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In addition, our staff turnover rate of 10.3 percent (and 12.3 percent
for nursing) was significantly below the national agency mean of 23.6
percent, as reported in the FY2011 National Summary (Table 11).
But a bit of variation bubbled up as well. An LPN floater has been
successfully integrated into the FBC-East team, and covers cases when
an RN team member is off. This averts the need for the other RN case
managers to assume coverage responsibilities when a nursing colleague
is using benefit time. Theoretically, the RNs on this team should be able
to carry a slightly larger caseload of patients because they no longer
have coverage responsibilities (or the fluctuation in the patient care
responsibilities that coverage brings with it).
These FBC teams have also expressed an interest in conducting a pilot
to admit their own patients and not use the services of the admissions
department. They are hopeful that this will increase the likelihood of
team members connecting earlier with family members, which is a
frequent challenge for patients residing in facilities. Because of greater
flexibility in scheduling, they also hope it will decrease the time
between referral and admission. This pilot, which is clearly poised for
success, would dictate the need for smaller RN caseloads.
It is also worth noting that the FBC-Central team has a wellestablished
RN/LPN partnership that provides care across settings
for residents of a large continuing care retirement community. Their
caseload is nearly double that of an RN working independently and the
arrangement has resulted in many positives, such as continuity of care,
increased responsiveness to emergent needs, and a collegial camaraderie
envied by many. It does not, however, impact the caseload size of other
team members.
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