Q&A: Referrals to Postacute Care

Q. Can hospitals send referrals to skilled nursing facilities (SNF) and home healthcare and only present patients the choice of those accepting facilities?

A. Yes. If you send a referral to a postacute provider—we’ll use SNF as an example—and they look at it and yes, they have the resources, the skills to meet that patient’s needs, and they have an empty bed when the patient is being discharged. If you get three of those, you can show the three to the patient and say, “These are three that can take care of you.” If you have one, then you have one. If you have 12, then you may want to use your clinical judgement and counseling and look more at the quality ratings to narrow the list down. Medicare does not have a minimum list of providers to give to a patient; some hospitals do. They’ll say you have to have three providers, but that’s only so that people are forced to have a backup plan should the first provider be unable to take the patient. So the answer is you can give the patient a list of only those that are available.

This question was adapted from the HCPro webcast "Discharge Planning: Realignment of Standards and Workflow" featuring Jackie Birmingham, RN, BSN, MS, CMAC, and Janet L. Blondo, MSW, LCSW-C, LICSW, CMAC, ACM, CCM, C-ASWCM, ACSW.

Need expert advice? Email your questions for consideration in the Revenue Cycle Daily Advisor. Note: We do not guarantee that all questions will be answered.