Time spent on charting

[traylee]

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 !!

[RN In FL]

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.

You hit the nail on the head....I could not get it out. Redundant teaching. That's what we are re-certing. CHF, HTN, CVA....S/S. I mean c'mon, how much teaching, for many of these lil old people, bless their hearts.

[Libby1987]

That's weird that you're recerting seemingly unnecessarily and 98% of your skilled services is teaching. I wonder what your intake numbers look like. Are there not a lot of new patients coming on service with acute or exacerbated illnesses or post ops needing skilled assessment? Or needing wound care and/or IV ATB's?

[RN In FL]

No Libby1987, from what I am seeing. The SOC, of course is, the old, "DC with HHC". So we go from there with the teaching. OK I can see, the initial, but for recert, that's where I have the problem. Maybe I am missing something. By the end of the 9 wks, pt have gotten stronger, and ready for discharge. That's when the "picking" come about with the RCT....and trying to find stuff. And starting that "teaching" all over again. Too much paperwork for nothing. Hardly any post ops. Lots of diabetics, I would rather have all of those, I feel like I am truly making a difference with them, with BS in the 400's, and non-compliance with diet! I have a justification for setting a frequency, other that 1wk9.

Thanks for listening....

[Libby1987]

Of course!

But so different from my experience. They don't push for recert here, it's on me to determine and justify need. Your deal sounds like it did back in the old FFS days.

[overtonis]

its unfortunate and its systemic problem thru all of healthcare.