For those of you who have been “following” Mom’s journey. She hit a speed bump a couple of weeks ago.
She had a bone biopsy, and there was some internal bleeding after the procedure; by the time she got home, she was in extreme pain and unable to walk.
She called the ambulance and was transported back to Cleveland Clinic. Mom spent 14 days as an inpatient while they tried to get her pain under control and start to resolve the hematoma that was on her “hip .”
As luck would have it, I was unable to be at the bedside as my son tested positive for COVID, and I was on a ten-day isolation protocol. So my care coordination was via phone and facetime.
Since my Mom lives alone, they thought it best to transition to an SNF with Rehab. I could hardly disagree as I couldn’t fly home to be with her.
The Case Manager (CM) gave her the “list.”
You know the one where they type in your home zip code and print out the list of providers closest to you and tell her to pick one.
Not knowing what to do, my Mom looked at the list and chose the one nearest to her home highlighted by the CM. The CM called them, but they didn’t have any beds open due to COVID staffing shortages.
So, my Mom proceeded to pick five more based on distance from her home. All had the same answer – no beds due to staffing shortages. I didn’t know that any of this was going on, but when I called later that day, she shared that she couldn’t find a rehab for her. I asked her to take a pic and send it to me (see photo).
This is the lesson for us as post-acute care providers.
The list – oh, that damn list! I want to cry every time I hear a Case Manager say I give out a list. While, in this case, it was an SNF list – it could have easily been a Home Health, Hospice, or In-Home Care list.
Look at that list. Yes, they will say to you – “well, we give them the star ratings to review.” But really…is that the best way?
Look how she highlighted the list – it was based on distance, so my Mom chose based on distance. This is to say; patients look to their Case Manager to help them navigate through all the choices – even when it is not a great criterion like distance.
Once I understood what was happening and that discharge was “now,” I got on the phone with some of the nurses, and while they would never come right out and say this one is good, or this one is bad, or I would rank the rehabs 1, 2, 3 – One of them said the exact words I used to say to my patients when I was an OT in the field:
“If It were MY MOTHER, I would try: Abc SNF or XYZ SNF or 123 SNF”
Again we are humans; they are humans; when asked, they will tell the patient their opinion, but you have to ask, and my Mom didn’t know to ask. So she simply followed the highlighted path.
It’s the hospital policy to offer a list and patient choice. The CM did that.
She also provided “outcome” measures on that list to meet the facility’s policy of “informed choice.”
I will submit it to you it’s not enough.
That is where you come in – you differentiate your agency beyond your star rating. How do you educate the Case Managers so that when a patient or daughter like me asks, “who would you send your mom to…” they would respond with Your agency’s name?
It’s up to you to position yourself as the expert in transitioning a patient to their home or a highlighting specific disease.
REMEMBER: It is not their job to remember you – it is YOUR job to make yourself someone they can not forget!
Are you struggling to differentiate yourself? Then, Roadmap to Referrals does it for you! Imagine having a new topic each week to elevate your conversations and position you as the expert in CHF, COPD, Parkinson’s, and many more!
Patients and clients deserve your care! It’s your job to engage your referral sources, so they see you as a trusted partner, and it is logical to refer to you when you are the expert!
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