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July 18, 2015

Top Five Reasons for Case Manager Burnout



The job of a case manager can be very stressful at times. Just like many jobs within the human services field, there is a high burnout rate. People decided to leave the human service field for a variety of reasons. Sometimes you decide to go into a profession then realize it’s not for you. There are other times when the profession you enjoyed has changed to the point where it’s no longer enjoyable. In some cases, the changes have caused mental and emotional stress to the point where it’s no longer worth it to stay in this field. Unfortunately, case management is starting to head in this direction (actually almost there). People are leaving case management jobs and moving on to other jobs in the field and some are leaving the human services field altogether. There are a number of reasons that cause employee burnout in case management. Here are just my top five based on my conversations with fellow co-workers and personal experience.

1. Unrealistic Expectations
Unreasonable and unrealistic expectations are at the top of the list as a reason for burnout. Over the years, caseloads and responsibilities have increased significantly. Some case managers have caseloads of over 50 clients and are still expected to complete all of the work to the same quality as they did in years past with lower caseloads. Documentation requires more detail and there are more forms required than ever before. Most if not all of these increased requirements have come with little to no increase in salary or compensation. This is a perfect recipe for burnout.

2. Documentation
Excessive documentation is second on my list of burnout causes. Progress notes, quarterly reports, treatment plans, and a host of other forms can take its toll. Multiply each of these forms of paperwork by 35 to 50 clients can lead to one stressed out case manager. It seems like there is at least one new form added to the documentation every year. New requirements and regulations also add to an already overwhelming workload.

3. Lack of Appreciation
Many case managers and human service professionals often feel unappreciated. Their hard work is often overshadowed by one or two mistakes. Human service professionals are rarely recognized for their accomplishments but are often criticized when things go wrong. Unfortunately, case managers and social workers are often shed in a negative light to the public when there is media coverage involved. From experience, I know that one negative incident can cause an entire department can get a negative reputation. Even within the agency, case managers are rarely acknowledged for their accomplishments but are highly criticized for anything that is not up to par. Case managers often feel that no matter how hard they work, they can never do enough to satisfy everyone.

4. Salary
Although case managers don’t do this job for the money, salary also makes the list for burnout. Simply put, the amount of work is not worth the salary that most case managers earn.  With all the recent increases in the amount of paperwork and regulations placed on intellectual disability case management in particular, there is very little discussion about increasing salaries or reimbursement for case management services. Even though salaries for case managers are pretty reasonable in comparison to many jobs in the human services field (my estimate is anywhere from $30k to 60k or more per year depending on the location), the increasing amount of work and scrutiny is starting to get unreasonable and is pushing people out of the profession.


5. Job Related Stress
This reason is a basically the sum of the previous four reasons for burnout. They all contribute to the overall stress level of the job. Internal and external scrutiny and the fear of being responsible for Medicaid paybacks is wearing people out. One of the major frustrations involves the auditing process. The fact that you can actually provide the service and then have someone come in and decide it’s not good enough and take money back is discouraging. I’m not sure if this is across all states but I have found that even if all progress notes are completed and treatment plan in place, payment for services can be denied for the entire three months if the quarterly report is not completed in time. Basically, one mistake can cost an agency approximately $3,000. The auditing process is necessary to maintain quality and to ensure that services are provided appropriately. However, it appears that the primary purpose is take away money from providers that clearly provided the service. This put a tremendous amount of pressure on department directors and supervisors and that stress inevitably trickles down the line to everyone in the department, especially case managers.

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