Re: national standards for PT productivity

[Guest guest]

This will not answer your question, but why is our profession so concerned about

national standards on productivity? What we should be doing is assessing

productivity for our own organization and what does it take to be profitable.

Someone could respond to your original post and say 10 patients per day is the

national standard. Does that mean your therapist is productive? Does that mean

your organization is making money? Maybe, maybe not. They may be productive, but

you may still be losing money because of your payor population and how you are

paid, fee schedule versus visit rate.

In my opinion, when you look at productivity, you have to look at the actual

income that is generated by that therapist or assistant and compare it to your

expenses to provide that visit and did you make or lose money.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc

www.gawendaseminars.com

Register for Documenting Therapy Services for Medical Review: Part 1

at http://www.gawendaseminars.com/news.aspx

Subject: national standards for PT productivity

To: PTManager

Date: Monday, August 15, 2011, 10:31 AM

 

Good morning- Does anyone have info on national standards for PT

productivity? Specifically, how many new and repeat patients would a PT be

expected to treat in an outpatient setting in an 8 hour day based on one-on-one

care?

Regards,

Tina

Tina , PT, MBA, Director of Rehab Services

St. ph's Hospital-Highland/HSHS SID

An Affiliate of Hospital Sisters Health System

phone

fax

tfrank@...

stjosephshighland.org

[Guest guest]

Rick

Thank you for stating what is often unsaid. Productivity may have no correlation

to the profitability of an organization or quality of its services. Ultimately

an organization's ability to make a profit so it may stay in business and

deliver quality service so referrals continue to be made are what is important.

A therapy team may be 100% productivity (meaning every minute of labor is spent

in billable/reimbursable activity) while losing money because of high costs and

low reimbursement. Another group may be 50% productive, but because of low cost

and high reimbursement, be very profitable.

Productivity is a gross measure of performance that is measured to control cost.

But unless the other side of the equation, reimbursement, is factored in,

productivity measures have little meaning.

If you wish to determine a meaningful productivity measure, back into it.

Determine your costs including labor, administrative and overhead. Add to that

what you would like to have as a profit margin. From this you can determine how

much reimbursable activity your therapy staff must engage in on average to equal

that number. Remember to consider bad debt and other factors that may result in

non-payment. If quality is important then there are likely non-reimbursable

activities you want staff to engage in such as meetings, documentation, phone

calls, marketing, etc. that impact cost also.

Ron Wall

Axiom Healthcare Group

Ontario, CA

To: PTManager

From: rick0905@...

Date: Wed, 17 Aug 2011 21:27:00 -0700

Subject: Re: national standards for PT productivity

This will not answer your question, but why is our profession so concerned about

national standards on productivity? What we should be doing is assessing

productivity for our own organization and what does it take to be profitable.

Someone could respond to your original post and say 10 patients per day is the

national standard. Does that mean your therapist is productive? Does that mean

your organization is making money? Maybe, maybe not. They may be productive, but

you may still be losing money because of your payor population and how you are

paid, fee schedule versus visit rate.

In my opinion, when you look at productivity, you have to look at the actual

income that is generated by that therapist or assistant and compare it to your

expenses to provide that visit and did you make or lose money.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc

www.gawendaseminars.com

Register for Documenting Therapy Services for Medical Review: Part 1

at http://www.gawendaseminars.com/news.aspx

Subject: national standards for PT productivity

To: PTManager

Date: Monday, August 15, 2011, 10:31 AM

Good morning- Does anyone have info on national standards for PT productivity?

Specifically, how many new and repeat patients would a PT be expected to treat

in an outpatient setting in an 8 hour day based on one-on-one care?

Regards,

Tina

Tina , PT, MBA, Director of Rehab Services

St. ph's Hospital-Highland/HSHS SID

An Affiliate of Hospital Sisters Health System

phone

fax

tfrank@...

stjosephshighland.org

[Guest guest]

I would also like to know. I thought 12 patients per day was the norm.

Hiten Dave' PT

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>

[Guest guest]

I would also like to know. I thought 12 patients per day was the norm.

Hiten Dave' PT

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>

[Guest guest]

I would also like to know. I thought 12 patients per day was the norm.

Hiten Dave' PT

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>

[Guest guest]

This is the universal question and there is no need to make it more complex than

it needs to be.  Don't focus on the number of patients, look at the number of

billable units or 15 minute increments.  If you work 8 hour days (32 units) ,

then 'x' units will get you the fraction or productivity percentage for the day.

 In SNFs, 'minutes' will do the same...

Focusing on # of patients is dangerous.  Do you want a therapist treating

12/day at 15 min increments each?  What about the 12/day therapist that stays

until 6pm because the treatments were longer? 

Go with measuring units and use chart audits and ethical standards to ensure

they don't over-treat less people (same number of daily units) if this becomes

an end around game.  

Set productivity measures per setting.  Outpatient would be different than

acute care, etc.  The APTA has a few patients/day/week and visits/day/week

information but I found these to be on the light side of what actually happens

in the Pittsburgh region at least. 

Alan Petrazzi, MPT, MPMRehab DirectorPittsburgh, PA 

 

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>

[Guest guest]

This is the universal question and there is no need to make it more complex than

it needs to be.  Don't focus on the number of patients, look at the number of

billable units or 15 minute increments.  If you work 8 hour days (32 units) ,

then 'x' units will get you the fraction or productivity percentage for the day.

 In SNFs, 'minutes' will do the same...

Focusing on # of patients is dangerous.  Do you want a therapist treating

12/day at 15 min increments each?  What about the 12/day therapist that stays

until 6pm because the treatments were longer? 

Go with measuring units and use chart audits and ethical standards to ensure

they don't over-treat less people (same number of daily units) if this becomes

an end around game.  

Set productivity measures per setting.  Outpatient would be different than

acute care, etc.  The APTA has a few patients/day/week and visits/day/week

information but I found these to be on the light side of what actually happens

in the Pittsburgh region at least. 

Alan Petrazzi, MPT, MPMRehab DirectorPittsburgh, PA 

 

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>

[Guest guest]

So this is always an interesting topic. My hospital was recently

purchased by a for-profit company, and they look at productivity in a

different way than we PTs are accustomed. They look at productivity not

in terms of how much revenue did the PT produce, but how well did the

manager control the organization's highest expense - staffing.

They commissioned a consultant to look at a large number of facilities,

about 200 for profits and somewhere around 1,500 nonprofits. They

examined productivity in all hospital areas and arrived at a " target "

for each area. ly, it is still a little rough as it is getting

fine-tuned. I have no idea about the details of their methodology.

For the therapies, we look at how many time units we produced and then

use the target to determine how many hours should it have taken to

produce those units. Now when they say hours, they are talking paid

hours. That includes productive and nonproductive hours - that is a huge

bone of contention at the moment. So, let's say that the standard is

0.47. If my number of paid hours for the day equals 0.47 times the

number of units, then I am 100% productive.

For example: if I produce 10 time units, the target would give an

expected number of hours of 10 x 0.47 = 4.7 paid hours. If the paid

hours for the day was 4.7, then 4.7 expected hours/4.7 paid hours x 100

= 100% productivity. If we had 6.0 hours of paid time, then 4.7 expected

hours/6.0 paid hours x 100 = 78.3% productivity.

The idea here is that the manager should be flexing staff, sending them

home when workload is low, reducing staff expense and, in their terms,

improves productivity. This works ok in the outpatient setting when

cancellations and no-shows are under control (moving target). It works

pretty well in inpatient rehab, especially when census is moderate to

high. As all productivity standards do, it fails miserably for acute

inpatient therapies for all the reasons we all know.

The system is not too bad for department-wide scrutiny when looking only

at worked hours rather than paid hours, and when the service is

significantly higher in outpatient volume over inpatient volume. It is

not good at all for a service, such as our OT which is heavier in

inpatient volume. Hopefully, as it evolves it will be a better tool.

Jim, PT

>

> Good morning- Does anyone have info on national standards for PT

productivity? Specifically, how many new and repeat patients would a PT

be expected to treat in an outpatient setting in an 8 hour day based on

one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

[Guest guest]

So this is always an interesting topic. My hospital was recently

purchased by a for-profit company, and they look at productivity in a

different way than we PTs are accustomed. They look at productivity not

in terms of how much revenue did the PT produce, but how well did the

manager control the organization's highest expense - staffing.

They commissioned a consultant to look at a large number of facilities,

about 200 for profits and somewhere around 1,500 nonprofits. They

examined productivity in all hospital areas and arrived at a " target "

for each area. ly, it is still a little rough as it is getting

fine-tuned. I have no idea about the details of their methodology.

For the therapies, we look at how many time units we produced and then

use the target to determine how many hours should it have taken to

produce those units. Now when they say hours, they are talking paid

hours. That includes productive and nonproductive hours - that is a huge

bone of contention at the moment. So, let's say that the standard is

0.47. If my number of paid hours for the day equals 0.47 times the

number of units, then I am 100% productive.

For example: if I produce 10 time units, the target would give an

expected number of hours of 10 x 0.47 = 4.7 paid hours. If the paid

hours for the day was 4.7, then 4.7 expected hours/4.7 paid hours x 100

= 100% productivity. If we had 6.0 hours of paid time, then 4.7 expected

hours/6.0 paid hours x 100 = 78.3% productivity.

The idea here is that the manager should be flexing staff, sending them

home when workload is low, reducing staff expense and, in their terms,

improves productivity. This works ok in the outpatient setting when

cancellations and no-shows are under control (moving target). It works

pretty well in inpatient rehab, especially when census is moderate to

high. As all productivity standards do, it fails miserably for acute

inpatient therapies for all the reasons we all know.

The system is not too bad for department-wide scrutiny when looking only

at worked hours rather than paid hours, and when the service is

significantly higher in outpatient volume over inpatient volume. It is

not good at all for a service, such as our OT which is heavier in

inpatient volume. Hopefully, as it evolves it will be a better tool.

Jim, PT

>

> Good morning- Does anyone have info on national standards for PT

productivity? Specifically, how many new and repeat patients would a PT

be expected to treat in an outpatient setting in an 8 hour day based on

one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

[Guest guest]

So this is always an interesting topic. My hospital was recently

purchased by a for-profit company, and they look at productivity in a

different way than we PTs are accustomed. They look at productivity not

in terms of how much revenue did the PT produce, but how well did the

manager control the organization's highest expense - staffing.

They commissioned a consultant to look at a large number of facilities,

about 200 for profits and somewhere around 1,500 nonprofits. They

examined productivity in all hospital areas and arrived at a " target "

for each area. ly, it is still a little rough as it is getting

fine-tuned. I have no idea about the details of their methodology.

For the therapies, we look at how many time units we produced and then

use the target to determine how many hours should it have taken to

produce those units. Now when they say hours, they are talking paid

hours. That includes productive and nonproductive hours - that is a huge

bone of contention at the moment. So, let's say that the standard is

0.47. If my number of paid hours for the day equals 0.47 times the

number of units, then I am 100% productive.

For example: if I produce 10 time units, the target would give an

expected number of hours of 10 x 0.47 = 4.7 paid hours. If the paid

hours for the day was 4.7, then 4.7 expected hours/4.7 paid hours x 100

= 100% productivity. If we had 6.0 hours of paid time, then 4.7 expected

hours/6.0 paid hours x 100 = 78.3% productivity.

The idea here is that the manager should be flexing staff, sending them

home when workload is low, reducing staff expense and, in their terms,

improves productivity. This works ok in the outpatient setting when

cancellations and no-shows are under control (moving target). It works

pretty well in inpatient rehab, especially when census is moderate to

high. As all productivity standards do, it fails miserably for acute

inpatient therapies for all the reasons we all know.

The system is not too bad for department-wide scrutiny when looking only

at worked hours rather than paid hours, and when the service is

significantly higher in outpatient volume over inpatient volume. It is

not good at all for a service, such as our OT which is heavier in

inpatient volume. Hopefully, as it evolves it will be a better tool.

Jim, PT

>

> Good morning- Does anyone have info on national standards for PT

productivity? Specifically, how many new and repeat patients would a PT

be expected to treat in an outpatient setting in an 8 hour day based on

one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

[Guest guest]

Your answer is only true if you are solely looking at productivity of the

therapist or assistant without regard to profitability of the clinic. I can tell

you in the private practice setting, productivity does relate, or should relate,

to the profitability of the clinic as well based on the productivity of the

therapist of the clinic. Actually, all settings should care about this.

In the example given by Alan and looking at billing 32 units, what if that was 8

patients times 4 units per patient. If those 8 patients were all Medicare or

other insurance companies that reimburse on a fee schedule (i.e. per unit

billed), then I would say the therapist is productive and most likely the clinic

is productive in terms of profitability (there are exceptions).

However, what if those 8 patients you saw for 4 units each were being reimbursed

on a per visit rate, say $55 - $60 per visit? The therapist is still

" productive " , but your clinic may not be productive (i.e. profitable). In this

situation, maybe you are more " productive " if you see 16 patients for 2 units

each.

How we define productivity really depends on what you want to know? From the

business owner standpoint, productivity also relates to profit-loss of the

clinic dependent upon productivity of the therapist, payor contracts, and

expense to provide that visit.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

To register for an audio conference on documentation given by a former Medicare

reviewer, go to http://www.gawendaseminars.com/news.aspx

> **

>

>

> Good morning- Does anyone have info on national standards for PT

> productivity? Specifically, how many new and repeat patients would a PT be

> expected to treat in an outpatient setting in an 8 hour day based on

> one-on-one care?

>

> Regards,

> Tina

>

> Tina , PT, MBA, Director of Rehab Services

> St. ph's Hospital-Highland/HSHS SID

> An Affiliate of Hospital Sisters Health System

> phone

> fax

> tfrank@...

> stjosephshighland.org

>

>

>