Employees are nurses that provide home health services. They don't track hours. Nurses are paid a set amount for each home health visit, regardless of the time necessary.

Some nurses will do several visits a day while some only do a few each week.

With the exception of elapsed time rules, any good ideas on how to measure or credit time for these employees?

Perhaps something like each visit = 3 hours, etc?

I don't do home health billing from the nursing POV; however, there should be a time factor built into your Medicare reimbursement, which is based on average time spent on a visit -- hence your reimbursement/visit.

I would figure out this time factor, and multiply it by visits to arrive at your total time for HR purposes.

One other issue is I would determine how ya'll make sure your in compliance with overtime laws if they don't turn in some kind of timesheet, even if it isn't used to calculate pay.