Study Shows Home Health Nurses With Smaller Caseloads Have Better Patient Satisfaction Ratings

June 15, 2022 by Alexa Hornbeck
Study Shows Home Health Nurses With Smaller Caseloads Have Better Patient Satisfaction Ratings
(Photo courtesy microbizmag.co.uk via WIkimedia Commons)

A recent report from Leading Age, a nonprofit advocacy organization, finds that home health nurse case managers with smaller caseloads typically have better quality of care and patient satisfaction ratings. 

The report, titled the “National Healthcare at Home Best Practices and Future Insights Study,” was done over the span of one year in collaboration with a consulting firm called BerryDunn.

Researchers examined over 400,000 data points from over 1,000 home health care agencies finding that registered nurse case manager caseloads under 25 have the highest star ratings for quality of care and patient satisfaction. 

Out of all the home health care centers included in the report, 64% of nurse case managers had caseloads of 20 to 25 patients. The rest primarily had lower caseloads of 19 or less, but any caseloads higher than 25 were associated with diminished quality and patient satisfaction. 


Timely documentation was also associated with agencies with fewer caseloads. 


During the pandemic home health agencies were also required by the Centers for Medicare and Medicaid Services to transition to a Patient-Driven Groupings Model, which relies more heavily on clinical characteristics and other patient information to place home health periods of care into meaningful payment categories.  

The increase in telehealth usage during the pandemic was also correlated with an increase in quality care ratings, with 92% of agency respondents using telehealth, with 44% continuing to use telehealth after patient discharge for population health initiatives.

Agencies began using non-clinicians for roles that weren’t clinical in nature, such as scheduling appointments, as two-thirds of home health agencies surveyed used a dedicated scheduler. 


The data shows that while there is a nursing shortage in the United States, agencies who use non-clinicians for roles that aren’t clinical in nature are doing so successfully without compromising the quality of care.

Alexa can be reached at [email protected]

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