ratio of home hospice patients to nurse

aimeee, BSN, RN · Jan 16, 2004

10-12 is about what we call a full load. 5-6 visits per day twice a week with one day for case management activities, emergency visits, and IDT meeting. Of course, much depends on what shape those patients are in and how far apart they live. If they were all in rough shape and there was a lot of road time in between them that might be a very challenging caseload.

Mazzi · Jan 16, 2004

The full time nurses have 10-12 pts. I only work 3 days a week and carry 6-8 pts. At times this is very difficult when I have more than 5 that need 2Xweek visits or more. I use one day for paper work and emergencies. Hope this helps.

mjamesRN · Feb 3, 2004

I'm in hospice training right now and for full time case managers, they "believe" that 16 is adequate. HA! I'm amazed at the paperwork. There are like 40 different documents I'm responsible for!

Why is it that every nursing job seems like I'm just a pawn to keep the healthcare agency out of court? I'm very dismayed. All I want to do is assist patients and family through the dying process, but the paperwork requirements are really turning me off.

jerseyRN · Feb 6, 2004

12-16 patient caseload, documentation on the laptop after dinner at the kitchen table

lynswim · Feb 11, 2004

Medicare guidelines are no more than 10-12 patients per full-time nurse :)

Lyn

DMB FAN2 · Feb 11, 2004

I currently have 13 patients, 3 of which have been imminently dying for a couple days. I usually do my laptop work at night also. I have alot of comp time but I am not able to take it. I think that 10 patients would be just right. :uhoh3:

doodlemom · Feb 11, 2004

Where I used to work, 10-12 was the standard. I know that a lot of for profit agencies will push you to take more.

jerseyRN · Feb 12, 2004

I didn't know Medicare regulates the nurse's caseload. We have RN case managers but also use LPNs to see patients. I guess that way the agency can justify RNs carrying more patients. My tops was 21 patients... almost twice as many as I really felt I could care for well. Plus you need to schedule and keep tabs on the LPN.

lynswim · Feb 12, 2004

Medicare doesn't regulate caseloads, they just make "recommendations" :)

Lyn

jerseyRN · Feb 12, 2004

Ah. Wish this recommendation was a rule!

doodlemom · Feb 12, 2004

Medicare does not regulate the number of patients you have to take. The NHPCO recommends and sees 10-12 patients as the average. Unfortunately, nobody regulates the number that you have. 16 patients is crazy...and 21 is totally insane! Sometimes if your case load is 10 and you've got high acuity patients, it is difficult to do a good job. You cannot possibly give 16 patients and their families the care and attention that they need and deserve. It makes me sad to hear that some hospices have gone in this direction. Unfortunately with the amount of competition from the for-profits, we may not be seeing the care that once was the standard for hospice. That is why I and so many others left the hospice that I used to work for. When the local mega hospital took us over, the standard of care went down and the amount of work increased. There was no support system left. I am hoping to find another job someday with a hospice where the care of the patients and their families are of utmost importance and the administration respects and supports/nurtures the team of people taking care of them - which encourages the team to do the best job they can. I feel fortunate that I had the opportunity to work in that environment in my previous job. I can only hope to find that again.