Nursing Homes Can Better Use Admissions Process to Minimize Discharge Anxiety

Families face major anxiety when the phone rings and it is either the business office or social work in a nursing home urging more family involvement in transitioning a patient out of a facility. Often there is a need for a person to complete the Medicaid application process and transition to a long-term bed in a different facility.

The very process scares a family and the nursing home is panicky about rendering weeks of uncompensated care. Families are understandable nervous as most have no clue about how the long-term care apparatus works in America. The nursing home is concerned about tons of uncompensated care which hits its bottom line hard. The question is how can we routinely improve this effort? One way is by making better use of the admissions process.

The right questions asked in the beginning can save lots of grief but in order to enact such a routine we have to move our minds beyond the Medicare billing and the profits accorded during this rehabilitative period. The admission period is an opportunity to gather lots of information which can be crucial at discharge. What is this patient's current financial condition? Is there a long-term insurance policy in place? Does the patient have an open and active no-fault auto claim? Has the family demonstrated a sincere interest in this person's long-term well-being? Do we need to recommend an independent case manager early on to help the patient and designated representatives explore post nursing home options?

Knowing some of this well in advance of the discharge date tells the nursing home if this is a likely assisted living placement, Medicaid applicant, etc. Further the grief associated with so many discharges can be eliminated, including hundreds of active lawsuits against nursing homes in America right now accusing the facility of prompting, arranging and in many cases forcing an unsafe discharge. Much of this grief can be avoided. In one recent settlement the award was over ten million dollars, ($10,000,000.00) after a patient was discharged to their private residence, de-compensated, fell and died.

Documentation from the nursing home proved they were well aware of this person's medical and cognitive state. The award will likely be reduced on appeal but the financial bite will still be hefty and the loss credibility enormously costly.

So let's minimize the anxiety; "use the beginning to plot a successful end".

Thanks for allowing me to share.