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Toni Talks about PT Today

The Declining Census

Published September 24, 2013 5:16 PM by Toni Patt

In previous posts, I've discussed staffing issues where I work. Those problems continue. So does the return of the frequent flyer. Now we have something even more troubling. Our census continues to drop. The facility is at one-tenth of its capacity. There doesn't seem to be an end in sight. As of the time I left work this afternoon, no admissions were expected.

I've worked in many facilities. They've handled census drops in various ways. At the "evil empire," we were so busy that a census drop meant a day when we didn't feel overwhelmed before starting. Other places cut support staff hours. No matter where I was, eliminating prn hours was the first response. Full-time staff was encouraged to keep busy and go home if there was nothing to do.

Today I was told our hours will be cut if the census doesn't improve. Increasing treatment durations is not an acceptable option. We can do that, but will still need to leave early. At the same time, a lot of things need to be done that aren't specifically patient care. When we're busy, we don't have the time. Now we'll have the time but not the opportunity.

Remember, like many facilities, staff has been cut to the bare minimum. There are always complaints about how long it takes for a bed pan, pain medicine or just about anything else. Obviously we aren't the only department feeling the pinch. But wouldn't it be nice if, instead of sending everyone home and cutting hours, the facility allowed enough staff to answer call bells or whatever else patients need instead of making them wait even longer?

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I can completely relate! I am the Department manager at my S.N.F and our census  has been low and admissions spotty at best. The company I work for contracts to 4 nursing homes within 75 miles of one another. The therapists in one of the other homes have been working an average of 5 hrs a day, so my regional   manager thinks it would be a perfect plan to take hours away from me and my staff to share with the others. The problem with this is that I can't complete my management job duties in a limited amount of hours. Even now I am working off the clock past my regular eight hours to complete the required tasks outside of patient care. My personal opinion is that ALL Dept. managers should be salary,since I receive unlimited phone calls outside of work hours, including weekends, that require my attention to work issues. VERY frustrated at the moment.

Charmin, P.T. - Rehab. Manager October 6, 2013 5:40 PM

I wonder if it has occurred to the bean counters that census is down because "customers" don't want to go someplace where the care is spotty due to lack of support staff or insurers don't want to reimburse because therapists can't do what is necessary to get the job done right for all their patients?

I often want to ask administrators and executives, "What exactly is our product?" I think they have forgotten that our 'product' is recovery and patient care. If we stop actually producing that product, why should anyone use our business? Would you buy a car without tires? How about a sofa with no cushions? Why should patients or insurers choose facilities who don't provide full rehab, which includes sufficient support staff!

I think the business people are the epic fail in this scenario.

Dean Metz September 25, 2013 4:17 AM

Every therapy business is a business, and (especially now) having a full time job doesn't mean job security. Wouldn't you rather start your own practice than work for an "evil empire"? It doesn't have to be that difficult and you can help a lot of people...TheraGo (dot com).

Joshua September 24, 2013 9:16 PM
Pittsboro NC

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