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Financial Planning:

WHAT IF A SKILLED NURSING VISIT DOESN'T QUALIFY?

Published on Thu Jul 07, 2005

Make the most of unpaid visits.

Single skilled nursing visits often go unpaid under the prospective payment system, but that doesn't mean they have no value.

No matter how hard you try to avoid unpaid SN visits, there will always be some, says consultant Rose Kimball with Dallas, TX-based Med-Care Administrative Services. Your best bet is to prevent those you can avoid and minimize the financial drain of those you can't avoid.

Evaluate your unpaid SN visits to determine how to turn lemons into lemonade:

Problem: You frequently make one visit to patients who aren't admitted to home care.

Solution: Improve referral and intake procedures, experts suggest.
 

  • Get as much information as possible up front from the referral source and the patient, says Rachel Hammon with the Texas Association for Home Care. Have cues for questions the intake staffer should ask, especially when trying to determine eligibility and caregiver access.
     
  • Consider using a registered nurse as the intake coordinator, suggests Christi Jarrett, clinical supervisor with Lake Norman Home Health in Mooresville, NC. Field experience lets the nurse identify potential problems before you make the visit.
     
  • Educate referral sources about appropriate patients for home health, especially if you are getting lots of inappropriate referrals.
     
    Problem: You want to cut the cost to your agency of single SN visits you must make.

    Solution: Decrease staff costs and increase the visit's value.
     
  • If you know - or suspect - a one-time SN visit, use a salaried clinician rather than a contract one, Kimball suggests. This keeps the visit from adding to your salary costs.
     
  • Use one-time visits to publicize your agency and what services you can provide, experts say. The patient  - or her family and friends - are likely to need your services in the future.
     
  • Accepting your share of these visits shows referral sources you're a team player. When they have the referrals you want, they're likely to remember your willingness to provide service when needed, experts say.

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