How long does an OT home assessment take, and where do the hours go?

How long is the home visit itself?

Between one and two hours for a standard adult home safety or home modification assessment, with the longer end for a multi-level home, a client who uses a wheelchair or walker, or a visit that includes trying transfers and equipment. The best Canadian figure comes from the validation work on the SAFER-HOME, the home safety tool developed at COTA Health in Toronto: Chiu and Oliver report that home safety assessments "are typically completed in one visit in an average of 1 to 1½ hours" (source 1). The I-HOPE, a performance-based home assessment, is listed at approximately 60 minutes to administer (source 2), and that is the structured part of the visit before any measuring. In the United Kingdom, Dorset County Hospital's patient leaflet for a pre-discharge home visit says the same thing in plainer words: "Visits normally last for 1-2 hours" (source 3).

A 2025 Australian matched cohort study gives a figure for the whole in-person service rather than one visit. Among 544 patients of an occupational therapy home visiting service, the median therapy time for those seen in person was 160 minutes, against 40 minutes for those seen by telehealth (source 4). That 160 minutes includes everything the service counted as therapy time for the episode, so it sits above the single-visit figures above, and it is a useful upper reference for an assessment that leads into equipment set-up and caregiver training.

What stretches the visit is rarely the walk-through. It is the measuring (every doorway the mobility aid has to pass, the tub rim, the toilet height, the step rises outside), the conversation with the client and whoever else is home, and the trial of transfers in the bathroom and bedroom. A visit that covers a single-level home with a client who walks unaided can be done in an hour; the same tool applied to a split-level with a power wheelchair, two caregivers and a pending ramp runs closer to two.

How long does the report take to write?

As long as the visit, and often longer. The clearest published allowance is ICBC's: for an initial occupational therapy assessment it funds "up to 3 hours of direct assessment time" and separately "up to 3 hours of report completion time", with the initial report due within five business days of the first meeting (source 5). The schedule does not claim a report takes three hours; it sets the ceiling the insurer will pay for, which is the closest thing to a public time budget for the write-up.

Other payers fold the writing into the visit fee. WSIB's occupational therapy fee schedule, effective January 26, 2026, pays $159.14 for a home visit, notes that "a visit is generally one hour in duration", and says that payment for reports "is included in the fee for occupational therapy services" (source 6). So an Ontario OT working a WSIB file is paid for one hour and does the report inside that fee, whatever it takes.

We did not find a Canadian time-and-motion study that measures how long occupational therapists spend writing home assessment reports, and this article does not invent one. What the funder allowances show, and what OTs describe, is the shape: the visit is an hour or two, and the report is an afternoon. The reason is not the typing. It is reconstruction, which the report-writing guide describes in its "where the time goes" section: turning handwritten notes and a phone full of photos into a room-by-room account, re-reading the notes to find the tub rim height, matching photos to findings, and then entering the same information a second time into the funder's form, in the funder's order.

What do funders allow for assessment, report and travel?

The allowances below are the public ones. Each is a cap or a flat fee, which is the payer's view of a reasonable assessment, and an OT whose assessment runs over the cap either absorbs the time or asks for more in writing before doing the work.

Two things stand out. The Ontario auto insurance rate has not moved since 2014 and sits well under the private-practice averages in the ACOTPA survey. And only ICBC publishes a separate report allowance; every other payer here either folds the report into a flat fee or leaves it to the hourly clock, so the time an OT spends writing is mostly invisible to the people paying for it.

How long until the client gets the report?

Where a funder sets a deadline it is usually five business days: ICBC wants the initial report within five business days of the first meeting (source 5), and WCB Alberta wants the completed Personal Care Allowance Assessment Report within five working days of the assessment (source 8). Where no funder is involved, the turnaround is whatever the OT's caseload allows, and the slow part is often outside the report: a contractor's quote the recommendation depends on, a funder form that needs a physician's signature, or a measurement that was not taken on the day and needs a second visit.

A second visit is the expensive case. It costs the travel again, the client's time again, and a day or more of delay, and it is almost always caused by a missing number rather than a missing judgment. The room-by-room measurement checklist in the report-writing guide exists to make that second visit rarer: if the clear widths, step rises and turning space were recorded the first time, the report can be finished from the desk.

Does a remote or telehealth assessment save time?

For the therapist's clock, yes, and by a lot, with a limit on who it suits. In the Australian matched cohort study, telehealth delivery of an occupational therapy home visiting service cut median therapy time from 160 minutes to 40 minutes without increasing adverse events, but 56 patients (20.6 percent of those who started by telehealth) had to be escalated to an in-person visit, mostly for equipment set-up and caregiver training (source 4). The authors' conclusion is the one to carry into practice: telehealth is not appropriate for all patients, and the service needs a route back to the home for the ones it does not suit.

The practical reading for a Canadian community program is that the visit and the assessment are separable. A home can be captured once, by the OT on the first visit or by a family member on a guided walk-through, and the clinical reasoning can then happen at the desk from a record that holds the measurements and the photos. The scan travels; the judgment stays with the clinician. What a remote assessment cannot do is set up a transfer bench or coach a caregiver through a stand-pivot, and those are the visits to keep in person.

Where do the hours go, and which can be shortened?

Put together, one home assessment on a community caseload breaks down into five blocks: travel to and from the home (up to the 90 minutes ICBC will pay for per session, and more in a rural catchment), the visit (one to two hours), the reconstruction of notes and photos into a room-by-room report (an afternoon), the funder forms (the same findings entered again in a different order, with the OCF-18 capped at $200 for the Ontario auto example), and, for some share of files, a second visit to collect a measurement the first one missed.

Travel and the visit are fixed by geography and by the client. The three blocks after them are documentation, and they are where the time can come back. Anything that captures the measurements and photos in a structured way during the visit shortens the afternoon, whether that is a printed checklist, a tablet form, or an assistant that does it for you. The sequence that works is the same whatever the tool: decide before the visit which measurements the report and the funder form will need, record them against the room and the finding while standing in the room, and write the report from that record rather than from memory.

Common questions