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 Report and Opinion by
Fred Caruso
"Pressing Issues"
Our most recent survey has
shown a number of trends and details about the changing home care environment. Since you can
download the entire report, I will limit my
comments here to a very few topics.
First: The three major concerns of home
care
agencies and staff in Colorado are:
1 -
The constantly
increasing paperwork-demands necessary to meet regulatory requirements,
2 - The growing shortage of RNs and all therapy
professionals, especially physical therapists, and
3 - Low and often
insufficient reimbursement rates for services.
When it comes to the paperwork
issue, one veteran agency chief, an RN by training and well
known in home care, got right to the point: "Paperwork and regulation are beyond
burdensome . . ."
A depressing outcome of "beyond burdensome"
is seen in the employment of fulltime staff at agencies found on
page 8 of the report and shown in the chart below. Home care now
employs nearly one fulltime administrator for every fulltime
Registered Nurse (27% RNS, 26% Admin). A nearly one-to-one ratio
should be considered a social disgrace.
You can draw your own conclusions as
to the value of this staffing ratio in terms of
patient outcomes. One can assume that the paperwork
burden contributes to the problem of professional shortages
simply by reducing the amount of hands-on time available for
those who treat patients.
Low and
inadequate reimbursement rates are issues constantly challenged
by HCAC. In view of the current financial crisis, the
association can hardly afford to give up the fight. In fact, the
pressure for fairness and realism must be increased.
I will post more data tidbits and personal opinion as
time goes on. Email me at any time at
fcaruso@assnoffice.com.
Again, the full report is
available in PDF format by clicking here!
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