Caseload Expectations - Multi-Pedia

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