Home health productivity points: visits, point systems and windshield time
A points target counts visits, not time, so the hours it takes depend on your territory and your notes.
Home health productivity points are a weighting each agency gives to each visit type. Your target is a number of points per day or per week. The points are set by your agency, not by Medicare, so two agencies can score the same visit differently.
Move from a facility into home health and the unit of measurement changes. Percentages of paid time largely give way to points, visits and the driving between them.
How home health productivity points work
An agency gives each visit type a point value. This guide uses one example throughout, the same one as the home health points calculator. In it, a routine visit is 1 point and an evaluation is 2 points. Your agency's point sheet may use other values, and it is the one that counts.
Agency point systems can weight other visit types too. A discharge visit, a resumption of care or a start-of-care visit with an OASIS assessment can each carry its own value. Ask for the full point sheet in writing when you join.
The target is points per day or per week. Hit the points and the day counts, however long it took. A percentage system measures how much of your paid time is billable. A point system does not measure time at all, so five points that take nine hours are still five points.
What a point system rewards
A point system rewards visits that sit close together on the map. Six routine visits within a two-mile radius and six spread across a county both score 6 points in the example. They are very different days.
It rewards familiar patients, because their notes are faster to write. It rewards visit types whose points are generous for the work they take. That is why the evaluation weighting is worth checking when you join an agency.
It penalizes anything that takes time without producing points. Examples are the patient who isn't home, a forty-minute family conversation and a physician's office call that takes three attempts.
Home health points per week: an example
Take a week target of 25 points. By the end of Wednesday you have done twelve routine visits at 1 point and two evaluations at 2 points.
- Points so far: (12 × 1) + (2 × 2) = 16 points
- Points still needed: 25 − 16 = 9 points
- Per remaining day, over two days: 9 ÷ 2 = 4.5 points
- Time, if all nine are routine visits at 70 minutes each including driving: 9 × 70 = 630 minutes = 10.5 hours
The 10.5 hours cover visits and driving only, before any notes. The home health points calculator runs this with your own agency's values.
Windshield time
Windshield time is the driving between patients. It takes time in every home health day and earns no points. How much there is depends on the territory. In the example above, each routine visit is about 45 minutes in the home and 25 minutes of driving.
For US speech-language pathologists, percentage targets in home health run lower than in skilled nursing facilities. A 2023 ASHA survey of US SLPs in health care found a median productivity requirement of 80% in home health. In skilled nursing facilities it was 85%. That survey covers SLPs only. In a point system the driving drops out of view. An agency can then set a points target that looks reasonable on paper and still produces long days.
When you weigh a home health role, ask about the average driving time between visits in the territory. The guide to productivity with travel time shows how to measure it and what it does to the numbers.
Where the documentation happens
Home health notes take time. Take a day that finishes visits at four and then needs two hours of notes in the evening. From a first visit at eight, that is a ten-hour day.
Ask at interview where documentation is expected to happen. Some agencies expect it in the home. Some expect it in the car between visits. Some leave it to the evening at home, unpaid, without saying so.
Put a number on it before you accept. Two hours of evening notes five days a week, over an assumed 46 working weeks, is 2 × 5 × 46 = 460 hours a year. That is 11.5 forty-hour weeks. The documentation time calculator works out your own figure.
Converting points into hours
A points target and a percentage target can't be compared directly, but you can convert both into time. Here is one six-point day, built from the example values above.
| Part of the day | Minutes |
|---|---|
| Six routine visits in the home, 45 minutes each | 270 |
| Driving, 25 minutes per visit | 150 |
| Notes, 20 minutes per visit | 120 |
| Calls and scheduling | 30 |
| Total | 570 (9.5 hours) |
Time with patients is 270 of 570 minutes, which is 47.4% of the working day. A facility role at an 85% target on a 450-minute paid day has 382.5 minutes with patients. The six-point day is 9.5 hours, whatever the contract says about hours. That is the figure to compare with the facility role and its pay.
Use your own recent weeks for the visit, driving and note times, not your best day.
Questions people ask about agency point systems
How does a home health PT point system work in New York?
Each agency, in New York or elsewhere, writes its own point sheet with its own values and weekly target. Ask the agency for the sheet. Then put its values into the home health points calculator to see how many visits and hours a week takes.
How do points work for a PTA in home health?
A PTA in home health works to the agency's point sheet too. Ask whether assistant visits score the same points as therapist visits and whether the weekly target is different. Employers set assistant targets and they vary. The COTA and PTA productivity targets guide covers how assistant targets are set.
Is a 30-unit week reasonable?
Convert it into hours first. Check whether a "unit" at your agency is a point or a visit. If it is 30 routine visits at 1 point each, with 70 minutes per visit including driving and 20 minutes of notes per visit:
- Visits and driving: 30 × 70 = 2,100 minutes = 35 hours
- Notes: 30 × 20 = 600 minutes = 10 hours
- Total: 45 hours, or 9 hours a day over five days
With less driving the week shrinks, and with more it grows. Whether 45 hours is reasonable depends on what the role pays and says about hours, which you can check with the real hourly rate calculator.
What to look for in an agency
Three things make a points target workable. The first is territories built by geography, not visits handed to whoever is free. The second is point values for evaluations and OASIS visits that match the time they take. The third is a straight answer at interview about evening documentation.
Two clinicians at the same agency with the same target can have very different jobs. A compact urban territory with fifteen minutes of driving between visits and a rural one with fifty produce the same points and very different days. Ask how many square miles the territory covers, the average driving time between visits, and whether visits are grouped by area or by availability.
Listen to how the documentation question is answered. An answer like "most of our clinicians finish up in the evening" presents unpaid evening notes as the clinicians' own choice of schedule. Some agencies build documentation time into the point system, and they are worth looking for.
This is general information, not employment or legal advice. Your agency's point sheet and your contract decide how your productivity is measured and paid.