What Has Happened to Hospice?

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Hi all! I was recently on hunt for a hospice job after being out of hospice for 3 years to regroup and recharge. I have a lot of hospice experience. But while interviewing, I've noticed that the powers that be have no qualms about a case load of 20 or more for their case managers. Is this happening everywhere? I had a caseload at the end of my last hospice stint of 18, and I found that to be too many patients to be able to care for them the way they deserve to be cared for. Is it because nurses are willing to take on too much? Or is it a standard now?

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Specializes in Hospice and palliative care.

I had a caseload of 20 only after we lost a couple of case managers to attrition and it was not for very long. In the past five years I have worked for two hospice agencies and both would do what they could to keep case loads in the 10-14 range. I can't imagine providing the desired care and follow-up with orders, etc. with a constant case load of 18-20.

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Specializes in Hospice.

I am the on-call nurse, but the case managers are taking over 20 clients each because we lost 2 case managers. Hopefully they get new hires so the case managers can actually manage care.

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A lot depends on the geographical distance and whether they are in nursing homes or at home. We had case loads no higher than 16, but they were all home patients and quite spread out. The other team had nursing home only patients where they could see 4-5 patients in one location just down the hall.

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yes, sadly that seems to be the trend right now. Quantity of patients over quality.

The same with productivity. I was hired for ~ 18 - 24 patient CM because some of them were palliative with one visit per week. But when you have all hospice it is impossible to do a good job especially when you have several who are actively dying and require daily visits or extended visits for symptom control.

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Specializes in Hospice. Worked ER, Med-Surg, ICU & ALF-Dementia.

My highest case load was 18 too. For me, 15 is pushing it. I am comfortable with 12-13. Good thing the hospice I work with cap it at 15.

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