Re: Productivity/weighted charging in acute & IPR

[Guest guest]

Kari-

I work in and supervise staff in an acute hospital and IRF setting. We do

weight our evaluations and SLP treatments by time spent for productivity

calculations. Productivity expectations are .48 hours paid per unit of service

in the acute hospital setting. All paid hours are included except paid time

off. Support staff hours are included in that expectation as well. The

expectation for the IRF setting is .40 hours paid per unit of service. It is a

tighter productivity expectation for the IRF setting. These have been set for

us with the assistance of a productivity consultant who compares us and sets

targets based on industry standard. It has had a big impact on the bottom line

of the corporation as we are only being allowed to staff to the level that our

volumes support per our productivity expectations. Because the biggest cost in

an organization is it's salary/benefit expenses, typically, the level of

reductions required to meet our standards effected a significant favorability in

the net operating margin as compared to previous years when the expectations

were not as high. These are not easy targets to hit if you have any support

staff (aides/techs or secretaries) or administrative hours that get included in

the calculations. Hope that helps.

Engesether, MPT

Director Inpatient Rehab Services

Sanford Bemidji

From: PTManager [mailto:PTManager ] On Behalf Of

kvvot70

Sent: Tuesday, April 05, 2011 6:56 PM

To: PTManager

Subject: Productivity/weighted charging in acute & IPR

Group,

What are your productivity expectations for staff in an acute care and in IPR

setting? Our acute hospital is ~600 bed, level I trauma, stroke & LVAD certified

facility, and our IPR is 22 beds. Currently we are reevaluating our charging

methods to determine the best, if any, appropriate weight for evaluations

(service based) vs treatments (time based for OT & PT) and service based SLP

charges. For example, if an average evaluation takes 45 minutes, are your

evaluation charges weighted to account for the time beyond 15 minutes? we have

historically used unit of service counters with $0 to weight them equally in

terms of time with treatments. This has helped us reach productivity

expectations for numbers of UOS per day, but we are reevaluating whether this is

the best method.

Appreciate any input or suggestions, thanks.

Kari V. Voll, OTR/L, Therapy Manager

Norfolk, VA

[Guest guest]

,

I'm wondering if your experience shows that for productivity standards to be

realistic and functional you must have a pretty tight recruitment process, and

perhaps even a certain critical mass of FTEs per service area. What if, for

example, you find yourself in need of half an FTE but can't find anybody but a

full timer, especially if that service area employs just one or two therapists?

Do you hold that group to your standards?

Dave Milano, PT, Rehabilitation Director

Laurel Health System

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Engesether

Sent: Wednesday, April 06, 2011 9:17 AM

To: PTManager

Subject: RE: Productivity/weighted charging in acute & IPR

Kari-

I work in and supervise staff in an acute hospital and IRF setting. We do weight

our evaluations and SLP treatments by time spent for productivity calculations.

Productivity expectations are .48 hours paid per unit of service in the acute

hospital setting. All paid hours are included except paid time off. Support

staff hours are included in that expectation as well. The expectation for the

IRF setting is .40 hours paid per unit of service. It is a tighter productivity

expectation for the IRF setting. These have been set for us with the assistance

of a productivity consultant who compares us and sets targets based on industry

standard. It has had a big impact on the bottom line of the corporation as we

are only being allowed to staff to the level that our volumes support per our

productivity expectations. Because the biggest cost in an organization is it's

salary/benefit expenses, typically, the level of reductions required to meet our

standards effected a significan t favorability in the net operating margin as

compared to previous years when the expectations were not as high. These are not

easy targets to hit if you have any support staff (aides/techs or secretaries)

or administrative hours that get included in the calculations. Hope that helps.

Engesether, MPT

Director Inpatient Rehab Services

Sanford Bemidji

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of kvvot70

Sent: Tuesday, April 05, 2011 6:56 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: Productivity/weighted charging in acute & IPR

Group,

What are your productivity expectations for staff in an acute care and in IPR

setting? Our acute hospital is ~600 bed, level I trauma, stroke & LVAD certified

facility, and our IPR is 22 beds. Currently we are reevaluating our charging

methods to determine the best, if any, appropriate weight for evaluations

(service based) vs treatments (time based for OT & PT) and service based SLP

charges. For example, if an average evaluation takes 45 minutes, are your

evaluation charges weighted to account for the time beyond 15 minutes? we have

historically used unit of service counters with $0 to weight them equally in

terms of time with treatments. This has helped us reach productivity

expectations for numbers of UOS per day, but we are reevaluating whether this is

the best method.

Appreciate any input or suggestions, thanks.

Kari V. Voll, OTR/L, Therapy Manager

Norfolk, VA

[Guest guest]

Are you realizing those targets on the whole as a department? If so, how have

you reduced tech, clerical, and administrative support and how has that impacted

your care delivery in terms of what mobility services you can safely provide?

Do you rely on nursing staff as additional assist? What impact on functional

outcomes and length of stay? Are Managers and supervisors taking on full

patient loads in addition to management responsibilities?

(Are all of your support staff and administrative hours included in your

submitted data as well as directors hours allocation if they oversee your

program?)

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@...

A J.D. Power and Associates

Distinguished Hospital for providing

" An Outstanding Patient Experience "

>>> Engesether 4/6/2011 8:16 AM >>>

Kari-

I work in and supervise staff in an acute hospital and IRF setting. We do

weight our evaluations and SLP treatments by time spent for productivity

calculations. Productivity expectations are .48 hours paid per unit of service

in the acute hospital setting. All paid hours are included except paid time

off. Support staff hours are included in that expectation as well. The

expectation for the IRF setting is .40 hours paid per unit of service. It is a

tighter productivity expectation for the IRF setting. These have been set for

us with the assistance of a productivity consultant who compares us and sets

targets based on industry standard. It has had a big impact on the bottom line

of the corporation as we are only being allowed to staff to the level that our

volumes support per our productivity expectations. Because the biggest cost in

an organization is it's salary/benefit expenses, typically, the level of

reductions required to meet our standards effected a significa!

nt favorability in the net operating margin as compared to previous years when

the expectations were not as high. These are not easy targets to hit if you

have any support staff (aides/techs or secretaries) or administrative hours

that get included in the calculations. Hope that helps.

Engesether, MPT

Director Inpatient Rehab Services

Sanford Bemidji

From: PTManager [mailto:PTManager ] On Behalf Of

kvvot70

Sent: Tuesday, April 05, 2011 6:56 PM

To: PTManager

Subject: Productivity/weighted charging in acute & IPR

Group,

What are your productivity expectations for staff in an acute care and in IPR

setting? Our acute hospital is ~600 bed, level I trauma, stroke & LVAD certified

facility, and our IPR is 22 beds. Currently we are reevaluating our charging

methods to determine the best, if any, appropriate weight for evaluations

(service based) vs treatments (time based for OT & PT) and service based SLP

charges. For example, if an average evaluation takes 45 minutes, are your

evaluation charges weighted to account for the time beyond 15 minutes? we have

historically used unit of service counters with $0 to weight them equally in

terms of time with treatments. This has helped us reach productivity

expectations for numbers of UOS per day, but we are reevaluating whether this is

the best method.

Appreciate any input or suggestions, thanks.

Kari V. Voll, OTR/L, Therapy Manager

Norfolk, VA

[Guest guest]

One other question....Are the .48 and .40 targets a combination of PT, OT, SP

services? Both IP and OP? Or do you have separate targets for each discipline?

Outpatient have different targets than inpatient?

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@...

A J.D. Power and Associates

Distinguished Hospital for providing

" An Outstanding Patient Experience "

>>> Engesether 4/6/2011 8:16 AM >>>

Kari-

I work in and supervise staff in an acute hospital and IRF setting. We do

weight our evaluations and SLP treatments by time spent for productivity

calculations. Productivity expectations are .48 hours paid per unit of service

in the acute hospital setting. All paid hours are included except paid time

off. Support staff hours are included in that expectation as well. The

expectation for the IRF setting is .40 hours paid per unit of service. It is a

tighter productivity expectation for the IRF setting. These have been set for

us with the assistance of a productivity consultant who compares us and sets

targets based on industry standard. It has had a big impact on the bottom line

of the corporation as we are only being allowed to staff to the level that our

volumes support per our productivity expectations. Because the biggest cost in

an organization is it's salary/benefit expenses, typically, the level of

reductions required to meet our standards effected a significa!

nt favorability in the net operating margin as compared to previous years when

the expectations were not as high. These are not easy targets to hit if you

have any support staff (aides/techs or secretaries) or administrative hours

that get included in the calculations. Hope that helps.

Engesether, MPT

Director Inpatient Rehab Services

Sanford Bemidji

From: PTManager [mailto:PTManager ] On Behalf Of

kvvot70

Sent: Tuesday, April 05, 2011 6:56 PM

To: PTManager

Subject: Productivity/weighted charging in acute & IPR

Group,

What are your productivity expectations for staff in an acute care and in IPR

setting? Our acute hospital is ~600 bed, level I trauma, stroke & LVAD certified

facility, and our IPR is 22 beds. Currently we are reevaluating our charging

methods to determine the best, if any, appropriate weight for evaluations

(service based) vs treatments (time based for OT & PT) and service based SLP

charges. For example, if an average evaluation takes 45 minutes, are your

evaluation charges weighted to account for the time beyond 15 minutes? we have

historically used unit of service counters with $0 to weight them equally in

terms of time with treatments. This has helped us reach productivity

expectations for numbers of UOS per day, but we are reevaluating whether this is

the best method.

Appreciate any input or suggestions, thanks.

Kari V. Voll, OTR/L, Therapy Manager

Norfolk, VA

[Guest guest]

In Inpt Rehab our productivity expectation is 75% (actually, 0.33 as we use a

ratio) for PT/OT and a little less for Speech. That's 24 units in an 8-hr day.

In acute it's 62.5% (0.45, or 20 units). Speech is again a little lower. Another

exception is that we expect our PT's on our acute ortho unit to achieve 69%

(0.40, or 22 units). We also have a slightly lower expectation for assistants

than therapists (56%/0.45/18 units), because the therapists come out ahead due

to evaluations.

We do weight evaluations in 3 increments, 0-30 (2 units), 31-60 (4 units) and

61-90 (6 units). Most other charges are per 15-minute increment (exceptions

include some related to wound care).

A couple years back we were visited by consultants who recommended increasing

our productivity requirements in acute, and the current numbers are a split

between what they recommended and what we used to require. At that time I did

some extensive comparisons with other organizations to see if what I could find

out jibed with what the consultants claimed, and they mostly did, except that

there was wide variability in how things are calculated. For example, a place

might say their expectation is 28 units in 8 hrs in acute, but that meetings or

in-services would be subtracted out of the time worked and adjust down the

expected figure. Or, they'd count such meetings as " units of service " for

purposes of tracking productivity, even though it wasn't included in their

financial reporting.

I'm happy to share the details of what I learned then with anyone if you want

to contact me separately. I'm always interested to hear from others trying to

come up with the best way to manage this fun stuff.

Dan Gaskell

Carilion Clinic

Roanoke, Virginia

>

> Group,

>

> What are your productivity expectations for staff in an acute care and in IPR

setting? Our acute hospital is ~600 bed, level I trauma, stroke & LVAD

certified facility, and our IPR is 22 beds. Currently we are reevaluating our

charging methods to determine the best, if any, appropriate weight for

evaluations (service based) vs treatments (time based for OT & PT) and service

based SLP charges. For example, if an average evaluation takes 45 minutes, are

your evaluation charges weighted to account for the time beyond 15 minutes? we

have historically used unit of service counters with $0 to weight them equally

in terms of time with treatments. This has helped us reach productivity

expectations for numbers of UOS per day, but we are reevaluating whether this is

the best method.

>

> Appreciate any input or suggestions, thanks.

>

> Kari V. Voll, OTR/L, Therapy Manager

> Norfolk, VA

>