Time spent on charting

Specialties Home Health

Published

Hi all !! I work as a home health case manager. Usually i see 6 pts a day or 1 SOC and 2 regular visits. Doesnt sound too bad but it takes me forever to get all my charting done. I work longer than my 8 hours after making phone calls and scheduling issues, We are supposed to have 6 reg visits or 1 SOC plus 2 reg visits to justify an 8 hr day. However, I am sittin gup late at night finishing my work. Does any one else have this going on ? thanks in advance for responding !!

Wow my day generally consists of 7 to 8 visits, usually at least two of them are oasis visits, one of them may be a SOC. A SOC does not bring my visit number down. Whomever works for the company that gives them a SOC and two regular visits and that's it... I want to know what company you work for.

our agency considers 6 SNVs a full load...of course, nurses do get days of 7 or 8. a SOC and 4 is also supposed to be manageable. problems come with the mix of acuities you may get, and amount of driving.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

When you are completing focused home health nursing you MUST be focused in your visit. You are there for very specific reasons and it is not a grab bag of care.

Get in, be pleasant, take care of business, document the duty, get out.

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I had a client who refused to allow me to be focused unless I was listening to her complain. She dragged each visit out longer than it needed to be, yet would actually use her remote to increase the volume on the TV when I was trying to provide teaching or otherwise verbally interact with her. Finally, when the agency found a different nurse willing to travel the distance, they replaced me on that case. I guess the client extended her complaining to calling the agency and complaining about me.

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Specializes in Managed Care, Onc/Neph, Home Health.

At my company, completing the OASIS is not the problem, its the 50 million other pieces of papers the agency has us to complete. Therapy triggers, Adult assessment, Discipline coordination, Chart Audit, 60 day summary, MD order sheet, Supply List, Medication List, and the 9 wk calendar. I know one day last week, I had 4 RCT, and 2 visits. No way you can do all that in the home. We are salaried, I am tired of staying up late, I just cant get caught up....:arghh:

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Exactly, I just took a homehealth position and they told me I would get paid per visit. Now I am wondering what about all of this paper work. If I do the paper work and if it takes me longer will I get paid for it.

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Specializes in Managed Care, Onc/Neph, Home Health.
Exactly, I just took a homehealth position and they told me I would get paid per visit. Now I am wondering what about all of this paper work. If I do the paper work and if it takes me longer will I get paid for it.

If you are paid per visit, I bet you won't...I would sure check it out. I have been on my job since Jan. and am seriously looking. Only RN's can do the SOC, ROC, and RCT's. Its too much when you are a small agency, and the admits are steady flowing in. I think I am done already

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One of the reasons they are paying you per visit could be to avoid paying you any extra for taking a long time to do paperwork. That is one of the downsides of pay per visit. If the client visit takes 55 minutes instead of the typical 30-40 minutes and you have follow-up doctor calls and your paperwork takes you two and a half hours to do, at home, that evening, then the agency makes out like a fat rat by only paying you a set amount for the visit (based on the minimum amount of time).

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Agree with Caliotter. Much depends on your patient population. Lately I've had a lot of protimes within a few minutes of each other, when that happens I'm the one who comes out ahead.

At the end of the year though, I have a good income commensurate with the hours I have put in.

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Also, your first couple of years can be rough. With experience comes many time savers.

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Specializes in Managed Care, Onc/Neph, Home Health.
Agree with Caliotter. Much depends on your patient population. Lately I've had a lot of protimes within a few minutes of each other, when that happens I'm the one who comes out ahead.

At the end of the year though, I have a good income commensurate with the hours I have put in.

Are you able to use the PT as a skilled visit?? Where I work, that would not be SNV, we would have to elaborate on "teaching and education, then throw the lab draw in there. But just documenting the PT only is not. 98% of my visits are "teaching" on disease processes, and its usually duplicated. That's why I want out, with each recert period :no:

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Specializes in Managed Care, Onc/Neph, Home Health.

Seems home heath isn't like it used to be with procedures, imo

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Are you able to use the PT as a skilled visit?? Where I work, that would not be SNV, we would have to elaborate on "teaching and education, then throw the lab draw in there. But just documenting the PT only is not. 98% of my visits are "teaching" on disease processes, and its usually duplicated. That's why I want out, with each recert period :no:

With concurrent therapy, yes. If my teaching is completed with teaching goals met then that is my skill (or purpose) even though it isn't a skilled service for Medicare. And of course we perform and document a focused assessment.

We do teaching, assessment and lots of procedures. We don't do redundant teaching and certainly don't recert a patient for redundant teaching.

I know what you're talking about and we're not doing anything where we can't justify medical necessity.

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