Each morning, I reconcile our patient roster to maintain an accurate census. Why? Every home health agency should designate a person to monitor its patient census. An inaccurate census will produce incorrect information that affects many areas of your home health agency such as staffing, management and operating cash flows.

Accuracy is Important
An inflated census can result in unrealistic expectations. If a home health agency thinks they have a 150 census and it is actually 100, a 50 patient difference can make a drastic difference in your agency's performance.

All parts of the organization can be negatively impacted by an inaccurate census:

• Agency administration should know their staffing needs for a census of 150 (depending on the technology you are using). An incorrect census could create unnecessary payroll expenses and inaccurate financial expectations.
• The management team needs to track the type of patient and referral source. An inflated census could predict the patients are coming from a particular source when in fact; they were discharged from service, but not in the census records.
• Marketing staff needs an accurate census to track marketing performance and identify the sources of new business. Without this information, they are left trying to build for the future on sifting sand.
• Accounting needs accurate cash projections (daily and monthly). If the money is not in the pipeline, it is not there to spend for future growth, bonuses, equipment, etc.

Maintain an Accurate Census
To prevent inaccuracies, your agency's patient census should be part of the referral and discharge process (an internal procedure to ensure that when a new referral is received or patient is discharged); the person responsible for maintaining the census is notified.

Paper-based agencies create a patient census manually in an Excel spreadsheet, beginning with patient charts and building from there. Since paper-based agencies cannot see the whole picture at the same time, the process is usually time-consuming and results are slow to formulate. If you use a home health software solution, the system creates your patient census/patient roster automatically, saving time and expediting your agency's ability to maintain an accurate census. However, reconciliation is still a hand-driven process that cannot be accomplished through software applications.

The key is following an internal process to discharge. As soon as you know the patient has all the required documents in place (Oasis-C Discharge/Discharge Summary and a Discharge order), discharge the patient in the patient record and remove the patient from your census.

If you are part of a Kinnser-subscribing agency, click here to view further instructions for maintaining an accurate patient census in Kinnser's Agency Manager™.

Pamela Pruitt has over 20 years experience as an accountant, with a majority in public accounting specializing in health care industry such as physicians, anesthesiologists, dentists, hospitals/clinics, etc. Ms. Pruitt is the Chief Accountant at All Nursing Home Health Services, Inc. in Houston, TX, as well as a Certified QuickBooks Pro Advisor, Certified Public Bookkeeper and Certified Bookkeeper. After hours, she blogs on Jobing.com and runs a business providing services to small businesses such as bookkeeping, accounting, and software setup, among other services. To reach Ms. Pruitt, call (281)617-1180 or visit www.ppruitt.com.