Blanketed approach to seeking continued care for our patients
Our case manager (UR) wants to send out a copy of the patient’s medical record to 10 or 20 SNF’s within a 100-200 mile range our facility to see if they are willing to accept a patient. These are inpatients, hard to place and we are in an extremely rural area with only a few SNF’s within driving distance for families in this area.
What kind of consent form would be needed to cover this blanketed approach to seeking continued care for our patients? Would this even be legal? Do any of you have such practices within your systems and if so, would you be willing to share your consent forms? Need some help please. I’ve never heard of such a proposition.
– Health Information Management director
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Courtney Nichols, RN | Feb 3, 2012 | Reply
What we do is give the patient or family a chose of were they want a referral sent to. They may pick their top 3, then we have a form were we check what facilities they have choosen and the patient or family member signs that form.
The form is simple and has all HH, SNF, Hospice, Rehab hospitals, DME, ect in our area listed.
Jackie Birmingham | Feb 5, 2012 | Reply
A serious challenge for both the hospital and the patient. ‘Hard to place’ is not a great feeling for the patient. However, a ‘blanket approach’ is not the best option for many reasons. You can do that, but should you? First – look at the hospital policy regarding the scope of the ‘consent for treatment’ signed on admission. Discharge planning is a ‘treatment’, so you may be covered for sending information. But, you also must closely watch the HIPAA and potential ‘accounting of disclosure’ – do you need to tell the patient about all the SNFs covered (or uncovered) in the blanket approach. This question needs to be worked through by reviewing your own hospital/department policy with your compliance officer, Utilization Review committee (physician) and medical records department. You may also want to contract your local QIO which handles the ‘appeals for discharge- the IM (Important Message) – predictably, if you plan to send a patient 100-200 miles away, expect an Appeal for discharge. Have you looked at CAH (Critical Access Hospital)Swing beds in addition to searching for SNF beds.
Bottom line – it all depends on your ‘official’ hospital policy on discharge planning.
Good luck – feel free to contact me directly.
Jackie Birmingham
jackiebirmingham@jackiebirmingham.com
Janice M Bradley RN CM | Feb 8, 2012 | Reply
We give a list of the SNF’s in the local area and ask the pt/family to choose top 3; if none of those offer a bed we then send to the “blanket list” as this we feel is covered under the “consent to treat” which is signed on admission.
Casey RN BSN CCM | Feb 8, 2012 | Reply
We use an encrypted referral system called MIDAS that will send out a form with only initials of the patient on it to blanket providers with the request for a bed and type of insurance they have and our (the CMs) contact information if they have a bed available. Per our policy, we send this generic form if we want to use the “blanket” approach. However, in real life very few of us use this option even though it is available. We generally send to the top 3 the patient picks or call on the phone to see if they will take the patient before we send information. Hope this helps! Casey