I am now working (a result of one contract company leavingand another signing 
on) for a contract company that requires at least 90 percent productivity in 
a skilled nursing facility.  If I want to use PRN help I must be over 100% 
and they have a bonus system.  Several employes left the company because of 
the company's standards saying it is unethical.  I have a large caseload and 
find it VERY difficult to do one on one with everyone and some ADL's are 
limited because of time.  We are strongly encourage to not use group code for 
billing.  Also, We are not "allowed" to bill THEREX if we choose to do UE 
strengthening.  We have a tech who does help with the repetious tx activities 
which allow us to provide concurrent therapy. 

Is 90 percent unreasonable in Long term care?
What is billable time?  (i thought it is actual tx time not time running 
around looking for a w/c) 
Is there anything I can do??  Can someone tell me how they manage a situation 
like this?

I do provide quality services to my patients and provide them with the 
treatment they need... even at my expense (lost hours secondary to drop in 
productivity).  However, I feel like I am running around like a chicken with 
its head cut off with limited time for documentation, screenings, inservices, 
etc.  Also leaving is not an option at this time!

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