Transferring to another level of care

[RN010101]

Hello!

I was hoping for some help.

What do you do or what do you say in cases where:

-the patient does not want to be transferred to LTAC? I've heard many patient say "why can't I stay here? Why do I have to go to an LTAC?

and

-the patient does not want to be transferred to a SNF, when it is the most appropriate discharge plan (no LTAC criteria, needs rehab, etc.)?

Also, any advice on how to deal with patient/family members who take a while to decide on which facility they would like placement on. I've had a case where a patient stayed in the hospital unnecessarily since the family would not decide on which SNF.

Thanks in advance!

[RN010101]

Hi again, any thoughts?

[SummerGarden, BSN, MSN, RN]

Is this homework?

When trying to discharge a patient to a LTAC be sure to tell him/her about the good news of their discharge from the hospital setting and up-sale the LTAC's ability to continue to care for the patient in the appropriate setting until he/she is able to discharge to [fill in the blank].

SNF is the same conversation.....

Remember people can make whatever choices he/she wants to make... Just give them the information they need to make an informed decision to include the amount of money that insurance is not covering now that they have been discharged....

[MunoRN, RN]

At facility I've worked at, social takes into account patient/family preferences for a particular facility to be transferred to but we're not bound by it, and if they haven't made a choice by the time we need to finalize the transfer arrangements then they are out of luck. Patient's and families have the right to choose their own facility, but it's up to them to make those arrangements, the facility's only responsibility to ensure they are being transferred to the appropriate level of care. I've never known of a patient who remained in the hospital because they didn't want to leave or because they wanted a different facility other than where they were placed by SW.

[Been there,done that, ASN, RN]

The patient needs a little chat with the doctor, problem solved.