don't waste a lot of time looking at the questions and figuring out how to ask them Now it takes me aprox 3-3.5 hrs including home time to complete the entire SOC.

osanti · Jun 24, 2010

I understand how you feel...there are a few things that may helpl the initial process...if you like, i am willing to tell you....

mcmich729 · Aug 30, 2010

Hi!

I am sure you are much faster at the process by now, but I have recently began the process and I am feeling your pain. It is taking me way too long, greater than 5 hours visit included. We document the Oasis admission and then create a new pathway for a general skilled nurse visit. :uhoh3: I am sweating this, trying to ensure accuracy and no Oasis errors. The time I spend documenting is lengthy and then it goes to an auditor who spends a good bit of time on it. If only the patient had the benefit of all these hours. Additionally, since it takes me so long and I am new at the process I feel guilty claiming the length of time it takes me to do an admission. 3 hours is all I believe that is reimburseable to the agency, so the time I spend is my time and I tell myself I am paid in experience. If I don't get quicker I'll have to reconsider my choice of employ. :eek:Anyone with tips to speed the process?

KateRN1 · Aug 31, 2010

The agency gets reimbursed by the episode, not by the length of the visit (or by a daily rate if it ends up being a LUPA), so don't worry about how long it takes you to do it. In a roundabout way, the patient is getting the benefit of the time spent on the "paperwork" by ensuring a decent PPS payment for the episode and documentation that supports the patient's need for home health care. Many companies have additional documentation that is required that makes the SOC process so much longer than it needs to be, so that my also be influencing your time. I've been doing OASIS for quite a while and even now, it takes me close to two hours in the home, then another 1/2 to 1 hour afterwards to wrap everything up. It does get easier. The learning curve seems to be about six months, after which you will feel much more proficient and it won't take you quite as long to get it all done and you'll feel much more confident with your knowledge.