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How to Manage the Labor Expenses of Your Hospice Agency


Whether your hospice agency is using the productivity ratio or another staffing model, understanding the number of team members your agency employs is paramount to the successful execution of your chosen staffing model.

Why the Number Matters

Payroll and related expenses, on average, make up 40% of the net revenue of hospice agencies and are typically driven by the number of hours that an individual works. For instance, if it is known that a hospice aide is assigned to see ten patients a week; add to that the number of visits each team member completes and you can estimate payroll expenses. However, while calculating both numbers is helpful, knowing the exact number of employees you have working will help you better manage your labor expenses. When you count employees, rather than productivity, roles or visits, it is much easier to identify inefficiencies that can lead to excessive payroll costs.

Where the Dollars Hide

Once you know the number of employees on your team, carefully review the hours that they work. This involves comparing the hours worked to their scheduled hours. It is common for an on-call nurse to be used for admissions during the week or for an RN case manager to be used to admit patients when the team includes an admissions nurse. Upon reviewing the actual hours worked versus the scheduled hours worked, you will be able to identify an added payroll expense that might otherwise go unnoticed.

Likewise, you may find that you have an RN case manager reporting hours worked on the weekend when they are scheduled to work Monday through Friday. You can conduct this exercise across all disciplines, and don’t forget your administrative staff. Axxess supports your hospice agency through our custom scheduling solution included in our innovative, easy-to-use hospice software. Our hospice app is available on any device, simplifying scheduling needs for your organization by making shift and clinician changes as needed, on the spot. This presents a great opportunity to leverage the reporting within your EMR to simplify your analysis and ensure that each dollar of payroll is maximized.

Seek to Understand

By and large, hospice professionals (administrative and clinical) make informal adjustments to their schedules or roles to meet their patients’ needs and/or help their teammates. It is important to understand why these informal adjustments are being made to make the best decisions for resetting your payroll expenses. Spending time in interdisciplinary group (IDG) meetings is a great way to understand what is going on with your team or, if you have multiple teams, a specific team. IDG discussions can include answers to why two hospice aides are visiting a patient or why a member of the admissions team is continuing to see a patient that has been admitted.

Engaging your team, seeking to understand why their hours are not aligned with the budget, helping them understand the reasoning and calculations behind your chosen payroll monitoring system and working together to develop a strategic plan to align the work with the budgeted payroll expenses will result in continued quality patient care, increased employee satisfaction and an improvement to your bottom line. Axxess provides an innovative hospice software that enables enterprise and smaller hospice agencies to remain compliant and provide exceptional care.

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