I've noticed a growing trend to prohibit overtime. Until recently, overtime was frowned on but permitted if caseload supported it. That isn't happening anymore. The same is true to a lesser extent for using contract labor to fill staffing gaps. Many facilities and rehab companies have in-house contract therapists who must be used instead.
Just last week I ran into this. By Friday I had one hour of overtime, which meant I had to leave one hour early. That sounds great except I had to do the same amount of work in less time because our caseload didn't support an extra person. I think everyone can guess how this played out. I was able to see all the patients on my caseload but everyone got shorter treatments. For me, the day was rushed and I'd rather have worked the extra hour to make things easier on me.
This week there will be two of us in the same situation. We'll need to leave early one or more days to prevent the overtime. That's great if caseload doesn't continue to build and nothing happens. More than likely, Friday will come and both of us will be scrambling to get everything done. Somehow we'll manage but at what cost? Sure, it's stressful to constantly monitor your time. But the real losers are the patients.
No overtime is permitted in the SNF where I work on Saturday. This doesn't affect me directly since I only work there once a week. But indirectly, it means a higher caseload because someone went home early and didn't get enough minutes. Or, none of the regular staff can work the weekend because it would mean overtime. I'm sure there are occasions when Part B patients are missed so Part A patients can be seen when staffing is tight.
This all arises from the need to cut costs due to cuts in reimbursement. There were times I needed my overtime to survive. Getting weekend work isn't as easy as it used to be since that's another area of cost cutting. I wonder when the people making these decisions are going to decide enough is enough and put the emphasis on quality of care rather than cost of care.