How Admitting an Ideal Resident Can Improve Your Profitability

When it comes to admitting residents, how do you determine who is the best fit for your facility? By creating an ideal resident profile, you can successfully determine the best possible census mix. This will help reduce rehospitalization rates and ensure that your staff are able to properly care for the residents you are admitting.

Here’s what to look for in an ideal resident.

1. Healthcare Needs Match Your Facility’s Capabilities

It’s critical to ensure that the patient’s care needs match your care proficiencies, including clinically complex services or non-therapy ancillaries. If the patient has a lot of complex needs that your facility and staff are not equipped to handle, it could cost your facility a lot of money and result in rehospitalization.

2. Meets the Criteria of Your Facility’s Referral Sources

If the resident is referred by your local partner hospital, they are likely the ideal resident for your facility. Your partners should be aware of your competencies and track record, and therefore refer patients who are the best fit for your facility and capabilities.

3. Presents a Thorough Financial Picture

It’s important to determine whether the patient has a confirmed payer source before admitting them. They should also have a high reimbursement potential and maintain your balance of high and low payers, and understand what they will pay if they stay long-term.

4. Provides a Complete Clinical View

Their hospital, physician and family need to provide details about their past and potential healthcare needs. This will help you determine whether your facility is able to provide the level of care they require. You may also need to meet with the patient’s family or social worker in order to gather all of the documentation you need to make an informed decision about their admission.

Between PDPM and historically low censuses, providing quality care and attaining positive outcomes are more important than ever. Take the time to identify your ideal resident so you can improve your financial health in 2020. Check out our blog post How to Achieve an Ideal Census Mix to learn more.