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Ankota: Home Care Next Generation Blog

How is Home Care Scheduled? Let Me Count the Ways...

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There are many types of home care that make up the home care industry. At Ankota, we generally focus on the non-medical care that allows elderly individuals to age-in-place rather than being institutionalized in a nursing home. Even within the non-medical home care sector there are a variety of ways that scheduling is done. Below is an overview.

How is Home Care Scheduled? Let me count the ways...

 
  • Non-medical home care (also known sometimes as private duty or Medicaid waiver home care): Generally there is a "pattern" of care where the caregiver has set scheduled times like Monday, Wednesday and Friday from 8:30 AM to 11:30 AM. 
  • Even though there are often fixed schedules, most caregiving organizations are more focused on the duration of care than on the exact times. So if a caregiver is scheduled from 8:30 AM to 11:30 AM, if they arrive a bit ahead of time such as at 8:26 AM they're expected to depart after their scheduled time (e.g., at 11L26 AM in this case)
  • Consumer Directed Services (CDS or something called CD): In the CDS model of care, generally the home care agency plays an administrative role in the care, which includes making sure that the care is delivered, billed and paid for, but the consumer (the person receiving the care) decides when the care should be delivered.
  • Sometimes this is "scheduled by duration" such as scheduling a placeholder visit for 3 hours a day but letting the caregiver clock-in at a time that they agree to with the client. Other times CDS visits aren't scheduled at all, and instead the visit starts when the caregiver clocks in.
  • Contiguous visits: A lot of programs authorize different types of care, such as personal care and respite care that can be delivered by a single caregiver in a single visit but needs to be billed as separate services on the back-end. Sophisticated home care software will generally allow the caregiver to clock-in and out only once and it will handle the splitting (in this case between personal care and respite) on the back end.
  • Home Health Care Nursing: Generally in home health care, the nurses in charge (generally RNs) have a census of patients and they do the critical visits for those patients such as initial assessments, recertifications and discharges, and if they're available they also do the "regular visits" in between but often there are LPNs who cover most of the regular visits. 
  • The scheduling mechanism most commonly used is to set up a pattern of care like "twice a week for three weeks" for which the industry would use the nomenclature 2W3. Then the nurses are managed by a quota system that for example let's them do up to 5 visits in a day and up to 8 hours in a day (where in most cases the number of visits is the key).
  • A lot of systems do a very basic schedule like putting the twice a week visits on Tuesday and Thursday, the 3 times a week on Monday, Wednesday and Friday and the once a week visits on Wednesday. Then the nurses manually adjust their own schedules balancing patient need and efficiency.
  • In reality it's not very efficient at all for the nurses or home-bound patients, but it's hard to automate because nurses are very much used to the way they've always done it.
  • Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy  and Home Infusion: These types of care are generally scheduled like nursing visits and they have some similar dynamics where PT is delivered by PTs and PTAs (Physical Therapy Assistants) and OT has OTs and COTAs (Certified Occupational Therapy Assistants)
  • HME/DME Scheduling: Another service housed under the broad umbrella of Home Care is Home Medical Equipment (HME) or Durable Medical Equipment (DME). These two terms are pretty much synonymous but purists will tell you that DME is what is used and HME is what the practitioners do. Anyway, the scheduling model here generally requires allocation of "deliveries" to a technician and vehicle in geographic areas and then a route optimization mechanism to minimize driving time.

Believe it or not, there are even more ways that home care is scheduled. An important takeaway is that people looking for "home care scheduling software" should make sure that the vendors they're considering are experts in the model that they need.

Also, some agencies do both home health (e.g., nursing and PT) and home care (non-medical care) and try to use one software package for both. This approach has a high failure rate due to the differences described above.

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Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Readmission avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact us

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