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Caseload Expectations

Caseload Expectations

What are good caseloads for clinical disciplines? Believe it or not, the traditional caseload model works well from a financial perspective. HOWEVER, most Hospices do NOT staff at these levels. In fact, there is a perception that caseloads are much higher and therefore, they are working hard. "Reported" caseloads are almost always inflated. Clinicians look at the number of patients on the "boards" and think that is their actual caseload.

As a rule of thumb, subtract 2 or 3 from the caseloads reported by most Clinical Managers. Most Clinical Managers do not factor in "float" staff or PRN. If they did, they would realize that the "actual" caseloads are less.

This is another place where quantification saves the day by giving us true perspective. We cannot manage by "feelings." It is part of the human condition to exaggerate work situations. It feeds egos and makes us feel like we are contributing...AND each person will create their own standards unless they are clearly delineated.

It should be understood that as a Leader of a BUSINESS area, you have a responsibility to evaluate and scrutinize performance. This requires measurement so that decisions are not merely subjective speculations.

It is necessary for all Hospices that are serious about the business of Hospice to establish a common point of reference for measurement and evaluation of performance. Use of EXPECTED AVERAGES or MINIMUMS provides such common measurements. Minimums are absolute. On the other hand, Averages provide clinicians more latitude. It should be understood that individual cases or situations would necessitate more or less time and effort. An average takes this into account. An average provides a GUIDELINE.

The following numbers are MVI's general GUIDELINES regarding caseload expectations:

Hospice Homecare
Computed Caseload/FTE Visit Duration Weekly Visits
Category Acceptable Excellent Acceptable Excellent Acceptable Excellent
a. Nursing 12 14 70 60 20 25
b. Aide 10 12 70 60 22 28
c. SW 30 35 70 60 15 20
d. Spiritual 75 100 60 45 25 30
e. Admissions 50 50 120 90 10 12

Nursing Homes and ALFs
Computed Caseload/FTE Visit Duration Weekly Visits
Category Acceptable Excellent Acceptable Excellent Acceptable Excellent
a. Nursing 16 18 55 45 26 28
b. Aide 12 14 55 45 25 27
c. SW 32 34 55 45 24 26
d. Spiritual 100 120 45 30 20 30
e. Admissions 50 50 105 75 10 12

Hospice Homecare

Computed Caseload/FTE
Category Acceptable Excellent
a. Nursing 12 14
b. Aide 10 12
c. SW 30 35
d. Spiritual 75 100
e. Admissions 50 50
Visit Duration
Category Acceptable Excellent
a. Nursing 70 60
b. Aide 70 60
c. SW 70 60
d. Spiritual 60 45
e. Admissions 120 90
Weekly Visits
Category Acceptable Excellent
a. Nursing 20 25
b. Aide 22 28
c. SW 15 20
d. Spiritual 25 30
e. Admissions 10 12

Nursing Homes and ALFs

Computed Caseload/FTE
Category Acceptable Excellent
a. Nursing 16 18
b. Aide 12 14
c. SW 32 34
d. Spiritual 100 120
e. Admissions 50 50
Visit Duration
Category Acceptable Excellent
a. Nursing 55 45
b. Aide 55 45
c. SW 55 45
d. Spiritual 45 30
e. Admissions 105 75
Weekly Visits
Category Acceptable Excellent
a. Nursing 26 28
b. Aide 25 27
c. SW 24 26
d. Spiritual 28 30
e. Admissions 10 12

*Some numbers may be rounded up for ease of memorization.

Multi-Pedia

ADC Average Length of Stay Benefits Percent Caseload Expectations Computed Caseloads Crisis Care Percent Served Days Cash on Hand Days in AP Days in AR Debt to Equity Development to Return Ratio Development Signature Programs Direct Labor % of All Labor Direct Labor NPR Direct Labor PD Direct Patient Related Expenses NPR Direct Patient Related Expenses PD Facility Mix Percentage Facility Related Facility Team Patient Days Percent Indirect Labor Marketing Incentive Median Length of Stay Mileage Rate Net Operational Income Net Revenue PD Operational Costs Organizational Net Income % of Hospice Homecare Net Revenue Revenue to Payroll Dollar Segment Indirect Percent Net Revenue Segment Net Income The Role of Financial Reserves Total Indirect Volunteer Level of Activity What is Net Patient Revenue What is The Model