How many do you Case Manage in a Certified Home Health Agency?

annaedRN, RN · Jan 29, 2012

In my agency all the fulltime RNs case manage. Of course, the amount varies with the census - but routinely I have 20-25, the most I have had was 32. Once it is over 25, I feel that I personally am not able to case manage as efficiently - it is harder to really get to know my patients at that point. Productivity is 5 a day for us, but that too varies - it is usually 5-6. We are salaried - so that rare day when it is 3-4 patients - we jump for joy. Only once in a blue moon we have 7 to see.

Burlshoe114 · Jan 29, 2012

It depends on what is going on.

Example - 2 SOC admits can be a full workday, or it might be 5 repeat visits. Occasionally I will have 6. It really depends on what is going on that day.

My agency has something nice - If the routine visits are scheduled and they cancel after 1100, we do not have to call the scheduler to replace them unless we know we are short-staffed. This is great, as no patient likes being called and told they will have an unexpected nurse on their door-step in T-minus 60 minutes, no matter how homebound they are.

I do wish there was a way to get patients who don't want home care visits to refuse Home Health BEFORE we drive out to their homes!

emilysmom,RN · Jan 29, 2012

I am a RN Case Manager but see most of our own patients all the time. Recently my company hired an LPN to help with routine visits. But I see 6-8 and that can include a SOC or ROC. I also see a patient here and there on the weekends or I am asked to do a SOC or ROC on the weekends too. We are paid per visit. Minimum is 5/day. Every company is different.

Hello, I
am wondering what the norm is for case management in a Certified Home Health Care Agency?
Is there a limit in terms of how many you can safely Case Manage and how many visits per day that you do?
Thank you

fawnsternurse · Feb 1, 2012

Hi, thank you everyone for your responses. I am wondering if there is a standard of care in terms of how many a person can safely case manage. We are in NY state and the agency has my friend Case Managing upwards of 50 patients and making 6-8 visits per day and some can be SOC and re certs.

Is this common practice and is there a link or phone number that can be called to find out if this is illegal and/or unsafe Nursing practice?

In my estimation this is nothing short of slave labor

Susan317 · Feb 4, 2012

If she is getting paid by the visit,she may want 6 to 8 visits a day.

juliam · Jul 5, 2012

fawnsternurse, I am with you 100%! I just started Case Managing and was informed the other day that I will be responsible for management of approximately 46 patients. I can't find anything on the safety/legality of this situation and am looking for information. Are there rules? What are they? Are they state by state or federal laws? Do I call the Nursing Board? Everything I find on this site states the average is between 10-15 patients for management, which seems reasonable to me but 40+ just seems RIDICULOUS and unsafe!!? I don't know that I'm cut out for this....help?

OkieeRN · Jul 6, 2012

Idk if there are any rules, perhaps there are guidelines through ANCC for certified case managers but I am not sure. I can say that at my last job I carried 40-45 patients on my caseload and saw them all for all oasis visits plus the less stable ones on a PRN basis. The job I have now I only carry 30-35 and I do not see the patients. We have an oasis RN who sees all our pts. I desk case manage only now.

MountainRN53 · Jul 15, 2012

This is great info. Am sincerely considering getting back into HH after a bad experience at an LTC. I worked for over 11 years at a non-skilled staff agency and then became their field assessment nurse. I worked for Gentiva a few years back for a shot time. I'm hoping I can find a good company that supports their employees.

NCIANurse · Jul 20, 2012

I case manage probably 25, my standard day is between 6 to 8 visits, does not matter if these are every 2 week supp visits or all SOC's. My manager really tries hard to make sure we nurses (there are 3 of us) each have a good mix of daily pts (like dsg changes), every 2 weekers, twice weekly, etc. I prefer cardiac/neuro pt's, another nurse prefers wounds, but we do get a good mix of all.

Managing 40+ really depends on frequency of visits/primary dx. We've managed that many each at certain times, but when that happens alot of them are just weekly med fills, biweekly supp visits, etc, and when we get high on census my agency is really great about only taking referals that we can handle.

pacunuse2009 · Jul 27, 2012

Hi where do you work if I may ask? I worked in Oklahoma city as a case manager, for several co. And hospitals. The last place I got to stay in office and o true case management. It was wonderful, wish I would have never left. It was for 21 st century home health co. What a wonderful place!

OkieeRN · Jul 28, 2012

I have hear of 21st but do not work for them. My agency is relatively small, we are a close knit group :)