How to Achieve an Ideal Census-Mix

February 12, 2020 Melissa Bagnoli

Skilled nursing providers across the U.S. continue to face falling occupancy rates. In fact, occupancy rates dropped to a record low of 81.7% in 2018, according to the National Investment Center for Seniors Housing & Care (NIC). NIC experts say policy changes related to reimbursement and competition from assisted living and home health are both factors in the occupancy decline.

Since facilities can no longer depend on “heads in beds” to reach revenue targets, they must take a deeper dive into the level of care needed and what the payer will reimburse. Facilities need to change their approach when considering what type of resident admission they will accept.

Here are 3 ways to obtain your ideal census mix and increase your profit margins in your skilled nursing facility.

1. Gain Full Visibility into the Resident Prior to Admission  

Coverage determination should be completed before the patient is discharged from the hospital. Failing to do this prior to admission could leave you at risk financially, because you may not be reimbursed for the care you provide to that resident. When looking at eligibility coverage you should be on the lookout for MSP, Med A, home health episodes, benefit period, and payer coverage from (both covered and non-covered excluded services). This will help ensure you are reimbursed for the care you deliver.

2. Implement a Thorough Pre-admission Screening Process  

Hospitals send standard discharge documents such as fact sheets and H&Ps, but it doesn’t paint a complete picture of the resident’s profile. Collecting all resident information prior to admission such as MRIs, scans, blood work, pre-existing conditions, and original diagnoses, will help you make an informed decision – but those can often be overlooked. Having this information in advance with a customer relationship management tool will help reduce the likelihood of a readmission.

3. Track and Communicate Referral Status to Referral Partners and Facility Staff

Integrating with a third-party system that hospitals use to push out referrals can give you visibility into their patient population. If you’re able to track the referral types your facility is receiving, you can use this information to up-skill your staff to be able to care for that type of resident. This will allow your facility to make quick and informed decisions when it comes to accepting a patient, and will also reduce the risk of re-admission. 

Hospitals and post‐acute facilities need to focus on patient selection and processes when transitioning a resident from the hospital to the post-acute facility. This process should start before the resident is even referred to the facility. Managing and understanding care requirements prior to admission helps to ensure you have the right resources in place and that you’re not missing out on revenue and reimbursement.

With the right technology in place, you can achieve your ideal census mix.


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