Table 2. Total costs per patient day by patient classification.
| Patient classification | Procedures used | Aide time contribution in minutes | RN/LVN time contribution in minutes | Total staff time required | Total costs per patient day |
|---|---|---|---|---|---|
| Type A1 | N/A | N/A | N/A | N/A | N/A |
| Type B (1-4 ADL) |
Medications | 11.67 | $ 1.79 | ||
| Charting | 9.90 | 4.64 | 1.65 | ||
| Bathing | 9.23 | 0.85 | |||
| Dressing | 8.89 | 0.83 | |||
| Mobility | 33.70 | 3.20 | |||
|
|
|
|
|||
| Total | 61.72 | 16.31 | 78.03 | $8.33 | |
| Type C (5 ADL) |
All Type B | 61.72 | 16.31 | $ 8.33 | |
| Incontinent | 26.48 | 2.50 | |||
|
|
|
|
|||
| Total | 88.20 | 16.31 | 104.51 | $10.83 | |
| Type D (6 ADL) |
All Type C | 88.20 | 16.31 | $10.83 | |
| Feeding | 48.30 | 4.72 | |||
|
|
|
|
|||
| Total | 136.50 | 16.31 | 152.81 | $15.55 | |
| Type E1 (3 ADL + tube feed) |
All Type B | 61.72 | 16.31 | $ 8.33 | |
| Tube feeding | 43.70 | 9.43 | |||
|
|
|
|
|||
| Total | 61.72 | 60.01 | 121.73 | $17.76 | |
| Type E2 (3-4 ADL + decubitus) |
All Type B | 61.72 | 16.31 | $ 8.33 | |
| Decubitus care | 19.62 | 5.27 | |||
| Turn and position | 30.93 | 3.04 | |||
| Spec, skin care | 11.60 | 1.87 | |||
|
|
|
|
|||
| Total | 92.65 | 47.53 | 140.18 | $18.51 | |
| Type CE-1 (4 ADL + tube feed) |
All Type B | 61.72 | 16.31 | $ 8.33 | |
| Tube feeding | 43.70 | 9.43 | |||
|
|
|
|
|||
| Total | 61.72 | 60.01 | 121.73 | $17.76 | |
| Type CE-2 (5 ADL + decubitus) |
All Type C | 88.20 | 16.31 | $10.83 | |
| Decubitus care | 19.62 | 5.27 | |||
| Turn and position | 30.93 | 3.04 | |||
| Spec, skin care | 11.60 | 1.87 | |||
|
|
|
|
|||
| Total | 119.13 | 47.53 | 166.66 | $21.01 | |
| Type DE-1 (5 ADL + tube feed) |
All Type C | 88.20 | 16.31 | $10.83 | |
| Tube feeding | 43.70 | 9.43 | |||
|
|
|
|
|||
| Total | 88.20 | 60.01 | 148.21 | $20.26 | |
| Type DE-2 (6 ADL + decubitus) |
All Type D | 136.50 | 16.31 | $15.55 | |
| Decubitus care | 19.62 | 5.27 | |||
| Turn and position | 30.93 | 3.04 | |||
| Spec. skin care | 11.60 | 1.87 | |||
|
|
|
|
|||
| Total | 167.43 | 47.53 | 214.96 | $25.73 | |
| Type DE-3 (6 ADL + comatose) |
All Type D | 136.50 | 16.31 | $15.55 | |
| Incontinent2 | 1.88 | 0.18 | |||
| Feeding2 | 9.96 | 0.98 | |||
| Observation and assessment/vital signs | 7.59 | 4.93 | 1.57 | ||
| Turn and position | 30.93 | 3.04 | |||
|
|
|
|
|||
| Total | 186.86 | 21.24 | 208.10 | $21.32 | |
| Type DEE-1-2 (5 ADL + tube feed + decubitus) |
All Type CE-2 | 119.13 | 47.53 | $21.01 | |
| Tube feeding | 43.70 | 9.43 | |||
|
|
|
|
|||
| Total | 119.13 | 91.23 | 210.36 | $30.44 | |
| Type DEE-1-3 (5 ADL + tube feed + decubitus + coma) |
All Type C | 88.20 | 16.31 | $10.83 | |
| Tube feeding | 43.70 | 9.43 | |||
| Comatose care | 50.36 | 4.93 | 5.77 | ||
|
|
|
|
|||
| Total | 138.56 | 64.94 | 203.50 | $26.03 | |
| Type DEEE 1-2-3 (5 ADL + tube feed + decubitus + coma) |
All Type DEE 1-2 | 119.13 | 91.23 | $30.44 | |
| Comatose care | 50.36 | 4.93 | 5.77 | ||
|
|
|
|
|||
| Total | 169.49 | 96.16 | 165.65 | $36.21 |
1
Type A patients were defined as those likely to be discharged within 90 days. For them, the present reimbursement system appears to be functioning well and consequently they were excluded from the incentive system.
2
Comatose residents are credited with the total care needs for incontinent patients and spoonfeeders. The difference between the weighted incontinent care mean time and total incontinent care time for bowel and bladder incontinence is 1.88 minutes, or $0.18. The difference between the weighted mean time for partial and total spoonfeeders and total spoonfeeders is 9.96 minutes, or $0.98.