How Quickly are NPs Required to Complete Patient Charts?

Last week my husband and I risked taking our 4 month old on an international vacation. Fortunately, the little guy was a champ during the flight and our plans went off without a hitch. During our getaway, however, I received a dreaded email titled “Incomplete Patient Chart”. If you’re a nurse practitioner, you probably know exactly the kind of email I’m talking about. 

In a hurry to pack and fit in a little sleep before our trip, I vacated the hospital forgetting to sign off on the chart for my last patient of the shift. “Ugh” I thought when I checked my inbox. I knew exactly the patient this was referring to. Now, out of town, I was faced with the prospect of trying to log in remotely to the hospital’s EMR system which I had done before with mixed success at best. Predictably, the remote login went less smoothly than the 10 hour flight with a lap child and I was unable to complete my chart on time according to hospital policy. 

While my workplace expects nurse practitioners to complete patient charts within about 24 hours of ending a shift, they are thankfully pretty understanding about the occasional oversight. What’s the policy for providers in your clinic or hospital?

Completing charts in a timely manner is a hot button issue at some facilities. After all, without a complete chart, a patient encounter cannot be coded and submitted for reimbursement with an insurance carrier. Understandably, healthcare companies are looking to collect in timely fashion and hold high standards for providers when it comes to documentation. The Medical Group Management Association (MGMA) polled healthcare facilities about their policies for completing patient charts. Here’s what they found: 

  • 30% of facilities require that charts be completed within 24 hours of a patient encounter
  • 29% of facilities require that charts be completed within 48 hours of a patient encounter
  • 20% of facilities require that charts be completed within 72 hours of a patient encounter
  • 21% have other policies or do not track time to chart completion

The organization also found that the most common incentive used by employers to enforce chart completion policies is financial. Facilities either deduct pay or withhold paychecks from providers until charts are complete. 

How quickly does your employer require nurse practitioners to sign of on charts? Is there a penalty for noncompliance?

 

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