15 Minute Turnaround on Referrals

 

One of the first things I learned in the nursing home industry is that when you receive a referral, you’ve got to act quickly to capture it.  A typical scenario is that a discharge planner at a hospital either faxes out a referral to multiple facilities or uses an email referral distribution service such as e-Discharge to distribute the referral to multiple facilities.

From the time you get this referral, you are competing with other facilities to see who can generate an answer the fastest.  What usually happens is the admissions director gets the referral off the fax or email and does the following:

1.  Takes the face sheet to the business office manager to check the insurance.

2.  At the same time, gives a copy of the referral to the Director of Nursing so he/she can determine if the facility can take care of the the patient.

That’s really all that’s needed.

Yes, you need a chest x-ray and yes, you need a pre-admission evaluation completed in some states, but all that can be taken care of AFTER you accept the referral and prior to admission.

If there is an issue with the insurance the BOM may mark “No” on the referral.  Or, if the DON identifies expensive medications or equipment needed, we may have to do a cost-out, especially on a Part A referral.  Any denials or barriers to admission should come directly to the administrator who should have the final decision.  The administrator has to enforce this process with the team.  Referrals can never take a back seat on the bus.

The referrals can NEVER sit on someone’s desk for hours at a time.  You have 15 minutes to get an answer to your discharge planner.  That’s it.   The answer isn’t always Yes or No.  It may be, “We’re interested, but we need a little more information – the last few days of nursing notes…”

If you snooze, you lose.  I have seen some one facility with an average turnaround time of 9 minutes.  That’s outstanding!  Make it easy on your discharge planner and on your team.  Make processing referrals quickly and smoothly a priority in your building.

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2 Responses to “15 Minute Turnaround on Referrals”

  • Brad on

    The company I work for requires a face to face assessment to be conducted. What are your thoughts on this as we don’t have someone stationed at the hospitals so the time to get there can definitely be more than 15 minutes.

  • Mark on

    Hi, Brad. I think your company is probably losing referrals. However, they may have had some bad admits which forced them to implement the face to face. I think there is a balance somewhere in between. I almost never do an onsite but my staff can handle higher acuity. Actually, the only time we do onsite is when we are suspicious of behavior problems.

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